Spécificité des stratégies de coping des patients en rémission de la maladie de Crohn : une étude qualitative

International audienceIntroduction: Crohn's disease (CD), a chronic inflammatory bowel disease, has strong psychological and social repercussions related to the specificity of the symptomatology. To better understand how patients cope with the disease, coping strategies have been studied but without taking into account the specificity of the CD experience.Objective: Our objective is to identify the perceived coping strategies used by patients in relation to their illness experience.Method: Using a qualitative approach, semi-structured interviews and thematic content analysis with 33 CD patients in remission were conducted.Results: Our results highlight that some of the coping strategies used are not taken into account by the coping scales frequently used in the literature. Indeed, the illness experience appears to be fundamental in the establishment of new strategies based on the experiential knowledge patients use to reduce the stress induced by a potential relapse. Moreover, coping strategies based on positive emotions are also implemented, and they enable patients to make sense of the disease.Conclusion: The coping strategies, i.e., “experiential knowledge” and “positive emotions”, may shed more light on the complexity of the illness experience of CD patients and allow us to make recommendations concerning the psychological support of patients.Introduction: La maladie de Crohn (MC), maladie inflammatoire chronique de l’intestin, entraîne de fortes répercussions psychologiques et sociales en lien avec la spécificité de la symptomatologie. Pour mieux comprendre comment les patients font face à la maladie, les stratégies de coping ont été étudiées mais sans prendre en compte la spécificité du vécu de la MC.Objectif: Identifier les stratégies de coping perçues utilisées par les patients en rapport au vécu de leur maladie.Méthode: Trente-trois entretiens semi-directifs ont été menés auprès de patients MC en rémission et analysés via une analyse de contenu thématique.Résultats: Nos résultats mettent en évidence des stratégies de coping absentes des échelles de coping : l’expérience de la maladie paraît fondamentale dans l’établissement de nouvelles stratégies centrées sur des savoirs expérientiels utilisés afin de réduire le stress induit par la survenue potentielle d’une rechute. Des stratégies de coping basées sur des émotions positives à partir desquelles des stratégies de mises en sens de la maladie peuvent également être mises en place.Conclusion: Les stratégies de coping « savoir expérientiel » et « émotions positives » peuvent permettre de mieux comprendre la complexité du vécu de la MC et orienter l’accompagnement psychologique des patients

Measurement of the overall digestibility of carbon from carbohydrates following the ingestion of 13

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Measurement of the colonic acetate production after lactulose ingestion in humans - using isotopic dilution

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Comparison of metabolic responses to digestible and partly undigestible starches in healthy humans

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Infliximab induces clinical resolution of sacroiliitis that coincides with increased circulating FOXP3(+) T cells in a patient with IPEX syndrome

International audienceImmune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare monogenic primary immunodeficiency due to mutations of FOXP3, a master transcription factor of regulatory T cells (Treg). IPEX syndrome leads to fatal course in most cases during early childhood or severe multi-organ immune-mediated disorders in patients who survive. Currently hematopoietic stem cell transplantation represents the only known effective cure for IPEX syndrome. However, older patients with a mild disease not severe enough to justify transplantation, raise concerns regarding the appropriate therapeutic management, which is therefore based on supportive and replacement therapies combined with pharmacological immunosuppression. Herein, we report the case of a 22-year-old man with an incomplete IPEX syndrome without endocrine disorders having suffered from severe enteropathy since his birth treated with a combination of various immunosuppressant agents. He developed severe exacerbation of inflammatory low back pain in relation to sacroiliitis. Eventually, infliximab was initiated to control his back pain with rapid resolution as well as digestive improvement and also reduced biological inflammatory markers. In parallel, flow cytometry analysis revealed an increase in the frequency of circulating FOXP3+ CD4+ Treg cells. Altogether these data highlight that anti-TNF may represent a promising therapeutic option in patients with IPEX syndrome

In vivo and in vitro fermentation of resistant starch and lactulose by human colonic microflora

Proceedings of the Annual Symposium on NutritionInternational audienc