IBD: Navigating the Road to Recovery With Positivity

In honor of World IBD Day on May 19, we’re spotlighting a teenager who hasn’t let his inflammatory bowel disease hold him back

At age 13, Mohammadmoein (Mo) Moezzi was an active, healthy kid who loved playing water polo, looked forward to math class, and watched documentaries in his spare time. But when he started passing stools much more than usual, he wondered if something might be wrong. Then, after he saw blood in his stool, his family took him to the emergency room, and he ended up staying at Stanford Medicine Children’s Health for two and a half weeks.

Doctors in Stanford Medicine Children’s Health’s Center for Inflammatory Bowel Disease (IBD) and Celiac Disease ran tests to find the cause of Mo’s symptoms. His pediatric gastroenterologist, Jonathan Moses, MD, medical director of the IBD program, ordered a full workup, including a colonoscopy, ultrasounds, an upper endoscopy to look at the inside of his digestive tract, and two MRIs. Based on the results, Dr. Moses narrowed Mo’s condition down to ulcerative colitis, a type of IBD that involves inflammation in the inner lining of the large intestine (colon). Mo’s case was severe enough to require hospitalization to stop the loss of blood, fluids, and minerals. “During this whole thing, I didn’t have any pain, but I worried about what would happen and whether I’d have a normal life,” says Mo.

Finding the right medication

Because there isn’t a cure for ulcerative colitis, the goal of therapy was to keep Mo healthy and ideally to achieve remission by controlling symptoms and inflammation. This meant finding the right medication that would reduce inflammation by suppressing his overactive immune system. With ulcerative colitis, not every medicine works the same way on each child. “Sometimes, the first one, two, or three medications don’t work, and we adjust,” says Dr. Moses.

“Ulcerative colitis can be life-threatening, and before we had steroids, there was a high mortality rate with severe cases,” he says. “But we are now able to manage it more effectively with newer medications on the market, and we can get kids into remission.” The combination of medications helped Mo gain back some of the 40 pounds he’d lost before he was diagnosed.

Getting Mo into remission meant trying more medications and doses than is typical. “They were very proactive when we had questions for the medical team,” says Mo’s father, Meysem Moezzi. “We’d leave a message in MyChart, and it would be answered fast. The team did a very good job finding the right treatment.” Mo is now 15, and the regimen he’s on has been working for the past seven months—working so well, in fact, that he was recently able to stop taking the steroids.

Dedicated support for unique challenges

The Center for Inflammatory Bowel Disease and Celiac Disease is unique in that it offers a multidisciplinary approach with physicians, nurse practitioners, psychologists, social workers, dietitians, nurse educators, and surgeons to develop a therapy plan that is individualized for each child. A comprehensive evaluation determines the kinds of support that each patient needs. For Mo, this included connecting his family with the dedicated IBD pharmacist and social worker who work with families in an array of capacities. Social workers often help children adjust to their new diagnosis and establish a care plan at their school. Other times, they teach children strategies to manage stress, pain, anxiety, or depression, which can be associated with IBD. For Mo and his family, the social worker stepped in to help with switching Mo’s school status from in-person to online during his hospital stays. The social worker also helped Mo’s family get supplemental insurance to cover costs.

The IBD pharmacist worked behind the scenes getting appeals and prior authorizations for Mo’s medications. “The field is growing quickly, and every year or two there is a new medication we have to learn about,” says Dr. Moses. “It’s becoming more difficult to get them through insurance, so our pharmacist writes appeal letters when the insurance company denies coverage. The pharmacist can also provide detailed medication education for families.”

Moving forward

Children with ulcerative colitis, or any type of IBD, need long-term care, and even though Mo’s colitis is in remission, he will require close monitoring of symptoms and blood work. Mo has tests done based on his current therapy and has been seen in the Stanford Children’s Interdisciplinary Care Clinic, which provides medical, nutritional, emotional, and psychosocial care.

But Mo is feeling great and is as active, energetic, and gung-ho as ever. He’s learned what foods trigger flares (fast food is a clear culprit) and avoids them. He’s back playing sports. And he’s glad to be well enough to attend school. Mo is excited to study biology because he’s decided to become a dentist one day. “I looked at all of the professions that pay really well but don’t have as much stress involved as, like, a surgeon would,” he says. Mo radiates positivity when asked if he has advice for other teens with IBD. “I say, never get sad about it,” he advises. “If you think about it too much, you’ll get stressed, and that will make it worse. After they find the right medicine, life just goes back to normal.”

For Dr. Moses, getting Mo back to school, his studies, and sports is gratifying. “Our job is to get kids back on track for the lives they want to have,” he says. “The joy is seeing them grow up and thrive.”

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