IBD overview

Inflammatory bowel disease (IBD) refers to different long-term conditions that involve inflammation of the digestive tract. The two main types are ulcerative colitis and Crohn’s disease. Each has different natures and causes. But both ulcerative colitis and Crohn’s disease typically include diarrhea, rectal bleeding, pain, and weight loss. Ulcerative colitis involves inflammation and ulcers along the intestinal lining of the large intestine and rectum. Crohn’s is characterized by inflammation of the lining of the digestive tract as well as deeper layers of it.

Potential causes

The exact cause of inflammatory bowel disease is still unknown. It’s caused by a combination of genetic makeup, environmental exposure, and the health of your gut microbiota, resulting in an overactive immune system which attacks within.

Immunity

One of the main clinically recognized causes is trouble with the immune system. Your immune system is designed to fend off foreign invaders such as viruses or bacteria. But autoimmune conditions such as IBD result in abnormally functioning immune systems. As a result, your immune system attacks cells in your digestive tract. Researchers think that bacteria in the digestive tract can mistakenly trigger the immune system, then the immune response leads to damaged cells, inflammation, and typical symptoms of IBD.

Gut microbiota

The impact of gut microbiota on IBD has gained a lot of attention in the last decade. That’s because as research suggests, the microbiota is an integral part of the gut-brain axis. The gut-brain axis signals between the brain and the gut. In fact, gut microbial alteration, or when there are more “bad” bugs than “good”, may be associated with gastrointestinal disorders such as IBD.

Want to boost your healthy bacteria? Check out this article.

Diet

It was previously thought that diet was a culprit, but now it’s known that although these may aggravate IBD, they aren’t the cause. However, hypotheses have suggested that diet can alter the microbiome which then may lead to IBD. Another theory is that dietary allergies can trigger an immune response. But this is also not yet proven.

Observational studies have shown associations between diet patterns and the risk of diagnosis. These studies display that increased consumption of meat and animal products may up the risk of symptoms, whereas more fruits and vegetables are typically associated with a lower incidence of the diseases.

Stress

In the past, it was widely believed that there was a psychological aspect to IBD. Previous research suggests that psychological issues played a role in the development of the disease. That’s because, with IBD, there is damage to the intestinal tract, so a physical cause versus a mental influence.

However, most chronic diseases can be stressful on the body and mind. More stress can make the condition feel worse. If there is pain and inability to achieve desired life activities, there can be depression or anger. These feelings may increase bothersome IBD symptoms, creating a negative cycle.

Recent research also indicates that stress acts as a relapsing factor for IBD. It can also directly influence the digestive system, making symptoms worse. In patients with anxiety or depression, the inflammatory markers are also higher, potentially causing more damage and pain. There has been an increasing incidence of anxiety and depression in both children and adults with IBD. Therefore, healing mental health can be a valuable approach to enhancing and managing the treatment of IBD.

Sleep disorders

Lack of sleep can have a negative impact on many diseases. When it comes to IBD, several studies suggest the associations between sleep, immune function, and inflammation. The relationship between sleep disturbances and inflammatory conditions is complex and not quite understood. But lack of sleep can increase inflammation in the body.

Several studies have also found that patients with both inactive and active IBD have reported sleep issues. More research is needed to link each type of sleep disturbance to different aspects of IBD but improving sleep quality may provide an opportunity to improve disease outcomes.

Want to improve your sleep? Check out: 15 Tips for How to Get a Good Night’s Sleep with IBD

Other factors

Some science also suggests other factors may increase the chance of developing IBD. For example, smoking may double the chance of developing Crohn’s disease. While antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, and birth control pills may increase the chance of developing it. Other causes for colitis include infections such as food poisoning from E. coli and Salmonella, and poor blood supply.

Road to remission

Now you know a bit more about the ins and outs of your digestive condition, but how do you put these into practice? Nori Health is an evidence-based digital therapy for people living with IBD. This 6-week coaching program takes into consideration and coaches you through the possible causes of your condition with actionable tips. Register for the Nori Health program to be on the road towards remission.

This article has been written by Lisa Booth, registered dietitian and nutritionist, and co-founder of Nori Health. Content is based on her professional knowledge and our collection of 100+ scientific research study papers.

The post IBD: Nature and Cause appeared first on Nori Health.

Communicate your needs

Think about the last time you felt satisfied leaving your doctor’s office or after a call with them. Feeling like your concerns were truly heard and considered. What happened during that interaction that was helpful?

If it’s been a while or you feel like this hasn’t happened at all, it’s worth assessing the level of communication between you and your doctor. It can feel really frustrating when your needs aren’t met. There are of course cases when a doctor simply isn’t a good fit, but first, try to improve your interactions with these tips.

