Understanding Inflammatory Bowel Diseases (IBD):
|
|
- Hector Cross
- 5 years ago
- Views:
Transcription
1
2 Understanding Inflammatory Bowel Diseases (IBD): What Every Patient Needs to Know William H Holderman, MD Digestive Health Specialists Tacoma, WA
3 Today s Objectives Define IBD, its potential causes and diagnosis Discuss management and treatment Highlight special populations Review latest research Answer questions
4 What Is IBD? Comprises Crohn s disease (CD) and ulcerative colitis (UC) Overlapping symptoms and complications Crohn s disease can affect any area of the gastrointestinal (GI) tract, including the small intestine and colon UC affects only the colon An estimated 1.4 million Americans live with IBD 30,000 new cases diagnosed each year
5
6 IBD vs IBS IBS IBD Abdominal pain Cramping Altered stool pattern can be diarrhea constipation or both May report bleeding, usually normal HCT Usually no weight loss All labs usually normal Normal colonoscopy, normal imaging abdominal pain cramping usually diarrhea, but may have constipation bleeding with UC weight loss w/ Crohn s anemia, low albumin abnormal findings imaging abnormal colonoscopy
7 Inflammatory Bowel Disease Age of Onset
8 What Are the Potential Causes of IBD? Genetic Predisposition 20% 25% of patients have a close relative with IBD Environmental Factors Infections, antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), diet, smoking Immune System Abnormalities An inappropriate reaction by the body s immune system
9 Smoking in IBD Ulcerative Colitis Smoking can protect against UC Ex-smokers are more likely to develop UC Crohn s disease Twofold risk in current smokers Smokers are less responsive to treatment Smokers are more likely to develop recurrence of disease after surgery
10 The Spectrum of IBD CROHN S DISEASE Patchy inflammation Mouth to anus involvement Full-thickness inflammation Variable involvement Fistulas Abscesses Strictures Extraintestinal manifestations Increased risk of cancer Indeterminate colitis 10% 15% ULCERATIVE COLITIS Continuous inflammation Colon only Superficial inflammation Variable involvement Increased risk of cancer Extraintestinal manifestations
11 Ulcerative Colitis Proctitis Left-sided Colitis Total Colitis Small Intestine Not Involved
12 Crohn s Disease Anatomic Distribution ) Colon alone (20%)
13 Understanding Complications of Ulcerative Colitis Anemia from blood loss Perforation (rupture) of the bowel Colorectal cancer Toxic megacolon Perforation
14 Understanding Complications of Crohn s Disease Obstruction Intestinal obstruction Abscess Fistula Stricture Colorectal cancer Fistula
15 % Recurrence Postsurgical Recurrence of CD Years Radiologic/Endoscopic recurrence Symptomatic recurrence McLeod RS et al. Gastroenterology. 1997;113:1823.
16 Diagnosing IBD
17 Recognizing Symptoms of IBD Flares Diarrhea Often increased from usual course of disease Rectal bleeding Abdominal pain or cramping Low-grade fever Fatigue Extraintestinal manifestations Joint pain/swelling Eye inflammation Skin lesions Mouth ulcers
18 C-difficile in IBD patients
19 Diagnosing IBD Normal colon on colonoscopy UC on colonoscopy CD on colonoscopy
20 Management & Treatment of IBD
21 Comprehensive IBD Management Provide emotional support Prevent cancer Improve quality of life Replenish nutritional deficits IBD Management Goals Maintain steroid free remission Control symptoms Treat inflammation Treat complications Minimize treatment toxicity
22 Understanding Treatment Options Prescription medications Over-the-counter agents Complementary and alternative therapies Surgery
23 Prescription Medications Class Agents 5-ASA Agents Balsalazide (Colazal ) Mesalamine formulations Delayed release tablets (Lialda, Asacol, Asacol HD ) Controlled release tablets (Pentasa ) Extended release capsules (Apriso ) Rectal suspension (Rowasa ) Rectal suppository (Canasa ) Olsalazine (Dipentum ); Sulfasalazine (Azulfidine ) Corticosteroids Adrenocorticotropic hormone Budesonide (Entocort, Uceris) Hydrocortisone (Cortenema, Cortifoam ) Methylprednisolone (Medrol ) Prednisone Antibiotics Ciprofloxacin (Cipro ) Metronidazole (Flagyl ) Rifaximin (Xifaxin )
24 Prescription Medications Class Agents Immunologic Agents Azathioprine (Imuran, Azasan ) Cyclosporine (Neoral ) 6-Mercaptopurine (Purinethol ) Methotrexate Tacrolimus (Prograf ) Biologic Agents Adalimumab (Humira ) Certolizumab pegol (Cimzia ) Infliximab (Remicade ) Natalizumab (Tysabri ) Vedolizamab (Entyvio)
25 Stomach 5-ASA Release Sites Pentasa Asacol Azulfidine Dipentum Colazal Small Intestine Large Intestine Mesalamine in microgranules Mesalamine w/ eudragit-s Azo bond Rowasa Canasa
