Dr. Brian M. Kirsh, MD
Very kind and professional staff throughout!
 
-- Anonymous, Patient Satisfaction Survey - 2010
 

Inflammatory Bowel Disease (IBD) - Adult

What is Inflammatory Bowel Disease?

Inflammatory Bowel Disease (IBD) is a group of disorders that includes ulcerative colitis and Crohn's disease. These conditions frequently produce symptoms of abdominal pain and diarrhea. These conditions can often be difficult to diagnose due to their similarity to other conditions.

Crohn's Disease

Is an ongoing disorder that causes inflammation of the gastrointestinal (GI) tract. Crohn's disease can affect any area of the GI tract, from the mouth to the anus, but it most commonly affects the lower part of the small intestine, called the ileum.

Ulcerative Colitis

Is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. It occurs in continuous stretches of the colon, unlike Crohn's disease, which occurs in patches anywhere in the digestive tract.

Treatment

Depending on the level of severity, treatment may require immunosuppression to control the symptom, such as prednisone, anti-TNF drugs,azathioprine (Imuran), methotrexate, or 6-mercaptopurine. More commonly, treatment of IBD requires a form of mesalamine. Often, steroids are used to control disease flares and were once acceptable as a maintenance drug. In use for several years in Crohn's disease patients and recently in patients with ulcerative colitis, biologicals have been used such as TNF inhibitors. Severe cases may require surgery, such as bowel resection, strictureplasty or a temporary or permanent colostomy or ileostomy. Alternative medicine treatments for bowel disease exist in various forms; however such methods concentrate on controlling underlying pathology in order to avoid prolonged steroidal exposure or surgical excisement.

Usually the treatment is started by administering drugs with high anti-inflammatory effects, such as prednisone. Once the inflammation is successfully controlled, the patient is usually switched to a lighter drug to keep the disease in remission, such as Asacol, or Lialda®, a group of drugs called mesalamines. If unsuccessful, a combination of the aforementioned immunosuppression drugs with a mesalamine (which may also have an anti-inflammatory effect) may or may not be administered, depending on the patient.

For more advanced treatment, we have an infusion center in our main office location for the administration of infliximab (Remicade®) and certolizumab pegol (Cimzia®)which are biological anti-inflammatory treatments used to induce and maintain IBD remission. For outpatient therapy, patients can self-inject adalimumab (Humira®) on a weekly schedule to maintain remission.

For More Information contact the Crohn's and Colitis Foundation of America see: http://www.ccfa.org