Employer showing support to an employee. IBD support.

“There are a lot of individuals out there living with this in their workplace – and they need help”

Gail Attara, Gastrointestinal Society

“What plan sponsors need to understand is that these medications are crucial to maintaining quality of life and slowing down [disease] progression. Employers cannot pay for everything, but they need to offer some flexibility in their plans”

Christine Than, AON

“I often hear my patients say this is a hidden disability, because you can look completely well but be suffering considerably with symptoms that are really embarrassing. It can affect your ability to work normally in a workplace, be productive, and do everything that’s expected of you”

Dr. Vipul Jairath, gastroenterologist

Overcoming the challenges of IBD in the workplace

IBD symptoms take a toll on every aspect of a person’s life – including work. Thankfully, there are things employers can do to offer valuable support to employees who suffer from this disease

Read on

Gail Attara

Gastrointestinal Society

Dr. Vipul Jairath

University Hospital

Judith Luczak

UKG

Christine Than

AON

Industry experts

CURRENTLY SITTING at 0.8% of the population, or roughly 322,000 people, Canada's rate of inflammatory bowel disease is the highest in the world – and such a high rate makes it more than likely you have employees who are struggling with a constellation of symptoms on a daily basis. Experts say it’s time to do something about it. “There are a lot of individuals out there living with this in their workplaces,” Gail Attara, president and CEO of the Gastrointestinal Society, summed up in a recent roundtable. “And they need help.”

person is doing everything correctly – on appropriate medication, committed to a healthy lifestyle, getting all necessary tests and treatments – there’s no guarantee there won’t be a sudden flare-up of symptoms. “That’s the biggest fear patients express to us,” she said. “They just don’t know what the day is going to hold.”

There’s also a stigma attached to many of the symptoms, Attara noted, such as embarrassment about using the washroom at work or fear of having to rush out of a meeting unexplained. And there are considerations beyond the walls of the office: people may be waking up to use the bathroom throughout the night, for example, and be late for work or simply not feel like themselves, or facing extreme tiredness from anemia, which can be a side effect of IBD. Coping with the array of symptoms can be exhausting and lead to fatigue and trouble concentrating. “The consequences of disease, particularly uncontrolled disease, can manifest in different ways in the workplace,” said Jairath. “It’s not just ‘I have to rush to the washroom’ – although that’s one important aspect – but there are other aspects of chronic disease that come into play.” Attara agreed, noting it’s important to realize that IBD is a “long and enduring thing,” and even if the

For fellow panelist Judith Luczak, practice manager, professional services at UKG, “from an HR perspective, it comes down to being respectful.” If an employee comes to HR, feel out what they are comfortable sharing, and clearly delineate what they are OK having passed on to their manager and what, if anything, should be explained to colleagues so that an abrupt exit from a meeting, for example, isn’t “perceived as something that it’s not, without having to advertise” the real reason.

There is a need to ensure that any accommodations made come across as fair and equitable, while protecting individual privacy – a bit of a juggling act for all involved, but the one essential component is open dialogue. “It’s about education and awareness, not just from an HR and employer perspective, but employee and colleague perspective as well,” Luczak said. “It has to start with that initial uncomfortable conversation so that together you can come up with a plan so that accommodations can be made.”

Another way employers can have a positive impact on employees living with IBD is through the benefit plans they offer. Attara noted that the key thing is keeping the disease under control, so “they’re in the workplace, functioning every day, accomplishing things,” and that is done through trial and error with the medications that exist to manage IBD. According to Christine Than, assistant VP, pharmacy lead, health solutions at AON, most of the industry has broad plans that would cover first-line medications, but limit coverage for the more expensive, second-line therapies. “What plan sponsors need to understand is that these

medications are crucial to maintaining quality of life and slowing down [disease] progression,” Than said, adding another piece of the puzzle is a health spending account or personal account to provide financial support for employees who need nutritional supplements, a constant supply of over-the-counter medication, or even transfusions to manage anemia. “Employers cannot pay for everything, but they need to offer some flexibility in their plans,” she said.

Employers should be mindful of providing robust, agile coverage that gives employees what they need to stay healthy, Attara added. “The ideal plan is to have so many options that the person can move quickly from one treatment to the next, because if a product stops working, they really need to find something else.” IBD doesn’t just affect a person physically. It also takes a mental toll – which means going beyond drug plans. Than pointed to employee assistance programs for nutritional advice or mental health assistance, and said that on the benefits side “we can work harder on communicating these benefits and how they can support IBD.” Because, ultimately, it’s a team effort to help employees struggling with this

invisible disease: from the medical field providing facts and tools, to HR making sure policies align, to employers taking on the responsibility of staying abreast of challenges and changes, “the theme, again, is juggling,” Luczak said. “You don’t know what you don’t know. As employers we can have these great plans, we have these great accommodations, but options aren’t communicated. Unpack the benefits package and make sure employees understand what the offerings are: the EAPs, additional extended care, short- and long-term disabilities, leave and attendance policies, what’s included in the medical packages. The onus isn’t just on the employer or the HR department – it’s working through and making certain there’s awareness not just about the diseases, but about what the opportunities are.”