26 Benefits Induces remissions in UC and CD Quick fix Inexpensive Oral or rectal Corticosteriods Risks No long-term benefits Numerous side effects Cushingoid changes Hypertension Diabetes Osteoporosis Acne Cataracts Depression Growth retardation
27 Immune-Modulators Imuran (azathioprine) & Purinetheol (6-MP) Myths Dangerous drugs used to treat cancer Cause cancer Should not be used longer than 3 years If they don t work over 3-6 months, they will not work Must be stopped before or during pregnancy Facts Very slight increased risk of lymphoma Can be used for more than 3 years If they don t seem to work at first, the dose needs to be reassessed Can be used during pregnancy, Must be monitored
28 Over-the-Counter (OTC) Agents Address only specific symptoms Antidiarrheal agents Laxatives Pain relievers Important to discuss with physician before taking any OTC medications
29 Complementary & Alternative Therapies: Probiotics Good bacteria that restore balance to the enteric microbiota-bacteria in the intestines May be helpful in aiding recovery of the intestine and maintaining remission Important to discuss with physician before initiating treatment
30 Surgery in IBD Crohn s Disease Strictureplasty Resection of small intestinal segment Colectomy (partial or complete) Proctocolectomy Ulcerative Colitis Proctocolectomy (removal of the colon and rectum) With ileostomy Restorative (ileoanal or J pouch) Unlike UC, CD cannot be cured with surgery Disease is cured once the colon is removed
31 Understanding the Importance of Diet & Nutrition in Managing IBD Causes of nutritional deficits Decreased intake (no desire to eat) Active disease Protein and fluid loss Decreased absorption of nutrients (when small intestine is affected by CD) Fat Vitamins Small intestine
32 Understanding the Importance of Diet & Nutrition in Managing IBD Create a food journal Eliminate problematic foods Strive for a well-balanced, healthy diet based on Hydration Electrolyte balance Continual adequate nutrient intake
33 IBD in Special Populations
34 Understanding IBD in Children & Adolescents Special considerations Ability to swallow capsules or tablets Side effects of drug therapy Risks of long-term corticosteroid use Emotional/social concerns Adherence Growth failure and need for nutritional supplementation Emotional well-being
35 Understanding IBD in Pregnant Women Special considerations IBD should be controlled before considering pregnancy Remain on most prescribed medications Well-balanced diet with vitamins, including folic acid Ongoing communication between obstetrician and gastroenterologist
36 IBD Research
37 IBD Research Genetics Several genes linked to both CD and UC Large genome-wide studies continue Biologic markers Measurable substances that may help characterize disease Clinical trials Better understand disease Develop novel therapies
38 Living Well With IBD Be compliant with medications Understand your disease and possible complications Schedule follow-up appointments Maintain a well-balanced diet Establish a support system Empower yourself with information Follow Helpful Tips handout
39 Percentage of Patients (%) Remaining in Remission Adherence Decreases Risk of Relapse 100 Adherent Nonadherent 25 0 Time (months) Adherent n = Nonadherent n = Kane et al. Am J Med. 2003;114:39-41.
40 Health Maintenance in a Crohn s Disease Patient Immunizations Therapy with steroids, immunosuppressants, and biologics increase risk of infection 1 Smoking cessation Bone density Cancer screening Smoking associated with complicated disease, need for surgery, suboptimal response to medical therapy, and postoperative recurrence Increased risk of osteoporosis 1,2 and osteopenia in IBD, particularly with steroid therapy 1,3 Colorectal cancer 1 Nonmelanoma skin cancer 1 Depression Significantly higher prevalence of major depression in IBD compared with controls 4 Image adapted from: Osteopenia: Knapp KM, et al. Case Rep Med. 2010;629020:1-4. Colorectal Cancer: Aihara H, et al. Gastroenterol Res Pract ;971383:1-5. Sinclair JA, et al. Gastroenterol Clin N Am. 2012;41: Baumgart DC, Sandborn WJ. Lancet. 2012;380: Lichtenstein GR, et al. Am J Gastroenterol. 2009;104: Graff LA, Walker JR, Bernstein CN. Inflamm Bowel Dis. 2009;15:
41 Questions & Answers
Garrick Brown, MD. Digestive Health Specialists Tacoma Gig Harbor
Garrick Brown, MD Digestive Health Specialists Tacoma Gig Harbor Today s Objectives Define IBD, its potential causes and diagnosis Discuss management and treatment Discuss complementary and alternative
More informationUnderstanding Inflammatory Bowel Diseases: What Every Patient Needs to Know
Understanding Inflammatory Bowel Diseases: What Every Patient Needs to Know An educational program for patients, families and caregivers living with Crohn s disease and ulcerative colitis. Dr. William
