Inflammatory Bowel Disease

Discussing the latest advances in Crohn’s disease and ulcerative colitis

September 25th, 2015 · Leave a Comment

The Success of In Vitro Fertilization (IVF) in IBD Patients

By Kanaaz Pereira Kanaaz Pereira

The ability to become pregnant is an issue that many women face, and having inflammatory bowel disease (IBD) certainly adds to the many challenges.¬†Women who undergo colectomy and ileal pouch‚Äďanal anastomosis (IPAA or J-pouch)¬†are at an increased risk for infertility due to surgical factors, and often consider using assisted reproductive techniques such as¬†in vitro fertilization (IVF).

Dr. Sunanda Kane, M.D., talks about some encouraging news as investigators from two tertiary centers in Boston have shared their experience with IVF.

The information in these studies, which have been published in Clinical Gastroenterology and Hematology, and The American Journal of Gastroenterology, is potentially reassuring, and provides further hope for infertile couples with IBD.

Read the first study online here.

Read the second study online here.

For more information about IBD, visit

Dr. Kane is a gastroenterologist at Mayo Clinic.


Tags: American Journal of Gastroenterology, Clinical Gastroenterology and Hepatology, colectomy, IBD, J-pouch, Sunanda Kane

September 13th, 2015 · Leave a Comment

No Association Between Isotretinoin Exposure and IBD

By Kanaaz Pereira Kanaaz Pereira

The association between the use of Isotretinoin, a synthetic vitamin A derivate, and the risk of inflammatory bowel disease (IBD), remains a controversial issue, according to a study published in JAMA Dermatology.

Dr. Joseph Murray, M.D., and colleagues conducted a single-center study of about 1,000 people in Olmsted County, Minnesota, and separated them into two groups.The exposed group included patients with prior isotretinoin exposure, and the nonexposed group were defined as patients who never received isotretinoin or received it after the diagnosis of IBD. The findings of the study did not show an increased risk of IBD with prior isotretinoin use. If anything, the risk seemed to be decreased!

The existing evidence is also reassuring for dermatologists, as Isotretinoin is the standard treatment for severe acne. Since a causal association between Isotretinoin and IBD remains unproven, Dr. Murray suggests that physicians should not avoid prescribing this effective acne therapy because of concerns for the development of IBD.

Read the full study online here.

For more information about IBD, visit

Dr. Murray is a gastroenterologist at Mayo Clinic.


Tags: acne, IBD, Isotretinoin, JAMA Dermatology, Joseph Murray

August 27th, 2015 · Leave a Comment

New Stem Cell Therapy for Crohn's Fistula

By Kanaaz Pereira Kanaaz Pereira

Crohn’s fistula can be a devastating condition with a high recurrence rate. Listen to Mayo Clinic gastroenterologist, William Faubion, M.D., talk about exciting new research that shows how stem cells have been used to successfully treat Crohn’s fistula. This study has been published in Stem Cells Translational Medicine.

Read the study online here

For more information about IBD, visit

Dr. Faubion is a gastroenterologist at Mayo Clinic, specializing in pediatric and adult inflammatory bowel disease (IBD).




Tags: Crohn's Disease, Crohn's fistula, IBD, stem cells, Stem Cells Translational Medicine, William Faubion

August 17th, 2015 · 1 Comment

Fecal Transplants for Ulcerative Colitis?

By Kanaaz Pereira Kanaaz Pereira

There is currently great interest in treating ulcerative colitis with fecal microbiota transplantation (FMT), which involves transplanting gut fecal bacteria from healthy people into patients with ulcerative colitis. Edward Loftus Jr., M.D., a gastroenterologist at Mayo Clinic, talks about two newly published studies in Gastroenterology; both studies examined the efficacy of fecal microbiota transplantation in ulcerative colitis, but arrived at different conclusions.

In the first trial, adult participants received fecal transplants from healthy anonymous donors via retention enema. Results from this trial showed that fecal microbiota transplantation safely induced remission in patients with active ulcerative colitis.

In the second study, patients with moderately active ulcerative colitis were also treated with donor stool; this time it was delivered via nasoduodenal tube, where a tube is inserted down the nose, through the oesophagus and stomach, and into the duodenum. However, the outcome of this study showed no significant improvement in the disease.

Researchers explored the reasons why one trial of FMT for ulcerative colitis was positive, while another was negative. They questioned the different modes of delivery of fecal microbiota, raising the possibility that administering it via the upper GI route might render the active bacteria ineffective by the time it reaches the diseased colon. The difference in frequency of infusions between the two trials could also have been a significant factor.

The jury is still out on whether FMT can effectively treat ulcerative colitis, and Dr. Loftus strongly cautions against a do-it-yourself or at-home treatment. Rather, he encourages patients to be part of a clinical trial, and there is hope that as researchers are able to better understand the active component of FMT, it will enable future therapies.

For more information about IBD, visit

Dr. Loftus is a gastroenterologist at Mayo Clinic.

Tags: Edward Loftus, fecal transplant, Gastroenterology, IBD, ulcerative colitis

August 7th, 2015 · Leave a Comment

Therapeutic Management of Children with Very Early-Onset Bowel Disease

By Kanaaz Pereira Kanaaz Pereira

Once a medical rarity in children, inflammatory bowel disease (IBD) is increasingly common in kids today. Patients who are diagnosed with this disease at a very young age, sometimes less than 6 years old, have what is known as very early-onset IBD (VEO-IBD). Mayo Clinic gastroenterologist, Michael Stephens M.D., discusses a study published in The Journal of Pediatrics, that evaluates the diagnosis, management and long-term outcomes of children with very early-onset IBD.

