Continuum studies whole-person, whole-course care. Living with IBD involves more than bowel inflammation: food, work, relationships, mental health, other illnesses and changing needs with age all shape daily life. We bring detailed cohort studies together with population data to understand these connections and identify questions that could lead to better care.
What we have shown
PREdiCCt followed 2,629 people with IBD in self-reported remission across 47 UK centres for a median of 4.1 years. Higher baseline faecal calprotectin was strongly associated with subsequent flares. Higher habitual meat intake was associated with objectively confirmed flares in ulcerative colitis, while no consistent associations were observed for ultra-processed foods, fibre or polyunsaturated fatty acids. These findings identify questions for further investigation; they do not show that a dietary change will prevent an individual’s flare.
Our collaborative study of health conditions before and after IBD diagnosis examined 1,583 conditions and identified 312 significant associations, including 125 before diagnosis. Comparison with Finnish data supported the broader relevance of many findings. The associations highlight connections with immune, metabolic and psychological health without establishing that IBD causes each condition.
Current questions
Current work examines psychosocial factors and flare, the gut microbiome, health across a lifetime with IBD, women’s health and ageing. We are interested in how cumulative inflammation relates to health beyond the bowel, including cardiovascular outcomes, and which aspects of that burden might be changed through care.
Patient-reported experience and objective measures of inflammation answer different questions. Understanding both is central to this programme. The goal is care that takes symptoms and quality of life seriously, recognises wider health needs and gives patients evidence they can use in decisions about their lives.