More informationInflammatory Bowel Diseases
Objectives Today s discussion will address the following topics: Similarities and differences between Crohn s disease (CD) and ulcerative colitis (UC) Risks and benefits of medication, surgery, and integrative
More informationI B D. etter than this. isease UNDERSTANDING INFLAMMATORY BOWEL DISEASES
I B D m etter than this isease UNDERSTANDING INFLAMMATORY BOWEL DISEASES What types of people have learned how to manage their IBD? Athletes Musicians Firefighters DOCTORS HEROES Artists Presidents Actors
More informationSpeaker Introduction
Speaker Introduction Stephen B. Hanauer, MD Professor of Medicine and Clinical Pharmacology University of Chicago Pritzker School of Medicine Chief of Gastroenterology, Hepatology, and Nutrition University
More informationHow do I choose amongst medicines for inflammatory bowel disease. Maria T. Abreu, MD
How do I choose amongst medicines for inflammatory bowel disease Maria T. Abreu, MD Overview of IBD Pathogenesis Bacterial Products Moderately Acutely Inflamed Chronic Inflammation = IBD Normal Gut Mildly
More informationThis program is supported by an educational grant from Janssen Biotech Inc., Shire, Inc., and a sponsorship from Takeda
This program is supported by an educational grant from Janssen Biotech Inc., Shire, Inc., and a sponsorship from Takeda Today s Presenter Adam S. Cheifetz, MD Director, Center for Inflammatory Bowel Disease
More information10/23/2014. Program Goals
Program Goals Help you understand ulcerative colitis and its effects Review current treatments, including medications, and surgery Provide tips for managing your disease through diet and complementary
More informationThis program is supported by an educational grant from Janssen Biotech Inc, and a sponsorship from Takeda.
This program is supported by an educational grant from Janssen Biotech Inc, and a sponsorship from Takeda. Objectives Today s discussion will address the following topics: Similarities and differences
More informationInflammatory Bowel Disease
Inflammatory Bowel Disease Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine. Crohn's disease andulcerative colitis are the principal types of inflammatory
More informationThe ABCs of Inflammatory Bowel Disease. Jennifer Choi, M.D. Associate Director March 31, 2012
The ABCs of Inflammatory Bowel Disease Jennifer Choi, M.D. Associate Director March 31, 2012 What Will This Talk Cover? What is IBD? What causes it? What are complications of it? How do I find out if I
More informationMedical therapies and IBD
Medical therapies and IBD Although there is no cure for IBD, there are many treatment options available. There is no standard treatment for IBD that is effective in all situations or for all patients,
More informationWelcome to Week 2 of the Crohn s & Colitis Foundation of America (CCFA) Online Support Group.
Welcome to Week 2 of the Crohn s & Colitis Foundation of America (CCFA) Online. Last week s material consisted of an overview of inflammatory bowel diseases (IBD), specifically Crohn s disease and ulcerative
More informationWe will discuss: Inflammatory Bowel Diseases. Life With IBD. What Are the Potential Causes of IBD?
We will discuss: Similarities and differences between Crohn s disease (CD) and ulcerative colitis (UC) Risks and benefits of medication, surgery, and integrative treatments in inflammatory bowel diseases
More informationTreating Crohn s and Colitis in the ASC
Treating Crohn s and Colitis in the ASC Kimberly M Persley, MD Texas Digestive Disease consultants TASC Meeting Outline IBD 101 Diagnosis Treatment Burden of Disease Role of ASC Inflammatory Bowel Disease
More informationULCERATIVE COLITIS. Sean Lynch, MD and Richard Bloomfeld, MD Wake Forest University School of Medicine Winston-Salem, NC
ULCERATIVE COLITIS Sean Lynch, MD and Richard Bloomfeld, MD Wake Forest University School of Medicine Winston-Salem, NC What is Ulcerative Colitis? Ulcerative colitis (UC) is a disease marked by inflammation
More informationWhat Will This Talk Cover? 101: The Basics of Inflammatory Bowel Disease. Terms & Abbreviations. What Is Normal GI Anatomy?
101: The Basics of Inflammatory Bowel Disease What Will This Talk Cover? What is IBD? What causes it? What are complications of it? How do I find out if I have IBD? How do we treat IBD? Jennifer Choi,
More informationCrohn's disease CAUSES COURSE OF CROHN'S DISEASE TREATMENT. Sulfasalazine
Crohn's disease Crohn's disease is an inflammatory condition of the digestive tract that affects children and adults. Common features of Crohn's disease include mouth sores, diarrhea, abdominal pain, weight
More informationCrohn's Disease. What causes Crohn s disease? What are the symptoms?