Canada & IBD

number of Canadians dealing with IBD; at 0.8% of the population, this is the highest incidence of IBD in the world

Takeda Canada was established April 1, 2009 as part of a significant global expansion by Takeda Pharmaceutical Co. Ltd., a research-based global pharmaceutical company with a 250-year heritage. Takeda is the largest pharmaceutical company in Japan and one of the top 20 pharmaceutical companies worldwide. Takeda Canada’s goal is to bring important medicines to Canadians who need them.

Find out more

Gail is the president and chief executive officer of the Gastrointestinal Society. She began in 1996 as executive director of the organization’s sister charity, the Canadian Society of Intestinal Research, and led that organization form a small BC charity into a national presence before co-founding the GI Society in 2008. The two organizations collaborate to provide useable evidence-based information to gastrointestinal and liver patients in Canada.

Gastrointestinal Society

Gail Attara

Dr. Jairath is a professor of medicine, epidemiology, and biostatistics, and a gastroenterologist. His clinical practice is based at University Hospital, London, Ontario, where he leads a team providing specialist care to patients with Crohn’s disease and ulcerative colitis. The team includes a clinical nurse specialist, several advanced IBD fellows, and close collaboration with specialists in colorectal surgery and nutrition.

University Hospital

Dr. Vipul Jairath

In her role within the UKG Global Delivery Services Organization as a practice leader for delivery services, Judith has contributed her expertise in human capital management, focused on human resources and on healthcare, to the UKG PRO/Dimensions. She serves as a SHRM A-Team captain as well as a member of the APA’s government relations task force and numerous industry subcommittees. She has presented at such events as UKG/KronosWorks and the APA’s annual conference, and participated in many programs for SHRM.

UKG

Judith Luczak

Christine is an associate vice-president and pharmacy lead with the Health Solutions practice at Aon. In this role, she develops strategies at a national level in respect to drug claim management as well as drug utilization reviews. Moreover, she is responsible for drug trends monitoring, innovation monitoring, and legislative changes which could affect drug plans. Christine joined Aon in 2013. She is a Quebec-based pharmacist and has held various positions in the health industry, specifically in health technologies where she was an account manager and clinical pharmacist within a major pharmacy benefits manager.

AON

Christine Than

A robust, agile benefit plan

Published 30 October 2023

“It’s about education and awareness.... It has to start with that initial uncomfortable conversation so that together you can come up with a plan so that accommodations can be made”

Judith Luczak, UKG

322,000

the economic cost of IBD in Canada, 2012

$2.8B

Fast facts: Crohn’s Disease

approximate number of Canadians living with CD

129,000

number of those Canadians who have had to be hospitalized

84%

number of those Canadians who have had surgery

65%

Fast Facts: Ulcerative Colitis

approximate number of Canadians living with CD

104,000

number of those Canadians who have had to be hospitalized

51%

number of those Canadians who have had surgery

16%

A person with Crohn’s disease or ulcerative colitis, the two types of IBD, experiences symptoms ranging from abdominal pain, increased bowel movements, bleeding, and weight loss to skin rashes, eye issues, and joint inflammation and pain. It can present at any time and interrupt normal functioning in every area of life. “I often hear my patients say this is a hidden disability, because you can look completely well but be suffering considerably with symptoms that are really embarrassing,” said Dr. Vipul Jairath, professor of medicine, epidemiology, and biostatistics, as well as a gastroenterologist, and roundtable panelist. “It can affect your ability to work normally in a workplace, be productive, and do everything that’s expected of you.”

A hidden disability

Education, accommodation, & flexibility

a long-haul truck driver with IBD is given extra time to complete a route because of more frequent stops for bathroom breaks. “At the end of the day, they need their jobs, and we need them to be able to work. We want to make sure it’s a good partnership and a collaboration,” Luczak said. “You have to trust each other, be open and honest, and educate.” As Jairath underscored, “the key word to describe all this is flexibility.”

Attara named the extensive testing typically required for people with IBD, including procedures like colonoscopies that require preparation, as another area where employers can help ease the burden. “Knowing these individuals are working, focused, and want to do their jobs but might need some accommodation – working after hours or in a different way from their colleagues – without a stigma attached is essential.” She added that by implementing a diversity policy that goes beyond conventional diversity to include health in a comprehensive way, whether it’s IBD or another illness, a broken leg, or a particularly low point in someone’s life, “we’re working toward solving this problem.” Accommodations aren’t always easy, especially for workers who might not have the ability to work remotely, such as frontline staff in a variety of industries, but even in those situations something can usually be figured out – for example,

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