Keep a journal

It’s normal to forget the details of your condition and how you feel on a daily basis. That’s why it can be favorable to keep a journal with your condition concerns and successes. At least a few days before your appointment, make a list of your troubles and recent symptoms. If possible, track them and see if you notice a connection to your daily habits. The more details you can provide, such as medications and supplements you’ve been taking, the better.

Use a helpful tool such as Nori Health to help you keep track of, and connect your behaviors to your symptoms. Before you go to the doctor, narrow the list down to the main points you discovered and consider giving the list to your doctor so they can follow along.

Speak up

Doctors tend to take the information you provide and prioritize the main concerns that are presented early during your appointment. Make sure they know your main issues at the start of the appointment. When you’re experiencing bothersome symptoms, make sure to be honest about how they feel. If you tell your doctor you have a “bit” of pain, they most likely won’t take action to help improve it. But if your pain is keeping you up at night and interfering with sleep, say so!

Listen

Like any form of effective communication, half is listening. If you’re not fully present and taking in what your doctor is recommending, you may not be able to effectively put their advice into action. If your doctor talks fast, it’s good to take a breath, focus on what they say, and ask them questions along the way. Consider bringing a notepad or tape recorder. Or bring a friend or family member to the appointment to help be a second pair of ears, especially when something more detailed or stressful is being discussed.

Share your knowledge

Doctors are extremely well educated, but you can’t expect them to know everything. As you work your way through the Nori Health program, you’ll learn about exciting new research as well as experiment with habit-changing methods. Share the education that you found interesting and helpful. This helps your physician adjust your treatment and personalize it towards what works best for you.

Follow-up

Take the initiative to ask your doctor when the next visit should be. Get it on your schedule and prioritize your health by sticking to it. If your doctor or clinic allows you to keep email communication, use it to share your progress, even if things are going well! If you have any shift in your lifestyle or start to experience symptoms, make note and don’t wait until they get bad.

Nori health: ongoing support

Nori Health will be there for you between your doctor visits to help you understand what’s going on with your condition and what habits you have control over. Using the program also helps provide you with the space to express your symptoms so you can more easily communicate them to your physician and health care team. In addition, build your support system by sharing with your friends, family, and support groups.

Nori Health is a 6-week digital therapy program guided by a chat coach. Improve symptoms and quality of life through personal and anonymous conversations. Patients increase management of the condition by over 30%, with relief related to extreme fatigue and pain.

If you’re a physician or pharma company and want to provide Nori to help improve engagement and treatment for your patients. Click here to learn more.

This article has been written by Lisa Booth, registered dietitian and nutritionist, and co-founder of Nori Health. Content is based on her professional knowledge and our collection of 100+ scientific research study papers.

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IBD and increased stress

You’re not alone. Studies show that people with a medical condition such as IBD are the most vulnerable to the negative effects of stress. And the problem is that stress typically makes matters worse. In conditions that are influenced by a nervous system response, such as pain or digestive disorders, stress can overwork the already compromised system. It can also increase the risk of mental health issues such as depression and anxiety. Creating a never-ending cycle.

How to maintain healthy habits

When times get tough, it’s even more important to up your self-care strategies. One of the best ways to start is by changing your attitude. So take a breath, accept where you are (and who you are) today, and let’s go step by step to help you maintain healthy habits in times of stress.

Think big picture

It’s completely normal to have ups and downs on the road to success. And this goes for almost anything, including healthy habits. Rather than beating yourself up about a shift backward, assess your overall progress. In general, have you been feeling better, or maybe you’ve implemented some small habits such as drinking an extra glass of water? Congratulate yourself for the big picture progress you made rather than focusing on what you haven’t done.

Break it down

Goals and tasks can feel daunting, especially when you’re feeling stressed or overwhelmed. But by simply breaking it down into smaller goals, you’ll be able to take actionable, less overwhelming steps. Start with an overall plan, even if it’s a vague idea. For instance, say you want to get back to healthy eating. Focus on the specific aspects then write out a concrete goal, such as eating one more serving of vegetables per day.

Pair it with pleasant

When you’re already feeling overwhelmed, adding another to-do can tip you over the edge, especially when it’s something you don’t want to do. Rather than “making” yourself do something, pair it with something you do like doing. That’s because we’re programmed to want a reward. Science suggests that our brains produce a chemical, called dopamine, which signals our motivation and desire for reward. So say for example you want to interact with the Nori Health program on a daily basis, “reward” yourself with a TV show, a nice cup of tea, or something else that motivates you, after your in-app conversation.