Crohn's Disease Crohn s disease is an ongoing disorder that causes inflammation of the digestive tract, also referred to as the gastrointestinal (GI) tract. Crohn s disease can affect any area of the GI
More informationUnderstanding IBD Medications. and Side Effects
Understanding IBD Medications and Side Effects What s Inside? About Crohn s Disease and Ulcerative Colitis 2 Treatment 4 Over-the-Counter (OTC) Medications 5 Prescription Medications 6 Off-Label 8 Pediatric
More informationCrohn s Disease. Resident Lecture 1/17/19
Crohn s Disease Resident Lecture 1/17/19 Objectives Features/Classification of Crohn s Disease Medical Treatment Surgical Indications Surgical Considerations 2 Case 25 yo F presents to your office with
More informationUlcerative Colitis. National Digestive Diseases Information Clearinghouse. What is ulcerative colitis (UC)?
Ulcerative Colitis National Digestive Diseases Information Clearinghouse What is ulcerative colitis (UC)? Ulcerative colitis is a chronic, or long-lasting, disease that causes inflammation and sores, called
More informationINFLAMMATORY BOWEL DISEASE 101: From Hurdling New Diagnosis to Optimizing Treatments
INFLAMMATORY BOWEL DISEASE 101: From Hurdling New Diagnosis to Optimizing Treatments Phillip Minar, MD Pediatric Gastroenterologist Cincinnati Children s Hospital Medical Center Objectives of Session What
More informationTreatment Options. Suresh Pola, MD Kaiser San Diego
Treatment Options Suresh Pola, MD Kaiser San Diego Overview of Treatments! Medications! Diet! Complementary and Alternative Medicines! How to treat Pain Treatment Goals and Target! Goals of Treatment should
More informationOf Treatment For Inflammatory Bowel Diseases
Balancing The Risks And Benefits Of Treatment For Inflammatory Bowel Diseases Corey A. Siegel, MD Assistant Professor of Medicine Dartmouth Medical School Director, Inflammatory Bowel Diseases Center Dartmouth-Hitchcock
More informationINFLAMMATORY BOWEL DISEASE (IBD): CROHN S DISEASE
INFLAMMATORY BOWEL DISEASE (IBD): CROHN S DISEASE Symptoms The symptoms of Crohn s disease can vary from person to person, based on where the disease is in the body and how bad the inflammation is. The
More informationWhat is Inflammatory Bowel Disease (IBD)?
INFLAMMATORY BOWEL DISEASE (IBD) What is Inflammatory Bowel Disease (IBD)? Inflammatory bowel disease, or IBD, is when there is inflammation, or swelling, in the gastrointestinal (GI) tract and a lifelong
More informationCROHN S DISEASE. The term "inflammatory bowel disease" includes Crohn's disease and the other related condition called ulcerative colitis.
CROHN S DISEASE What does it consist of? Crohn s disease is an inflammatory process that affects mostly to the intestinal tract, although it can affect any other part of the digestive apparatus from the
More informationUnderstanding IBD Medications and Side Effects
Understanding IBD Medications and Side Effects a What s Inside About Crohn s Disease and Ulcerative Colitis... 2 Over-the-Counter (OTC) Medications... 5 Prescription Medications... 6 Off-Label... 9 Complementary
More informationEfficacy and Safety of Treatment for Pediatric IBD
Efficacy and Safety of Treatment for Pediatric IBD Andrew B. Grossman MD Co-Director, Center for Pediatric Inflammatory Bowel Disease Associate Professor of Clinical Pediatrics Division of Gastroenterology,
More informationMy Child Has Inflammatory Bowel Disease : Why? What now? What s next?
My Child Has Inflammatory Bowel Disease : Why? What now? What s next? George M. Zacur, M.D., M.S. Clinical Assistant Professor Department of Pediatrics and Communicable Diseases Division of Gastroenterology
More informationClinical Trials in IBD. Bruce Yacyshyn MD Professor of Medicine Division of Digestive Diseases
Clinical Trials in IBD Bruce Yacyshyn MD Professor of Medicine Division of Digestive Diseases Objectives Today s discussion will address the following topics: Similarities and differences between Crohn
More informationEfficacy and Safety of Treatment for Pediatric IBD
Efficacy and Safety of Treatment for Pediatric IBD Andrew B. Grossman MD Co-Director, Center for Pediatric Inflammatory Bowel Disease Assistant Professor of Clinical Pediatrics Division of Gastroenterology,
More informationWhat is ulcerative colitis?
What is ulcerative colitis? Ulcerative colitis is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells
More informationINFLAMMATORY BOWEL DISEASE 101: From Hurdling New Diagnosis to Optimizing Treatments
INFLAMMATORY BOWEL DISEASE 101: From Hurdling New Diagnosis to Optimizing Treatments Phillip Minar, MD, MS Pediatric Gastroenterologist Cincinnati Children s Hospital Medical Center 3.3.2019 Objectives
More informationWHAT IS ULCERATIVE COLITIS?
