Inflammatory bowel disease (IBD) is a chronic disease which steadily increases worldwide with the highest prevalence in Canada. Genetic susceptibility is considered to be an important factor in causing IBD. Organic cation transporters, SLC22A4 and SLC22A5 have been associated to IBD multiple times. Recently, SLC22A23, a novel gene that encodes for an organic cation membrane transporter protein has also been associated to IBD however; neither its gene structure nor its functions has been characterized. The aim of this study was to characterize the genomic structure of SLC22A23 gene using bioinformatics analysis, determine the tissue expression, characterize the location of the protein and perform functional studies using Liquid Chromatography-Quadrupole Time of Flight-Mass Spectrometry. We have identified the chromosomal location, the gene neighborhood and the genomic structure of human SLC22A23.The result of this study indicates that SLC22A23 gene is a membrane transporter and it is abundantly expressed in the intestine. / October 2015

In this thesis, I explore the meanings and experience of health and well-being in the lives of individuals with Inflammatory Bowel Disease (IBD). Taking an auto/biographical approach and utilising in-depth qualitative online interviews, I draw on the experience and narratives of seventeen individuals with IBD, including myself. The three main themes addressed are 'Living with IBD', 'Becoming a Patient', and 'Coping and Control'. I explore how IBD influences individuals' experience of personal relationships, and their medical encounters and treatments. I reflect on how and why these factors arise and the effect they may have upon the disease and its management and on individuals' feelings of well-being more generally. I look at the resulting illness narratives and the impact of IBD on the daily life experience and the identity of the individual. I interrogate existing research and add to it from my analysis. Throughout, the research highlights the importance of acknowledging the impact of biographical disruption on the life experience and identity of individuals along with changing illness narratives. There are implications for future research and for policy, including the time taken to reach diagnosis, the use of IBD guidelines in diagnosis and treatment, and patient control and choice as a contributing factor to influence future guidelines and treatment plans.

Background: Inflammatory Bowel Disease (IBD) is a group of chronic gastrointestinal diseases with a relapsing nature. The two main types are Crohn’s disease (CD) and ulcerative colitis (UC). Both CD and UC patients experience very similar and distressing symptoms: acute abdominal pain, vomiting, malnutrition, fever, fatigue, diarrhoea and rectal bleeding. These symptoms are disabling and have a severe impact on physical and psychosocial wellbeing. Around 30% of patients suffer from moderate to severe psychological distress and have difficulties coping with the illness even in remission. However, it appears that mental health is overlooked by clinicians who often focus on physical gastrointestinal symptoms only. Mindfulness-Based Cognitive Therapy (MBCT) is evidence based, group psychological intervention that has been successful in reducing depression and anxiety scores in patients with depression while improving overall quality of life. However, MBCT has never been tested in the IBD population before. PhD question: Can MBCT be used as an adjunct therapy to IBD symptom management, for improving IBD patients' general well-being and quality of life? Aims and objectives: The overall aim of the thesis was to develop and collate the evidence for a definitive randomised controlled trial (RCT) testing the effectiveness of MBCT for patients with inflammatory bowel disease (IBD). The thesis brings together six publications. The six publications were integrated into four objectives that collectively contributed in answering the overall PhD question. Results: The findings from the first three publications highlighted the disease-related concerns and psychological needs for patients with IBD. The findings from the last three publications highlighted how feasible it is to use MBCT in IBD and emphasised the IBD patients’ perspectives about MBCT. Conclusion: The thesis concluded that a definitive RCT of MBCT for IBD patients is both feasible and acceptable.