Let it go for a day

Some days are fine, some days are better, and some are downright a hot mess. It’s just part of life. If you’re having a tough one, try not to be so hard on yourself. Rather than beating yourself up about not meeting a certain goal, simply let it go and focus your energy on getting back at it tomorrow. It’s ok, and healthy, to give yourself a break.

Ask for support

It’s human nature to want to help one another out. In fact, evidence shows that helping others can also benefit our own mental health and wellbeing. So don’t be afraid to reach out for support when you get knocked off track. Support can come in many forms, from simply calling up a friend when you need to talk, to having a buddy to walk with.

Define your “why”?

Research suggests that our personal values guide our behavior and attitude. For instance, if it’s important for you to take care of your body, you may be more prone to pick up more fruits and vegetables at the store. Oftentimes we have a surface reason for doing something, but if you get clear on your deeper values, it can help steer you in the right direction especially when times get tough.

Nori Health: there for you

Nori Health is a 6-week digital therapy program guided by a chat coach. By completing the program, you’ll gain the strength to weather the storm of stressful times. In addition, you’ll increase energy and build a better quality of life with healthy habits such as optimizing diet, developing hydration routines, and integrating mood-boosting activities. You’ll learn how to better manage your stress and discover underlying triggers for a healthy work/life balance.

So, are you ready to build and maintain healthy habits to help your condition? Download Nori Health today.

The post Maintaining Healthy Habits in Times of Stress appeared first on Nori Health.

Nori Health provides evidence-based digital therapies for people living with inflammatory conditions. For improving quality of life and decreasing symptoms such as fatigue, pain, and anxiety. 

We are a seed-stage startup with a small, close team. Our mission is to close the 30% gap in quality of life between chronic disease patients and healthy individuals. We do this by providing top of class digital therapeutics (DTx), of which our first program for Crohn’s Disease & Colitis is now entering clinical trials. The company was founded by Roeland Pater, a Crohn’s Disease patient himself.

In the app, patients enroll in a 6-week program, guided by digital coach Nori. Patients have chat conversations with Nori across evidence-based topics, and based on their personal situation and (medical) needs. Insights are collected to optimize daily routines that are connected to their condition and quality of life. 

We are looking for a key addition to the team to take on the technical responsibility within the company. A CTO, or an experienced lead developer with the ambition to build his/her own team and grow into the CTO role.

Our office is based in Utrecht (The Netherlands), very close to Central Station.

Perks

• Become part of the founding team with shares in the company.
• Loads of responsibility and autonomy and a chance to make a real impact for patients across the world.
• Join a company on the verge of breaking through, so get ready for a nice ride
• Work in digital health, one of the fastest growing sectors in the world.
• Work directly with the management team, Roeland Pater (Founder & CEO) and Dandyano Zentveld (Co-founder & COO), and our circle of advisors to develop strategies and build the company further.
• Of course a solid contract and salary.

Job Requirements

• Strong vision on development of products and companies.
• Strong technical leadership experience, ideally within a scale-up / start-up environment (both on the people and organization side).
• Background/education in software engineering, with a track record to show for.
• Experienced with recruitment to support the growth of the right team.
• Excellent communication skills.
• Experience with medical devices or with other technology / apps in the healthcare sector is a big plus.

Responsibilities

• Developing a solid technical strategy in line with business milestones.
• Taking on roadmap projects yourself, until you have a team next year.
• Building and managing a strong team, which you will lead.
• Maintain code and write (automated) tests to ensure the product is of the highest quality.
• Both frontend and backend optimization.

Skills

• Full stack.
• React Native, JavaScript, TypeScript, Node.js.
• Ability to write well-documented, clean code.
• Rock solid at working with third-party dependencies and debugging dependency conflicts.
• Native build tools, like XCode, Gradle.
• REST APIs, the document request model, and offline storage.
• Automated testing suites, like Jest and Detox.
• Expo.io and their API’s.
• AWS.

For more information or to apply directly, send a short introduction to Roeland: [email protected] 

The post Job opportunity: CTO / Lead Developer at Nori Health appeared first on Nori Health.

Aminosalicylates (5-ASA)

Aminosalicylates (5-ASA) are specific medications that work on the lining of the gastrointestinal tract in order to decrease inflammation. These can help manage mild to moderate IBD. They can also be used for Crohn’s disease but are often more effective in ulcerative colitis.

-Sulfasalazine (Azulfidine)

-Mesalamine (Asacol HD, Pentasa, Lialda, Apriso, Delzicol)

-Olsalazine (Dipentum)

-Balsalazide (Colazal)

How do they work?