235 60th Street, West New York, NJ 07093 T: (201) 854-4646 F: (201) 854-4647 810 Main Street, Hackensack, NJ 07601 T: (201) 488-0095 Ulcerative Colitis WHAT IS ULCERATIVE COLITIS? Ulcerative colitis is
More informationBest Practices in the Diagnosis and Treatment of Inflammatory Bowel Disease
Best Practices in the Diagnosis and Treatment of Inflammatory Bowel Disease Mark Lazarev, MD Summary Inflammatory bowel disease (IBD) is a complex disease that is costly both in terms of medical costs
More informationLiving with Ulcerative Colitis
Living with Ulcerative Colitis What s Inside? Understanding the diagnosis 1 What is ulcerative colitis? 2 Will it ever go away? 3 A brief introduction to the 3 gastrointestinal (GI) tract Who gets ulcerative
More informationDr David Epstein Vincent Pallotti Hospital and University of Cape Town
Inflammatory Bowel Disease Management in South Africa in 2016 Pharmaceutical Care Management Association Dr David Epstein Vincent Pallotti Hospital and University of Cape Town Inflammatory Bowel Disease
More informationNEW CONCEPTS IN CROHN S DISEASE GLENDON BURRESS, MD PEDIATRIC GASTROENTEROLOGY ROCKFORD, IL
NEW CONCEPTS IN CROHN S DISEASE GLENDON BURRESS, MD PEDIATRIC GASTROENTEROLOGY ROCKFORD, IL CROHN S DISEASE Chronic disease of uncertain etiology Etiology- genetic, environmental, and infectious Transmural
More informationRegulatory Status FDA-approved indications: Entyvio is an α4β7integrin receptor antagonist indicated for: (1)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.50.12 Subject: Entyvio Page: 1 of 7 Last Review Date: September 20, 2018 Entyvio Description Entyvio
More informationWhat is Crohn's disease?
What is Crohn's disease? Crohn's disease is a chronic inflammatory disorder that causes inflammation of the digestive tract. It can affect any area of the GI tract, from the mouth to the anus, but it most
More informationTreatment of Inflammatory Bowel Disease. Michael Weiss MD, FACG
Treatment of Inflammatory Bowel Disease Michael Weiss MD, FACG What is IBD? IBD is an immune-mediated chronic intestinal disorder, characterized by chronic or relapsing inflammation within the GI tract.
More informationCarefirst.+.V Family of health care plans
Carefirst.+.V Family of health care plans CVS care mark POLICY Document for ENTYVIO The overall objective of this policy is to support the appropriate and cost effective use of the medication, specific
More informationIBD Understanding Your Medications. Thomas V. Aguirre, MD Santa Barbara GI Consultants
IBD Understanding Your Medications Thomas V. Aguirre, MD Santa Barbara GI Consultants IBD Understanding Your Medications (& Your Doctor) Thomas V. Aguirre, MD Santa Barbara GI Consultants Disclosure I
More informationIBD Module 2: Medication and Patient Management. Kami Roake, PharmD Rheumatology & Gastroenterology Pharmacist University of Utah Hospitals & Clinics
IBD Module 2: Medication and Patient Management Kami Roake, PharmD Rheumatology & Gastroenterology Pharmacist University of Utah Hospitals & Clinics Objectives Describe current treatment guidelines and
More informationAli Keshavarzian MD Rush University Medical Center
Treatment: Step Up or Top Down? Ali Keshavarzian MD Rush University Medical Center Questions What medication should IBD be treated with? Can we predict which patients with IBD are high risk? Is starting
More informationPIBD03 - Page 1 of June-03
ENROLLMENT INFO Patient Demographics [enroll01] Date of assessment [e_assessdt] 1. Patient birthdate: [birthdt] 2a. Month of diagnosis (please enter the 2-digit month) [e_diagmnth] 2b. Year of diagnosis
More informationSurgical Management of IBD. Val Jefford Grand Rounds October 14, 2003
Surgical Management of IBD Val Jefford Grand Rounds October 14, 2003 Introduction Important Features Clinical Presentation Evaluation Medical Treatment Surgical Treatment Cases Overview Introduction Two
More informationDisclosure of Affiliations. The Way We Hope It Goes. Medicines and Surgery for IBD. None. Cases: Sweet and Not So Sweet
Immunomodulators and Complications of Surgery for Inflammatory Bowel Disease Disclosure of Affiliations None Thomas E. Read, MD, FACS, FASCRS Professor of Surgery Tufts University School of Medicine Senior
More informationThe Road to Remission
The Road to Remission Understanding, Treating and Living with Inflammatory Bowel Disease IBDCenterOrlando.com As many as 1.5 million Americans currently suffer from inflammatory bowel disease (IBD), and
More informationMedical Therapy for Pediatric IBD: Efficacy and Safety
Medical Therapy for Pediatric IBD: Efficacy and Safety Betsy Maxwell, MD Assistant Professor of Clinical Pediatrics Division of Gastroenterology, Hepatology, and Nutrition Pediatric IBD: Defining Remission
More informationINFLAMMATORY BOWEL DISEASE. Brittany Palasik, PharmD, BCPS University of North Texas System College of Pharmacy
INFLAMMATORY BOWEL DISEASE Brittany Palasik, PharmD, BCPS University of North Texas System College of Pharmacy Pharmacist learning objectives By the end of this presentation, the pharmacist should be able
More informationINFLAMMATORY BOWEL DISEASE 101: Understanding Your Child s Diagnosis
INFLAMMATORY BOWEL DISEASE 101: Understanding Your Child s Diagnosis Phillip Minar, MD Pediatric Gastroenterologist Cincinnati Children s Hospital Medical Center Objectives What is IBD Crohn s disease
More informationSlide 1 Medications in inflammatory bowel disease a primer for health care providers. Slide 2. Slide 3 Theory of pathogenesis. IBD - epidemiology
Slide 1 Medications in inflammatory bowel disease a primer for health care providers Athos Bousvaros, MD Associate director Inflammatory Bowel Disease Center Boston Children s Hospital 617 355 2962 Slide
More informationWhat is Crohn's disease?
