Employing people with IBD

If you have an employee who has told you they have either ulcerative colitis or Crohn’s disease (they may also have used the term inflammatory bowel disease (IBD)), you may be wondering what the condition is and the impact it might have on the job and the person working for you.

Understanding the condition is the first step in ensuring that you can support and get the best out of the working relationship with your employee.

This section will help you to:

• Understand what inflammatory bowel disease is
• Understand how the condition may affect your employee
• Understand how it can be possible, sometimes with minimal changes, for people with Ulcerative Colitis or Crohn’s disease to work successfully and to fulfill their potential
• Understand what you can do to help and how you can work together

Most people with inflammatory bowel disease (IBD) have productive lives and many work full time. However, like with any chronic condition, understanding and making necessary adjustments to take into account health needs can really help.

What is IBD?

Inflammatory bowel disease (IBD) is a term to describe chronic (ongoing) inflammation of the digestive system.

These conditions are life-long and may flare up or improve unpredictably. Many people with IBD will have long periods when they have few or no symptoms at all. 

What are the symptoms of IBD?

People with IBD are not unwell all the time. Most people have periods of remission where they feel relatively well interspaced with flare-ups when the condition gets worse. Flare-up symptoms include:

• Stomach pains
• Urgent and/or frequent need to go to the toilet
• Diarrhoea (sometimes with blood)
• Extreme tiredness
• Nausea and vomiting
• Lack of appetite
• Weight loss

What it is not..

• IBD is not the same as the more common Irritable Bowel Syndrome (IBS)
• It is not contagious

What is the treatment?

IBD is a chronic (ongoing) condition which means that it requires ongoing treatment. If taken as prescribed, most medicines will help to control the flare-ups so the person can get on with normal life.

Of course all medicines have the risk of side effects and a person with IBD may suffer from:

• Significant weight gain
• Roundness of the face
• Acne
• Mood swings
• Euphoria to depression
• Headaches
• Nausea
• Flu-like symptoms
• Increased risk of infection (getting colds and flu)

Will IBD affect my employee’s ability to do their job?

The majority of people with IBD are able to work full time. Studies suggest that people with IBD give high priority to maintaining their attendance and performance at work. More than half the people studied reported giving more effort at work to make up for any shortcomings that resulted from their IBD. People who were feeling fine in their current health had a total work productivity score that was better than the general healthy population.

How can I help to support my employee?

Understanding IBD and the effect it may have on your employee and discussing the situation with your employee will help you both find the best way to move forward.

If your employee feels supported and understood, they are more likely to feel positive about coming to work and feel a responsibility for their job and work colleagues.

Some things that might help include:

• Accessible toilet facilities: people with IBD may need urgent access to the toilet without much warning. Finding them a workspace close to the toilets can really help. People are also understandably concerned about smells and sounds, which can be embarrassing. These concerns are often a significant cause of stress
• Adequate toilet facilities: Workplace toilets often lack privacy and sufficient ventilation. In such cases, access to separate and individual facilities, such as a disabled toilet, can help to alleviate embarrassment
• Flexibility in working arrangements: If possible, having some flexible working hours means that your employee can work less when they feel under the weather and make up the time when they are well. Sometimes a later start can help with the option of making up the time. Some employers allow their staff to build up time in lieu so they can take it off when they need it
• Supportive social environment at work: Team mates or colleagues who support one another can help to improve productivity and team spirit. These factors are, of course, not only specific to IBD, but are also considered best practice management and good ways to attract and retain committed workers
• Time off for doctor or hospital appointments: Allocating time off (which is not part of the holiday allowance) is important
• Adjusting performance targets to take into account the effect of sick leave or fatigue
• Ability to work remotely: Finding a way to allow staff to work from home can help to reduce tiredness and help staff to feel taken care of, especially at times when they feel unwell

How should I go about it?

Finding the best way to help your employee should be a two-way process. Allocate a time to sit down together to discuss the best way forward. Ask your employee if they would like someone with them such as someone from occupational health or human resources.

Remember, hiding the symptoms of IBD can be a strain on employees. It may be a relief to talk openly about their condition. Showing respect and compassion is likely to result in the best outcome for everyone.

You could start by:

• Explaining that you would like to plan ahead so that you can think of strategies before the need arises to help your staff member. Assure your employee about maintaining confidentiality and respect
• Ask your employee what things they find difficult as a result of their condition
• Discuss what might help (including flexible working hours, access to toilet)
• Discuss a procedure for time off sick (how they would like to be contacted, doctors note required, etc)
• Discuss a procedure for coming back to work if an extended length of time off sick has occurred
• Cover: If your employee does need frequent toilet breaks, discuss how to organise cover from other staff members, if this is an issue
• Ask your employee whether they would like their condition to be kept confidential or what/how to tell other team members

By offering ongoing support and regular reviews, both you and your employee can find ways to adjust working practices to make it easier for them to continue working.

There may be times when some people with IBD are off work for longer than average. This may be due to a severe flare-up or occasionally due to surgery for their IBD. It is common for people to lose confidence about being able to return to work, even after a relatively short time away on sick leave, and keeping in touch with an employee can help with this.