These are chemically similar to the over-the-counter pain reducer, aspirin. They decrease the inflammatory response, so damaged tissues can heal. These medications block your body from making prostaglandins, or on-off switches in your cells that regulate pain and inflammation. Recent research also suggests that they decrease damaging molecules (reactive oxygen species) in your body.

Corticosteroids

These are a powerful type of medicine, used to reduce inflammation. Also referred to as steroids, they can be used with or instead of 5-ASA to help treat a flare-up. Unlike 5-ASAs, corticosteroids are not used for long-term treatment. That’s because they have some side effects such as weakening the bones. They work by lowering the activity of your immune system and limiting inflammation in the digestive tract.

-Prednisolone (brand names Deltacortril, Deltastab, Dilacort)

-Prednisone

-Hydrocortisone (Plenadren)

-Methylprednisolone (Medrone)

-Beclometasone dipropionate (Clipper)

-Budesonide (Entocort,Budenofalk)

-Budesonide-MMX (Cortiment)

How do they work?

Inflammation is a process in which your body “fights” against infection or foreign objects such as viruses. But if the immune system doesn’t work properly, it can cause inflammation and damage. Steroids reduce the amount of chemicals your body makes, which cause inflammation. They also reduce the activity of the immune system by interfering with the way that white blood cells (your body’s main “troops”) work.

Immunosuppressants

These are medicines that help reduce the activity of the immune system. By suppressing the body’s immune system, it cannot cause repetitive inflammation and pain to your body. They’re usually given to treat moderate flare-ups or to maintain remission. They’re effective in treating ulcerative colitis but usually take about 2 to 3 months to start working. One thing to be aware of is that they can make you more vulnerable to an infection so it’s important to report any signs or signals of a sickness to your doctor.

-Cyclosporine

-Azathioprine

-6-mercaptopurine

-Methotrexate

-Tacrolimus

How do they work?

As a normal immune response, your body flags harmful substances, such as viruses, so the next time it comes into your body, it will be prepared to attack and keep you safe. In autoimmune diseases such as colitis, your immune system mistakes healthy cells and tissue for these dangerous foreign objects. Immunosuppressive medications remove or slow down these overactive “troops” (such as C or T cells).

Biologic Medicines

These are medications used to reduce inflammation in the intestines. They are usually prescribed if other options aren’t working.

-Infliximab

-Adalimumab

-Golimumab

-Vedolizumab

How do they work?

These medications reduce inflammation in the intestines by targeting proteins that your immune system uses to stimulate inflammation. They block the receptors (almost like blocking a key from unlocking a door) and tell your cells what to do. This way you don’t have as much inflammation “coming in the door”.

Tofacitinib

This newer medication works by targeting the immune system but differently than other medicines. It’s recommended for people with more severe ulcerative colitis and if the other treatment or biologics don’t work.

-Tofacitinib (Xeljanz)

How do they work?

Enzymes help speed up chemical reactions in your body. Tofacitinib works by interfering with a specific enzyme (janus kinase) which influences the inflammation. So it basically stops the message to turn on inflammation in your gut.

Over-the-Counter (OTC)

Over-the-counter drugs can be helpful in some cases since they don’t require a prescription. However, it’s very important to consult a physician before taking them, since they may interfere with other medications. Keep in mind that they may help decrease symptoms but don’t address the underlying reason.

Antidiarrheals help reduce diarrhea by decreasing bowel movement and by slowing the digestive process. An example would be Loperamide (Imodium).

Pain relievers work by making so you don’t feel pain, via receptors (which receive information), or by decreasing inflammation. However, it’s important to consider the type of pain reliever you use. These should not be taken when you experience ulcerative colitis pain since they can cause flare-ups and make some symptoms, such as diarrhea worse: ibuprofen (Advil, Motrin), aspirin (Bufferin), naproxen (Aleve, Naprosyn). Rather, it’s best to stick to acetaminophen.

Take Control of Your Condition

The goal of ulcerative colitis medication is to reduce inflammation and the immune response, in order to decrease flare-ups and symptoms. Different medications respond differently with each individual. Finding the right medication regime can take some time but it’s important to work with your physician and communicate any changes in how you feel and your daily symptoms. In addition to following your medication regime, improve your quality of life, including improving fatigue, pain, and anxiety, with the help of Nori Health.

The post Ulcerative Colitis Medications appeared first on Nori Health.

Anti-Inflammatories

Inflammation is your body’s natural response to fighting against things that will harm it. When it comes to Crohn’s disease, it refers to inflammation that can occur anywhere along the digestive tract, but most commonly in the colon and ileum. Anti-inflammatory drugs help decrease the inflammation and swelling in the lining of your intestine. The most common ones that work for Crohn’s disease are Aminosalicylates (5-ASAs).