What is Crohn's disease? Crohn s disease is an ongoing disorder that causes inflammation of the digestive tract, also referred to as the gastrointestinal (GI) tract. Crohn s disease can affect any area
More informationCLINICAL MEDICAL POLICY
Policy Name: Policy Number: Approved By: CLINICAL MEDICAL POLICY Remicade (Infliximab) MP-026-MD-DE Provider Notice Date: 11/1/2016 Original Effective Date: 12/1/2016 Annual Approval Date: 9/17/2017 Revision
More informationDr. Elmer Schabel, MD. Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany (No conflicts of interest)
EMA workshop on the development of new medicinal products for the treatment of ulcerative colitis and Crohn s disease Overview of authorised medicines for IBD in Europe - previous regulatory positions
More informationConflict of Interest. Inflammatory Bowel Disease. Road Map. Scope of the Disorder (United States) Age-Specific Incidence of IBD*
Inflammatory Bowel Disease Conflict of Interest No conflicts of interest Sonia Friedman, M.D. Assistant Professor of Medicine Gastroenterology Division Brigham and Women s Hospital Road Map Background
More informationLiving with Crohn s Disease
Living with Crohn s Disease www.arztol.com What s Inside? Understanding your diagnosis 1 What is Crohn s disease (CD)? 2 Will it ever go away? 3 A brief introduction to the 4 gastrointestinal (GI) tract
More informationThe Medical Letter. on Drugs and Therapeutics. Sulfasalazine can cause reversible. therapy may be more effective Lialda (Shire)
The Medical Letter publications are protected by US and international copyright laws. Forwarding, copying or any other distribution of this material is strictly prohibited. For further information call:
More informationInflammatory Bowel Disease Medical Exam Questionnaire
Patient Name: MR: Date: Name DOB / / Age Marital Status Race Gender M / F Height Present Weight Usual Weight Insurance Managed Care Self referral Yes No Yes No Yes No Primary Care Physician Referring Physician
More informationImmune Modulating Drugs Prior Authorization Request Form
Patient: HPHC member ID #: Requesting provider: Phone: Servicing provider: Diagnosis: Contact for questions (name and phone #): Projected start and end date for requested Requesting provider NPI: Fax:
More informationFacts THE CROHN S COLITIS. Living Well with IBD
Facts THE ON CROHN S & COLITIS Living Well with IBD Inside this Newly Diagnosed Kit, get the facts that will help you manage your disease. Learn the top things you need to know, get advice from experts,
More informationNew Perspectives on the Diagnosis and Management of IBD. Disclosures
New Perspectives on the Diagnosis and Management of IBD Joel R. Rosh, MD Director, Pediatric Gastroenterology Goryeb Children's Hospital/Atlantic Health Professor of Pediatrics Icahn School of Medicine
More informationThe Role of Surgery in Inflammatory Bowel Disease. Cory D Barrat, MD Colon and Rectal Surgeon Mercy Health
The Role of Surgery in Inflammatory Bowel Disease Cory D Barrat, MD Colon and Rectal Surgeon Mercy Health THANKS FOR INVITING ME! I have no financial disclosures Outline - Who am I and what do I do? -
More informationThe Spectrum of IBD. Inflammatory Bowel Disease. Symptoms. Epidemiology. Tests for IBD. CD or UC? Inflamatory Bowel Disease. Fernando Vega, M.D.
The Spectrum of IBD Inflammatory Bowel Disease Fernando Vega, M.D. Epidemiology CD and UC together 1:400 UC Prevalence 1:500 UC Incidence 6-12K/annum CD Prevalence 1:1000 CD Incidence 3-6K/annum Symptoms
More informationDoncaster & Bassetlaw Medicines Formulary
Doncaster & Bassetlaw Medicines Formulary Section 1.5 Chronic Bowel Disorders (including IBD) Aminosalicylates: Mesalazine 400mg and 800mg MR Tablets (Octasa) Mesalazine 1.2g MR Tablets (Mezavant XL) Mesalazine
More informationUlcerative Colitis: State of the Art 2006
Ulcerative Colitis: State of the Art David T. Rubin, MD Assistant Professor of Medicine Inflammatory Bowel Disease Center University of Chicago Improving Management of Ulcerative Colitis (UC) Better classification/diagnostic
More informationCrohn s disease CONDITION GUIDE
Crohn s disease CONDITION GUIDE Introduction and how to use this guide... 1 Understanding Crohn s disease... 3 What is Crohn s disease?... 4 Crohn s and inflammatory bowel disease... 4 Signs and symptoms
More informationCertain genes passed on from parent to child increase the risk of developing Crohn's disease, if the right trigger occurs.
