Professional IDB Clinic Regains Pregnancy Hope for People with Inflammatory Bowel Disease

Many Australians with Inflammatory Bowel Disease (IBD) choose not to have children because they are concerned that their condition can affect their pregnancy. Today, the Royal Melbourne Hospital’s specialized unit provides the information and support that families need to safely have children.

Associate Professor Brit Kristensen helps run the IBD Pregnancy Clinic and says the job is very rewarding.

“The best thing for me is to help these women who were hesitant to give birth because they were afraid of not being pregnant or being at too high a risk,” she said.

“When you conceive a pregnant woman, you have a healthy baby at the end of the pregnancy. It’s life-changing for them.”

IBD affects 75,000 Australians

IBD generally consists of two conditions: Crohn’s disease and ulcerative colitis.

Both of them are lifelong autoimmune disorders in which the immune system attacks the intestines.

Well-managed patients can live with few symptoms, but if left untreated, their condition can be debilitating.

According to Dr. Christensen, Australia has the highest incidence of IBD in the world, affecting more than 1 in 200 people.

“It causes diarrhea, increased bowel frequency and urgency, bleeding, malaise, and severe abdominal pain.”

People are generally diagnosed with IBD status between the ages of 16 and 40-their peak reproductive year.

If the condition is in “deep remission”, the woman can have an uncomplicated pregnancy.

For those who have an active illness before becoming pregnant, there is a risk that their condition may worsen.

Babies are also at increased risk of being born early or underweight. This can lead to hospitalization in the neonatal intensive care unit and developmental problems.

“I felt supported”

Two mothers, Sarah Zerbib, were diagnosed with IBD in their teens.

She was in deep remission during most of her twenties and thirties.

When she became pregnant with her first child five years ago, she was “not too worried” about the complications.

Pregnancy went smoothly, but after giving birth, Zelvib had a serious redness.

“Because I wasn’t aware of the risks posed as a huge surprise,” she said.

“I’m very sick.”

She was referred to the IBD Pregnancy Clinic at the Royal Melbourne Hospital (RMH) before she became pregnant with her second child.

She said they made a “big difference”, helped her recover from flare-ups, and advised her when she was healthy enough to try to get pregnant.

“I was very informed. I felt very well cared for from every angle,” she said.

Six months after pregnancy, when Zelvib’s condition worsened, the clinic was able to safely coordinate fetal treatment.

Zelbib’s health improved and the baby was closely monitored.

Her daughter gave birth safely by Caesarean section in February.

“It can be a lot when you have to manage all the surprises of pregnancy and your condition,” she said.

“I felt empowered in terms of a lot of information and involvement in decision making, and I supported it because the doctors were talking to each other.”

After giving birth, Zelvib had a “small” flare-up, but this time he says he was able to better manage Crohn’s disease with “more aggressive” treatment.

Her daughter is now over 8 months old and is “really fine”.

Need more clinics

RMH’s interdisciplinary IBD pregnancy clinic was the first in Australia.

Currently there is one in Sydney.

It treats men as well as women who are planning to become pregnant with Crohn’s disease or ulcerative colitis.

Many people with symptoms are worried about the effects of the drug on the foetation.

With the cooperation of IBD specialists, obstetricians, pharmacists, nurses and surgeons to assist pre- and post-pregnant people, teams can rest assured about their safety.

“It was great,” said Dr. Kristensen.

“Our clinic has a pharmacist who ideally sees a woman before she becomes pregnant. The pharmacist makes sure that the woman is taking the right medicine, sees it throughout, and feels safe. You can.

“The overall idea is to make everything go as smoothly as possible.”