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Physicians Review Methods in Managing Inflammatory Bowel Disease

Wednesday, May 20, 2009 - Danbury, CT

Inflammatory Bowel Disease (IBD) is broken into two forms ulcerative colitis (UC) and Crohn’s disease. Although treatments are readily available, early detection and prevention are key to long-term colon health.

Ten to 20 percent of UC sufferers have an affected family member. Smoking increases the chance to develop UC, while surprisingly those who have had their appendixes removed are at a lower risk. Fifty percent of patients experience no symptoms one year after treatment. Those who do can expect a mild to moderate range of rectal bleeding, diarrhea and abdominal pain.

One out of every five patients who have Crohn’s disease has an affected relative. Some factors that can increase the risk of developing Crohn’s include: smoking, stress, intestinal bacteria and residing in northern latitudes. Common complications that accompany Crohn’s are fistulas, strictures in locations that can make treatment more difficult.

Common symptoms that accompany IBD in general are arthritis, eye problems and liver disease. “Everybody will need a colonoscopy, even if you don’t have IBD,” said Dr. Brandwein. Ultimate goals for the treatment of IBD include induced and sustain remission, restore nutrition, decrease numbness and maintain quality of life.

Most IBD sufferers have mild cases that can be treated successfully with topical medicine. Fewer IBD sufferers have a moderate severity and can be adequately treated with steroids. The fewest group is the most severe and requires surgery to treat IBD. Probiotics, which contain “good bacteria,” can be used in combination with a healthy lifestyle to reduce the risk of IBD.

Dr. Foglia, physician specialist in colon and rectal surgery, highlighted one of the differences between ulcerative colitis and Crohn’s disease. UC starts at the anus and works its way up. Crohn’s, conversely, can attack anywhere in the GI tract and skip around.

Pharmacological treatments are based on severity and include antibodies, steroids, antibiotics and immune modulators. Methods of treatment are available in oral, intravenous and enema forms. When pharmacological treatments are administered, medicines must possess low pH levels to pass through the stomach and reach the small intestine.

Surgery is typically required when medications fail to address the problem. Various surgeries that are used to treat ulcerative colitis include: total abdominal colectomy (TAC), total proctal collectomy (TPC), and loop illiostomy. A majority of these surgeries will require either temporary or permanent illiostomy bags. This decreases risk of complications and allows time for healing. Complications for UC surgeries can include the need for a stoma, leaks, ongoing risk for cancer and pouch problems such as frequent bowel movements.

Surgical treatment for Crohn’s disease is required due to the failure of all previous medical treatments and includes resection strictureplasty and diversion. Preoperative procedures such as endoscopies, radiological screening and symptom evaluations provide the surgeon with valuable information he/she might need to effectively correct the problem. Laparoscopy, a newer, more commonly practiced minimally invasive surgical procedure allows for faster recovery, smaller incisions and performed with similar outcomes of traditional surgery but is less traumatic and faster recovery time.

About Danbury Hospital

Danbury Hospital is a 371-bed regional medical center and university teaching hospital associated with New York Medical College, the Yale University School of Medicine, the Connecticut School of Medicine and Columbia University Medical Center. The hospital provides centers of excellence in cardiovascular services, cancer, weight loss surgery, orthopedics, digestive disorders and radiology. It also offers specialized programs for sleep disorders and asthma management. Medical staff members are board certified in their specialties.

Danbury Hospital is ranked in the top 5 percent of hospitals in the country for overall clinical performance by HealthGrades®, a leading independent health care rating organization. It is the only health care facility in Connecticut ranked among the top 5 percent of hospitals nationwide for overall clinical performance four years in a row.

In the area of gastrointestinal care, Danbury Hospital is ranked in the top 5 percent nationally for overall gastrointestinal services and gastrointestinal surgery by HealthGrades®. This is the second consecutive year for the national award.




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