-Mesalamine (Pentasa, Delzicol, Lialda, Apriso)

-Olsalaizine (Dipentum)

-Sulfasalazine (Azulfindine)

-Balsalazide (Giazo, Colazal)

What do they do?

As mentioned above, these decrease excess inflammation in your body so damaged tissues (especially your intestines) can heal. They work by blocking your body from making prostaglandins, or on-off switches in your cells that regulate pain and inflammation. Recent research also suggests that they decrease damaging molecules (reactive oxygen species) in your body.

Steroids

Steroids, or corticosteroids, also help reduce the inflammatory response in your gut lining. They also reduce the activity of your immune system. This helps tame the body’s response to working against the body’s tissues, which is what causes your gut lining damage. These medications are taken for a while, for 3-4 months, in order to manage symptoms and put Crohn’s disease into remission.

-Prednisone (Deltasone, Rayos)

-Prednisolone (Veripred, Orapred, Omnipred)

-Hydrocortisone (Aquacort, Hydrocort, Cortenema)

-Methylprednisolone (Duralone, Medrol)

-Budesonide (Entocort)

-Beclomethasone dipropionate (QNASL, Qvar)

How do they work?

Steroids reduce the amount of chemicals your body makes, which cause inflammation. Almost like turning the volume down on the processes in your body that cause inflammation. They also reduce the activity of your immune system by interfering with the way that white blood cells (your body’s main “troops”) work.

Immunosuppressants

Just like the name describes, these medications suppress your immune system. They hold back the body’s disease-fighting immune response. You may have a combination in order for them to work better together.

-Azathioprine (Azasan, Imuran)

-Mercaptopurine (Purinethol, Purixan)

-Methotrexate (Trexall)

-Cyclosporin (Gengraf, Neoral, Sandimmune)

How do they work?

When your body has a normal immune response, it flags harmful substances, such as viruses or bacteria.  The next time this foreign object comes into your body, your immune system will be prepared to attack and keep you safe. In IBD, your immune system mistakes healthy cells and tissue for these dangerous foreign objects. Immunosuppressive medications remove or slow down these overactive “troops” (such as C or T cells).

Antibacterials

An antibacterial is anything that kills bacteria or suppresses its growth. When it comes to Crohn’s disease, antibacterials help treat infections that happen in the digestive tracts, such as with a fistula.

-Ciprofloxacin (Cipro, Proquin)

-Metronidazole (Metrogrel, Nuvessa)

-Rifaximin (Xifaxan)

-Vancomycin (Vancocin)

-Penicillin (Ampicillin)

-Tetracycline

How do they work?

Antibacterials work by blocking the function of bacteria or by stopping them from multiplying. This allows your immune system to have a one-up in the situation and fight the bacterial infection. Different types of antibiotics work on different bacteria. However, since many also kill healthy gut bacteria, it’s important to replenish them with a healthy diet and probiotics.

Biologics

These are called biologics because, unlike chemical medications, they are made from natural materials. They help stop some proteins in the body from leading to inflammation. These are more selective, in terms of focusing on a specific part of the body.

Anti-tumor necrosis factor agents (anti-TNF) bind to a protein that promotes inflammation in the intestines. All anti-TNF medications have been shown to reduce the symptoms of IBD but also help heal the inflamed intestine. Although they aren’t effective for every person.

-Adalimumab (Humira)

-Adalimumab-atto (Amjevita)

-Adalimumab-adam (Cyltezo)

-Certolizumab pegol (Cimzia)

-Golimumab (Simponi)

-Infliximab (Remicade)

How do they work?

These medications reduce inflammation in the intestines by targeting specific proteins that your immune system uses to create inflammation. They block the receptors (almost like blocking a key from unlocking a door) and tell your cells what to do. This way you don’t have as much inflammation “coming into the door” and causing pain to your intestines.

Over-the-Counter

Over-the-counter medications are the ones you can get for free. Before giving them a try, make sure to consult your physician. That’s because some may interfere with other medications you’re taking.

Anti-diarrheal medications

These help slow down how fast things move through your intestines, allowing more fluid to be absorbed in the body. Some also help balance and reduce inflammation in the intestines.

-Loperamide (Diamode, Imodium)

Pain relievers

Pain relievers such as acetaminophen (Tylenol), don’t help reduce swelling or inflammation, instead, they block your brain from releasing the signals that cause the feeling of pain. It’s best to avoid non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, aspirin or naproxen. That’s because these have side effects that can irritate the gut lining. Meaning, it could trigger flare-ups.

