Exploring Functional Medicine for IBD

Exploring Functional Medicine for IBD
A unique “microclinic” is finding QoL improvements exceed expectations.

Dawn Beaulieu, M.D., is pioneering functional medicine as an integrated service line within an inflammatory bowel disease (IBD) clinic. A gastroenterologist and director of the new Functional Medicine IBD Clinic at Vanderbilt University Medical Center, Beaulieu spent the last two years training and obtaining certification before creating Vanderbilt’s unique “microclinic.”

“Even when patients’ colonoscopies showed that they were better on medications, many were telling me they still had diarrhea or abdominal pain, or that fatigue or joint pain were still affecting their quality of life,” Beaulieu said. “I needed to find a way to do more to help patients feel better.”

“I needed to find a way to do more to help patients feel better.”

She developed a 10-week group program in which a multidisciplinary team of functional medicine caregivers help patients evaluate the impact of elimination diets and lifestyle changes. “Since initiation of the program all the measures have moved in the right direction,” Beaulieu said. Next, she hopes to develop a more formal research program examining how functional medicine may impact the body’s microbiome and inflammation at the cellular level.

Functional Medicine and IBD

Functional medicine is a diagnosis approach where detailed histories are used to explore the etiology of disease. Practitioners study imbalances in broad, conceptually connected systems like energy, assimilation, and defense and repair as underpinnings of regional or organ system pathologies.

Despite the relative paucity of randomized controlled trials, functional medicine and its parent discipline, integrative medicine, are gradually finding their way into traditional settings.

Evidencing Broad Improvements

The first 15 patients completed Beaulieu’s program from January through November of last year. While the primary focus was on a six-week elimination diet, the program also included teaching and sharing modules on exercise and movement, stress and resilience, relationships and networks, and sleep.

Patients reported their sleep quality, fatigue levels, IBD-related quality of life and multiple medical symptoms prior to each session. “Over the 10 weeks, symptom intensity lessened, as hoped, and sleep dysfunction dropped very slightly, but if you look at fatigue and overall symptoms, those plunges [from 43 to 27 and 75 to 28, respectively] are exciting,” Beaulieu said.

Beaulieu and her team are now in the middle of their sixth group program offering, and as of summer 2020, are also offering one-on-one programs in person and online.

Need for Research

Randomized controlled trials in functional medicine are confounded by the subjective nature of both the treatment and the reporting of results. “Functional medicine is still in its infancy in regards to research data,” Beaulieu said.

Beaulieu makes no apologies for the potential placebo effect inherent in a personalized self-assessed program, where the disease itself has a strong psychological component. “If they are feeling better and having better relationships with their family that is a major victory. Whether this quality of life persists, time will ultimately tell.”

With patients checking in twice a year or more, she and her team have built-in follow up for assessing the program’s staying power.