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more articles by Lemberg, Brent D. , MD  |  author's bio

New Approaches to Treating Inflammatory Bowel Disease

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?

 

Sometimes IBD 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 weak. 

 

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 disease?

 

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.

 

Dr. 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.

 

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