-Acetaminophen (Tylenol)

Lifelong Management

Crohn’s disease is a lifelong condition and requires lifelong adaptations. As your circumstances such as stressors and conditions change, so will your condition. That’s why it’s essential to continually communicate with your physician about how your medications are working. One of the best ways to track your medication impact, in relation to your lifestyle habits, is through a credible digital therapeutics app like Nori Health. Learn what ways you can take control of your condition and start feeling better.

The post Commonly Prescribed Crohn’s Medications appeared first on Nori Health.

Benefit of Digital Health Therapeutics

In 2019, the World Economic Forum reported that 55% of the world’s population is now online. This number is continually increasing as more markets are making the switch to digital offerings and situations such as pandemics require social distancing. This also means that medical and health services would benefit from making the shift.

When therapeutics are provided in a digital format, this offers the opportunity to collect data. This includes collecting patient habits, engagement numbers, and the benefit of different forms of care. This helps fill in the gaps between clinical evidence and real-world observation.

What is Real World Observational Evidence?

Real-world observational evidence is defined, just as it describes – evidence that is generated or that exists in the real world. It can be generated by different study designs such as randomized trials. The Food and Drug Administration (FDA) defines real-world data as data that relates to patient health status or the delivery of health care which is consistently gathered from different sources such as health records, data from home-use, and mobile devices.

Real-world evidence fills the gaps that a clinical trial can’t account for. It can help analyze the effects of treatments over a longer period of time. It helps increase understanding of patient lifestyle, behaviors, and demographics to ultimately improve customization of care while minimizing financial risk to both the patient and health care providers.

Real-World Evidence vs Real World Data – What is the Difference?

Real-world data can provide the information needed for real-world evidence. Real-world data is information that’s collected outside of a clinical trial. This includes medical records and patient statistics and biomarkers. This information gets de-identified in order to protect patient confidentiality and privacy. Analyzing this knowledge provides a bigger view of the population in terms of age, daily habits, environment, co-morbid conditions, and medical adherence.

Why is Real World Evidence Important?

When comparing randomized controlled trials (RCTs) to real-world studies, an RCT is considered to be higher in accordance. This is because it is conducted in a randomized, double-blind, and sometimes controlled setting. The problem is that it isn’t always relatable to real-life situations. In addition, RCT has limitations such as inclusion and exclusion criteria. The criteria ensure that a representative sample is collected. When considering in the context of the “real world”, it’s worth noting that any patient can be excluded.

This data provides the potential to help influence and design clinical trials and adds an element that would otherwise be lacking. For instance, measuring how often, and when, someone uses a digital health app with information linking their behaviors to their medication adherence can help improve clinical trial engagement.

Comparative research from real-world situations is helpful for efficiency studies and pharma related to economic impact studies. They can help doctors identify what clinical and environmental characteristics aid a patient in keeping to a drug regimen and ultimately making sure they are on the right medication and care path.

Real-world evidence helps supplement data from RCTs and can hopefully bridge the gap between a controlled RCT environment and real-world considerations. In real-world clinical practice, it’s about the individual patient. It’s also important to remember that every patient can be unique in the way that they respond to a drug or treatment.

Nori Health: Real-World Evidence

Nori Health has been conducting real-world evidence tests showing promising results*. Our overall aim is to help improve the quality of life and decrease symptoms. Nori continues to collect real-world evidence through anonymized PROMS answers and demographics.

A group of 85 randomized people living with Crohn’s Disease, ulcerative colitis, and IBS was included in a trial. These participants were sourced through hospitals and patient foundations. After completing the Nori Health program, patients showed promising results in the following:

Daily Management

• 35% average increase in score for daily management of the condition, which includes practical improvement in factors such as diet and exercise routines.

Daily management of a health condition such as IBD can empower the patient to identify and change problems that are contributing to the condition.

Social Life

• 56% of participants that completed the 8-week program indicate that they missed key social activities before the program, but did not anymore in the final 2 weeks of the program.

Social life and quality connections enable humans to thrive, yet suffering from a chronic illness can make it difficult to access social networks. Using the Nori app helped patients improve social isolation.

Confidence

• 44% of participants that completed the 8-week program believe that they have the right treatment for their condition, while they did not believe this before starting the program.

The main IBD patient struggles when it comes to caring to include a lack of multidisciplinary and psycho-social support and inability to communicate with health care providers. This results in a lack of confidence about their treatment.

Satisfaction

• 75% of participants are actively referring friends or family members that live with the same condition to the Nori program, hoping that they will complete it too.

Research shows that the satisfaction perceived by patients with chronic diseases affects clinical outcomes and healthcare costs.

Fatigue

• 22% of participants that completed the 8-week program indicated extreme fatigue before the program, but no more after the program was completed.