Topic Page: Crohn's disease Definition: Crohn's disease from Benders' Dictionary of Nutrition and Food Technology Chronic inflammatory disease of the bowel, commonly the terminal ileum, of unknown aetiology,
More informationINFLIXIMAB Remicade (infliximab), Inflectra (infliximab-dyyb), Ixifi* (infliximabqbtx), Renflexis (infliximab-abda)
Pre - PA Allowance None Prior-Approval Requirements Diagnoses Patient must have ONE of the following: 6 years of age or older 1. Moderate to severe Crohn s disease (CD) a. Patient has fistulizing disease
More informationEffective Health Care Program
Comparative Effectiveness Review Number 131 Effective Health Care Program Pharmacologic Therapies for the Management of Crohn s Disease: Comparative Effectiveness Executive Summary Description of Crohn
More informationCrohn s Disease. Questions & Answers
Crohn s Disease Questions & Answers GLASGOW COLORECTAL CENTRE Ross Hall Hospital 221 Crookston Road Glasgow G52 3NQ e-mail: info@colorectalcentre.co.uk Ph: Main hospital switchboard - 0141 810 3151 Ph.
More informationPEDIATRIC INFLAMMATORY BOWEL DISEASE
PEDIATRIC INFLAMMATORY BOWEL DISEASE Alexis Rodriguez, MD Pediatric Gastroenterology Advocate Children s Hospital Disclosers Abbott Nutrition - Speaker Inflammatory Bowel Disease Chronic inflammatory disease
More informationIndex. Surg Clin N Am 87 (2007) Note: Page numbers of article titles are in boldface type.
Surg Clin N Am 87 (2007) 787 796 Index Note: Page numbers of article titles are in boldface type. A Abscesses in anorectal Crohn s disease, 622 intra-abdominal, in Crohn s disease, 590 591 perirectal,
More informationIBD 101. Ronen Stein, MD Assistant Professor of Clinical Pediatrics Division of Gastroenterology, Hepatology, and Nutrition
IBD 101 Ronen Stein, MD Assistant Professor of Clinical Pediatrics Division of Gastroenterology, Hepatology, and Nutrition Objectives Identify factors involved in the development of inflammatory bowel
More informationUnderstanding Learning is the first step to getting help.
Understanding Inflammatory Bowel Disease (IBD) Learning is the first step to getting help. This booklet has been created through an educational grant provided by Fulford India Ltd., A subsidiary of Schering-Plough
More informationBeyond Anti TNFs: positioning of other biologics for Crohn s disease. Christina Ha, MD Cedars Sinai Inflammatory Bowel Disease Center
Beyond Anti TNFs: positioning of other biologics for Crohn s disease Christina Ha, MD Cedars Sinai Inflammatory Bowel Disease Center Objectives: To define high and low risk patient and disease features
More informationLiving with Crohn s Disease
Living with Crohn s Disease What s Inside? Understanding your diagnosis 1 What is Crohn s disease (CD)? 2 Will it ever go away? 3 A brief introduction to the 4 gastrointestinal (GI) tract Who gets Crohn
More informationCCFA. Crohns Disease vs UC: What is the best treatment for me? November
CCFA Crohns Disease vs UC: What is the best treatment for me? November 8 2009 Ellen J. Scherl,, MD, FACP,AGAF Roberts Inflammatory Bowel Disease Center Weill Medical College Cornell University New York
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice SCOPE Clinical guideline title: Ulcerative colitis: the management of ulcerative colitis Quality standard title: Ulcerative
More informationIBD 101. Ronen Stein, MD Assistant Professor of Clinical Pediatrics Division of Gastroenterology, Hepatology, and Nutrition
IBD 101 Ronen Stein, MD Assistant Professor of Clinical Pediatrics Division of Gastroenterology, Hepatology, and Nutrition Objectives Identify factors involved in the development of inflammatory bowel
More informationInflammatory Bowel Disease. Your Illness and Its Treatment
Inflammatory Bowel Disease Your Illness and Its Treatment What Is Inflammatory Bowel Disease? Inflammatory bowel disease (IBD) is inflammation (irritation and swelling) of the digestive tract. Your digestive
More informationBest Practices in the Diagnosis and Treatment of Inflammatory Bowel Disease
Mark Lazarev, MD November 14, 2013 Assistant Professor of Medicine, Johns Hopkins University School of Medicine Best Practices in the Diagnosis and Treatment of Inflammatory Bowel Disease 1 Talk outline
