New Approaches to Treating
Inflammatory Bowel Disease
By Brent Lemberg, MD
Inflammatory bowel disease (IBD) is
a chronic inflammation of the intestines that affects one to two million
Americans. The inflammation may affect just the colon (the large intestine) but
it can include the entire digestive tract. This disease can be difficult to
manage; however, recent advances in treatment are very promising and the
prognosis for patients with IBD is much better than it was even five years ago.
What are the symptoms of
inflammatory bowel disease?
is fairly benign, while at other times it can be life threatening. Inflammatory
bowel disease consists of two illnesses: ulcerative colitis and Crohn’s
disease. They have similar symptoms including ulcers and bleeding in the
intestinal tract, profuse bloody diarrhea, severe abdominal pain, and weight
loss. People suffering from these conditions feel extremely ill, anemic, and
What’s the major difference between
ulcerative colitis and Crohn’s disease?
The major difference between the
two conditions is that ulcerative colitis is limited to the colon (rectum and
large intestine), whereas Crohn’s disease can affect the entire digestive tract
from the rectum to the esophagus. (About 50 percent of the time Crohn’s disease
affects both the large and small intestine.) Ulcerative colitis and Crohn’s
disease are both chronic diseases that typically first develop in people
between 18-25 years of age. The incidence rises again in people between 50 and
60, which is a phenomenon that puzzles researchers.
What causes inflammatory bowel
We don’t really know what causes
IBD. It does not appear to be genetic. Researchers believe there may be some
sort of environmental factor found in more developed countries because IBD is
more prevalent in the United States than in many other countries. Once the
immune system is triggered, it essentially goes into overdrive, attacking the
intestine and causing chronic inflammation.
What are the
major breakthroughs in treating IBD?
Treatment for IBD has changed
dramatically in recent years. The first significant breakthrough came with the
discovery that patients suffering with IBD could gain substantial, immediate
relief from their symptoms with a biologic therapy rheumatologists have used to
treat severe arthritis. Similar to rheumatoid arthritis, IBD is an immunologic
disease. Patients who are terribly sick with IBD often feel significantly
better after one infusion.
The second major breakthrough, in
the treatment of severe ulcerative colitis, begins with the surgical removal of
the colon. Historically, these patients have had to undergo a colostomy, which
entails the creation of an artificial opening to the exterior of the abdomen
through which the intestines can eliminate waste. This requires the patient to
wear an external bag to collect bowel movements. However, in a new procedure
perfected at the Cleveland Clinic, the surgeon uses tissue borrowed from the
small intestine to create an internal pouch, enabling feces to pass naturally
from the anus to the outside. This new approach eliminates the need for a
colostomy and allows people to resume normal lives.
These new therapies enable
gastroenterologists to help patients with IBD turn their lives around, often in
a matter of days. Moreover, we can help these patients remain healthier for
longer periods of time than ever before.
Lemberg is a member of the medical staff at Cayuga Medical Center and is in
practice with Gastroenterology Associates of Ithaca, where he can be reached at
(607) 272-5011. He is board certified in internal medicine and board eligible
in gastroenterology and hepatology. Following his internship and residency in
internal medicine at the University of Rochester, Strong Memorial Hospital, Dr.
Lemberg completed a three-year gastroenterology fellowship at the prestigious
Cleveland Clinic Foundation, where he served as chief fellow in his final year.