Fatigue is reported to impact nearly 50% of patients in clinical remission and over 80% of those with active IBD. The result is a decrease in quality of life and productivity.

* Please note that all results published on this page are not scientific outcomes. We have completed these tests to establish the first results of the program, which will be followed by scientific research.

Nori Health: Utilizing Digital Health for Real-World Evidence

Nori Health offers an extension to treatment for a better quality of life. Our 8-week digital therapeutics program supports your medication and clinical trial adherence to gain better outcomes. With the proven increased daily management of the condition and engagement with social activities, this could promote the belief in current treatment.

This article has been written by Lisa Booth, registered dietitian and nutritionist, and co-founder of Nori Health. Content is based on her professional knowledge and our collection of 100+ scientific research study papers.

The post Digital Health: Real World Evidence appeared first on Nori Health.

Read press release here: https://www.pharmiweb.com/press-release/2020-10-26/nori-health-chronic-disease-management-chatbot-launches-ce-certified-iphone-app

Or download the app directly from the App Store: https://apps.apple.com/us/app/id1526463609

The post In the news: Nori Health launches iPhone app appeared first on Nori Health.

Your questions, answered

Here are answers to questions submitted by people just like you. This Nori Health community completed the 8-week program and gained access to bonuses including personal Q&A, guided meditation, and ebook.

Can I cure my IBD?

Currently, there isn’t a cure for IBD. But the disease will have periods when it gets worse and periods when it’s not active. Focusing on keeping inflammation lower and following your doctor’s advice (including taking prescribed meditations) can help reduce the number and length of remissions you have.

Learn more: Ulcerative Colitis Inflammation and How to Prevent It

I’ve heard that I can get cancer easier. Is that true?

People who suffer from IBD have a slightly higher risk of developing certain cancers (risk usually begins about 8 years after diagnosis) but studies show that this varies a lot depending on each individual, the type of disease (higher risk in ulcerative colitis), and length of diagnosis.

A slightly reduced risk has been seen in patients with ulcerative colitis who are treated with anti-inflammatory drugs. You can also keep your risk as low as possible by focusing on healthy habits such as good nutrition and sleep. Talk to your doctor about getting screened early.

What supplements should I take?

Supplements have not been proven to lessen the disease, however, if your physician discovers that you’re deficient in certain nutrients, they may recommend that you take supplements in addition to what you regularly eat.

You may be able to get all the necessary nutrients from a well-balanced diet. But this depends on the severity of your condition, surgeries, and other complications. Common supplements that are recommended by the Crohn’s and Colitis Foundation for IBD patients are: calcium, iron, folic acid, vitamin D, vitamin A, vitamin E, vitamin K, vitamin B12, zinc, and probiotics.

It’s very important to check with your doctor before taking these. Check the label and avoid supplements with preservatives, sugar alcohols, and lactose since this may increase symptoms.

Learn more: Ulcerative Colitis treatment (natural, and lifestyle changes)

How do I manage my pain?

It’s important to know that some alternative methods for pain management are not proven to be effective and some can be risky. It’s important to research them and discuss them with your physician before giving them a try.

One safe way to help manage pain is through mindfulness medication. This is a practice that welcomes you into the present moment. It may seem counterintuitive to check-in with your pain, but sometimes facing it can help slow down your breath and dissipate discomfort.

Learn more: Mindfulness Meditation for Pain Management 

It can also be helpful to focus on anti-inflammatory nutrients (ginger, green tea, turmeric) while limiting the more inflammatory foods (processed meats, sugar, junk food).

Learn more: IBS Pain: Alternative Ways to Make the Pain Go Away

If I feel good, do I have to keep taking my medication?

Always follow your doctor’s orders and check with them before making any changes to your medication. Even if you feel good, it’s important to continue taking your medicine. This is because if you stop taking some medications, your body may form antibodies against it, meaning that you could end up with allergic reactions to, or no benefit from, the medicine.

Fermented foods have helped me more than I can say. Why isn’t there more said about these things?

That’s great that fermented foods (kombucha, yogurt, kefir) have been helping you! If something helps and your doctor approves, by all means, stick to it.

Some studies suggest that gut microbiota (bacteria that naturally live there) play a role in triggering and worsening IBD. Probiotics have been suggested to help decrease IBD symptoms, but more research is needed to better understand the exact strains that have the greatest effects, the combination of prebiotics, and how well they stay in the gut.

Learn more: 8 Natural treatments for Crohn’s disease symptoms

Your health expert

Lisa Booth is a leading health expert and dietitian. She has coached IBD & IBS sufferers for over 10 years. She has worked for nutrition and mental health companies including Ginger.io and 8fit. She is currently the Co-Founder and Health Lead at Nori Health.