More informationOutline. Biologic Drugs in Inflammatory Bowel Disease Dr. Jason Etzel MD The Vancouver Clinic. Biologic Drugs. Biologic Drugs. Biologic Drugs Anti-TNF
Outline Biologic Drugs in Inflammatory Bowel Disease Dr. Jason Etzel MD The Vancouver Clinic Types of biologic drugs How do they work? How effective are they? Safety/Toxicity concerns with biologics Biologic
More informationHow to Optimize Induction and Maintenance Responses: Definitions and Dosing Advances in Inflammatory Bowel Disease December 6, 2009
How to Optimize Induction and Maintenance Responses: Definitions and Dosing 2009 Advances in Inflammatory Bowel Disease December 6, 2009 Fernando Velayos MD MPH University of California, San Francisco
More informationINFLAMMATORY BOWEL DISEASE. Jean-Paul Achkar, MD Center for Inflammatory Bowel Disease Cleveland Clinic
INFLAMMATORY BOWEL DISEASE Jean-Paul Achkar, MD Center for Inflammatory Bowel Disease Cleveland Clinic WHAT IS INFLAMMATORY BOWEL DISEASE (IBD)? Chronic inflammation of the intestinal tract Two related
More informationChapter 34. Nursing Care of Patients with Lower Gastrointestinal Disorders
Chapter 34 Nursing Care of Patients with Lower Gastrointestinal Disorders Lower Gastrointestinal System Small Intestines Large Intestines Rectum Anus Constipation Fecal Mass Held In Rectum Feces Become
More informationLaurie S. Conklin, M.D. Inflammatory Bowel Disease Program Children s National Medical Center
Laurie S. Conklin, M.D. Inflammatory Bowel Disease Program Children s National Medical Center CROHN S DISEASE Patchy inflammation Mouth to anus involvement Full-thickness inflammation Variable involvement
More informationINFLAMMATORY BOWEL DISEASE
1. Medical Condition INFLAMMATORY BOWEL DISEASE (IBD) specifically includes Crohn s disease (CD) and ulcerative colitis (UC) but also includes IBD unclassified (IBDu), seen in about 10% of cases. These
More informationP a g e 1. Inflammatory Bowel Disease Guidelines
P a g e 1 Inflammatory Bowel Disease Guidelines Introduction Inflammatory bowel disease (IBD) is a chronic inflammatory disease affecting the gastrointestinal (GI) system. It is comprised of two major
More informationIleal Pouch Anal Anastomosis: The Preferred Method of Reconstruction after Proctocolectomy in Children
Ileal Pouch Anal Anastomosis: The Preferred Method of Reconstruction after Proctocolectomy in Children Stephanie Jones, D.O. Surgical Fellow March 21, 2011 Ulcerative Colitis Spectrum of inflammatory bowel
More information5-ASA Therapy, Steroids and Antibiotics in Inflammatory Bowel Disease
5-ASA Therapy, Steroids and Antibiotics in Inflammatory Bowel Disease David T. Rubin, MD Associate Professor of Medicine Co-Director, Inflammatory Bowel Disease Center University it of Chicago Medical
More information3/22/2011. Inflammatory Bowel Disease. Inflammatory Bowel Disease Objectives: Appendicitis. Lemone and Burke Chapter 26
Inflammatory Bowel Disease Lemone and Burke Chapter 26 Inflammatory Bowel Disease Objectives: Discuss etiology, patho and clinical manifestations of Appendicitis Peritonitis Ulcerative Colitis Crohn s
More informationThis information explains the advice about Crohn's disease that is set out in NICE guideline CG152.
Information for the public Published: 1 October 2012 nice.org.uk About this information NICE guidelines provide advice on the care and support that should be offered to people who use health and care services.
More informationPharmacotherapy of Inflammatory Bowel Disorder
PHARMACY / MEDICAL POLICY 5.01.563 Pharmacotherapy of Inflammatory Bowel Disorder Effective Date: June 9, 2019* Last Revised: Feb. 12, 2019 Replaces: Extracted from 5.01.550 RELATED MEDICAL POLICIES: 11.01.523
More informationSelby Inflamm Bowel Dis. 2008:14:
Medical Management of Inflammatory Bowel Disease Freddy Caldera D.O. Assistant Professor Division of Gastroenterology Objectives Discuss Crohn s disease and Ulcerative Colitis Discuss Medications for Inflammatory
More informationPharmacotherapy of Inflammatory Bowel Disorder
PHARMACY / MEDICAL POLICY 5.01.563 Pharmacotherapy of Inflammatory Bowel Disorder Effective Date: Feb. 14, 2018 Last Revised: April 1, 2018 Replaces: Extracted from 5.01.550 RELATED MEDICAL POLICIES: 11.01.523
More information