The study found that children with VEO-IBD can present unique challenges to physicians and health-care providers. It starts as a relatively mild disease, and tends to be isolated to the large intestine. Over time, however, it changes in behavior, becoming more severe, and involving other regions of the intestine.

VEO-IBD is appearing more frequently on physicians' radars, and it is important to recognize that children are not small adults. Many of the children have definable problems with their immune system, and collaborating with good immunologists, as well as advanced genetic testing can facilitate more customized and enhanced treatment.

Read the full story online here.

For more information about IBD, visit

Dr. Stephens is a gastroenterologist at Mayo Clinic.

Tags: genetic testing, IBD, immune system, Michael Stephens, The Journal of Pediatrics, VEO-IBD

July 30th, 2015 · Leave a Comment

IBD vs. IBS: What's the Difference?

By Kanaaz Pereira Kanaaz Pereira

Often, inflammatory bowel disease (IBD) is easily confused with irritable bowel syndrome (IBS). Clinical manifestations of irritable bowel syndrome and inflammatory bowel disease can overlap. However, there are some clinical characteristics that can help differentiate between them:

  • IBD refers to the chronic swelling (inflammation) of the intestines.¬†Crohn's disease and ulcerative colitis are the two terms most often associated¬†to the different types of IBD. Most people with IBS will not develop IBD,¬†but¬†irritable bowel syndrome symptoms can occur with increased frequency and severity in patients with chronic IBD.
  • IBS is not a disease, and it does not lead to colon cancer or bleeding. IBD, on the other hand, can put patients at risk for colon cancer, and bleeding is a common symptom. Watery diarrhea is common in both, but¬†bloody diarrhea is consistent with IBD and¬†does not occur in IBS.
  • Excess gas, bloating, heartburn are more likely to be due to IBS, rather than IBD.
  • IBS is characterized by a combination of¬†abdominal pain,¬†cramps,¬†constipation, and¬†may be¬†relieved by a bowel movement. Abdominal pain due to IBD is often constant, in a specific location, and not relieved by a bowel movement.
  • Weight loss is common in active IBD, but is uncommon in IBS.

The facts above are by no means a complete list of signs and symptoms, but do give a general idea of the basic distinguishing factors between IBS and IBD.

For more information on IBD, visit

Tags: Colon Cancer, Crohn's Disease, IBD, Ibs, ulcerative colitis

July 11th, 2015 · Leave a Comment

Surveillance Colonoscopy May Reduce Colorectal Cancer Risk in Ulcerative Colitis

By Kanaaz Pereira Kanaaz Pereira

John Kisiel, M.D., a gastroenterologist at Mayo Clinic, helps us understand the benefits of surveillance colonoscopy for patients with ulcerative colitis (UC), which can reduce the risk of colorectal cancer. In this study, published in the American Journal of Gastroenterology, researchers report data from the St Mark’s Hospital UC surveillance program, one of the largest and longest-running programs in the world.

The study includes the following significant findings:

There is a higher risk of colorectal cancer in patients with ulcerative colitis. Regular surveillance colonoscopy helps in the detection of cancer at an earlier stage, allowing patients to retain their colon for longer, as well as increasing the survival rate.

Two types of colonoscopy have been performed in the last decade: chromoendoscopy, where dyes are instilled into the gastrointestinal tract, and white light colonoscopy. The rate of detection of pre-cancerous changes is significantly higher with chromoendoscopy, and it is important to note that subsequently the need for colectomy has decreased. However, the risk of interval cancer was about the same for those who got chromoendoscopy, as opposed to white light endoscopy. Thus, for patients and providers who may not have access to chromoendoscopy, high definition white light endoscopy is an effective option.

Approximately 50% of patients with high grade dysplasia had a synchronous colon cancer, and routine colonoscopy and removal of the high grade lesions alone is not sufficient.

Read the full story online here.

For more information about IBD, visit

Dr. Kisiel is a gastroenterologist at Mayo Clinic.

Tags: American Journal of Gastroenterology, chromoendoscopy, Colorectal Cancer, dysplasia, high definition white light endoscopy, IBD, John Kisiel, ulcerative colitis

July 3rd, 2015 · Leave a Comment

Genome Sequencing Plays Increasing Role in Pediatric IBD

By Kanaaz Pereira Kanaaz Pereira

Over the past two decades, researchers have been better able to understand the role of genetics in patients with inflammatory bowel disease (IBD). At Mayo Clinic, a unique collaboration between pediatric gastroenterology and the Center for Individualized Medicine (CIM) offers young patients the opportunity for deep sequencing of DNA, and in most cases exome sequencing to try to identify the genetic basis of their symptoms as well as a therapeutic strategy to treat them.

Dr. Michael C. Stephens, M.D., a pediatric gastroenterologist at Mayo Clinic has  been actively involved in an international effort to identify better ways to stratify patients with IBD, with a focus on factors that predict more-severe disease. "One of our goals is to use the integration across pediatric and adult GI as well as the CIM to provide a comprehensive multidisciplinary program for families with multiple affected members. The family could come to Mayo and have adult and pediatric specialists collaboratively build a treatment strategy," says Dr. Stephens.

Read more in the Digestive Diseases Update.

For more information on IBD, visit

Dr. Stephens is a pediatric gastroenterologist at Mayo Clinic.

Content originally posted in the Digestive Diseases Update.


Tags: center for individualized medicine, Digestive Diseases Update, genetics, IBD, Michael C Stephens

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