She understands the many challenges of living with a chronic disease and helps patients discover habit changes that promote an optimal quality of life.

Have another question?

This Q&A session is offered to participants who complete the last conversation in the Nori Health program.

If you have general questions about Nori Health and IBD, feel free to email: [email protected].

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Facing the full experience of pain, by slowing down and deep breathing can help dissipate the discomfort. Learn how with these easy ways to practice mindfulness meditation for pain management.

What is mindfulness meditation?

Simply put, meditation is focusing your attention on one thing for a period of time. It’s a practice that incorporates the body and mind. It has been used for ages to promote mental calmness and physical relaxation but now is more mainstream. A 2017 National Health Interview Survey found that U.S. adults who used meditation in the past 12 months, tripled between 2012 and 2017.

Mindfulness is defined by scientific research as awareness and nonjudgmental acceptance of one’s moment-to-moment experience. This includes observing thoughts, feelings, sensations, and the environment. Accepting whatever is going on in the moment, without labeling it as “good” or “bad”; recognizing that it simply “is”.

“It’s (mindfulness) a gateway into the full dimensionality of being human and being alive.” – Jon Kabat-Zinn in Oprah Winfrey’s The Wisdom of Sundays.

Meditation for chronic disease

Meditation has been scientifically suggested to be help conditions such as high blood pressure, some psychological disorders, and pain. Some research states that practicing it on a regular basis may soften symptoms of irritable bowel syndrome (IBS), flare-ups in ulcerative colitis, anxiety, and depression, and insomnia. This is partly due to the fact that meditation can help decrease the stress response.

Meditation for pain management

Stress is feeling emotional or physical tension. In small doses, it can be a positive thing, helping us avoid threats or increase motivation. As part of the stress response, our bodies produce hormones to “get us going” and out of danger’s way. When hormones such as cortisol, are elevated for an extended period of time, inflammation is increased and immunity is lowered. Inflammation can cause pain and worsen IBD symptoms.

Mindfulness meditation has been suggested to help people suffering from chronic inflammatory conditions such as rheumatoid arthritis and IBD. The National Center for Complementary and Integrative Health (NCCIH) found that mindfulness meditation helps control pain without the brain’s naturally occurring opiates. So combining mindfulness with pain medications and activities that activate the brain’s opioid region can be particularly effective.

The NCCIH had another study examined adults, aged 20 to 70, with chronic low back pain. They either received mindfulness-based stress reduction (MBSR) training, cognitive behavioral training (CBT), or standard care. The MBSR and CBT participants had similar levels of improvement, which was better than those who were given standard care.

How to practice mindfulness meditation

Just like any behavior change, mindfulness meditation is individual. What works for you may not work for someone else. There are many different types of meditation and it’s important to find what suits you best. The main goal of the practice you adopt is to quiet your mind and focus on the present moment.

The four main elements you’ll need for mindfulness meditation are a:

–Quiet space with as few distractions as possible.
–Comfortable posture (sitting, lying down, walking, stretching).
–Focused attention on a mantra or breath.
–Open mind, allowing thoughts and distractions to come and pass without judgment.

Let’s get started

To get started, sit or lie down in a comfortable, quiet place. The key is to be relaxed but not sleeping. It’s best to have no or few interruptions. If it feels good, close your eyes and begin to breathe normally.

It’s normal for thoughts to come and go. Observe them without judgment. Pretend they’re clouds passing by. Or similar to how you close tabs on your computer at the end of the day, think about closing the thoughts that aren’t needed in this moment.

When you focus on the breath, expand your belly then exhale slowly, contract the belly as you breathe out. Imagine letting go of stress or tension as you exhale.

After a few deep breaths, drop into this moment as it is. Can you experiment with simply being with sounds and sensations? The feel of the breath coming in and out of your body. Can you notice the entirety of the body? Just as it is.

Can you focus on an area of your body that is not hurting at this moment? Connecting the breath as you simply observe. Now can you be aware of a place in your body that is hurting? Even for the briefest of moments, trying to have a quick glimpse of that…

What was that like? How is it now that you’ve come in and out of that experience of pain? If you can feel whatever you were able to feel, you’re well on the way to developing a new and potentially healing relationship with your pain.

Patience is part of the practice

Just like life, there can be good days and not so good days when it comes to meditating. Remind yourself that it’s a practice so it takes time to get used to. Start with a few minutes of deep breathing each day. Then try to work up to about 15-20 minutes. What’s most important is to practice being aware and present, as often as possible.

This article has been written by Lisa Booth, registered dietitian and nutritionist, and co-founder of Nori Health. Content is based on her professional knowledge and our collection of 100+ scientific research study papers.

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