Inflammatory Bowel Disease

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

November 24th, 2014 · Leave a Comment

The Natural History of Crohn's Disease and Ulcerative Colitis in Olmsted County

By Margaret Shepard

Edward Loftus Jr., M.D., discusses the the epidemiology and natural history of Crohn's disease and ulcerative colitis in Olmsted County during Grand Rounds presented by the Center for Clinical and Translational Science. Watch the video on the Medical Professionals Video Center.

For more information about IBD, visit mayoclinic.org/ibd.

Dr. Loftus is a gastroenterologist at Mayo Clinic.

Tags: Crohn's disease, Edward Loftus, Grand Rounds, ulcerative colitis

November 19th, 2014 · Leave a Comment

Diet and Inflammatory Bowel Disease

By Margaret Shepard

Edward Loftus Jr., M.D., a gastroenterologist at Mayo Clinic, discusses the topic of using nutrition in the setting of inflammatory bowel disease (IBD), dietary changes that may help patients with IBD, and the difficulty of proving whether or not specific diets are helpful in treating IBD.

 

For more information about IBD, visit mayoclinic.org/ibd.

Tags: diet, dietary changes, Edward Loftus, IBD, nutrition

November 14th, 2014 · Leave a Comment

IBD and Cervical Abnormalities

By Margaret Shepard

Sunanda Kane, M.D., discusses a recently published study in Clinical Gastroenterology and Hepatology about cervical abnormalities in women with inflammatory bowel disease.

Data in the past has suggested women with IBD have an increased risk for cervical abnormalities found on pap smears. This is due to the immunosuppressants used to treat patients with Crohn's disease and ulcerative colitis.

A new study just published compares a large group of women with IBD to women without IBD. The study shows women with IBD have just as much screening as women without IBD. The risk for cervical abnormalities was higher in women with IBD. In women with Crohn's disease, there was an increased risk for cervical cancer development, about 50% higher than the healthy population.

What does this mean for women with IBD? It means women should get annual pap smears and any abnormal cells identified should be looked into further.

Read the full article online here.

For more information about IBD, visit mayoclinic.org/ibd.

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: cervical abnormalities, IBD, Sunanda Kane

November 7th, 2014 · Leave a Comment

Management of IBD in Pregnancy

By Margaret Shepard

Sunanda Kane, M.D., discusses the management of inflammatory bowel disease and pregnancy during Grand Rounds. She provides an update about recent research in IBD and pregnancy. Watch the video on the Medical Professionals Video Center.

For more information about IBD, visit mayoclinic.org/ibd.

Dr. Kane is a gastroenterologist at Mayo Clinic.

Tags: Grand Rounds, IBD, Pregnancy, Sunanda Kane

October 31st, 2014 · Leave a Comment

Patient Story: Scott Hennen on Ulcerative Colitis and Mayo Clinic

By Margaret Shepard

Story originally posted on Sharing Mayo Clinic.

Scott Hennen, a radio talk show host from Fargo, ND, had surgery at Mayo Clinic to remove his colon, which had developed several sites with precancerous cells related to his ulcerative colitis, which was first diagnosed in 1997.

Scott had previously described his reasons for being public about his medical condition in this post. In the video below, he offers more background on his medical history and why he came to Mayo Clinic for his operation:

For more information about IBD, visit mayoclinic.org/IBD.

Tags: patient story, Sharing Mayo Clinic, ulcerative colitis

October 24th, 2014 · Leave a Comment

Ann Strom's Patient Story

By Margaret Shepard

Originally posted on Sharing Mayo Clinic.

As a 14-year-old, Ann Strom understandably had knots in her stomach about starting her freshman year of high school.

These knots, however, did not go away.

Following several weeks of abdominal pain, Strom and her parents began to suspect that her upset stomach was more than the result of nervousness or flu.

After a series of tests conducted by her family doctor came back negative, Strom was transferred to a specialist at a University Hospital. Several more rounds of tests, including Strom’s first colonoscopy at the age of 14, ultimately diagnosed her with Crohn’s disease in Oct. 2003.

Throughout high school, Strom alternated between several different medications in an attempt to control her symptoms. At one point, she was taking 14 pills a day. One in particular had terrible side effects, including feeling jittery, shaking, an elevated pulse and a red, puffy face.

“It’s kind of hard to deal with,” said Strom. “High school is a lot about appearances, so sitting there with a puffy, red face isn’t really fun.”

As Strom transitioned out of pediatric care, she began to consider other medical facilities for treatment. “I decided, after my mom had a doctor at Mayo, to switch my care to Mayo,” said Strom.

Upon arriving at Mayo, Strom met Dr. David Bruining, who recommended an aggressive re-assessment of her diagnosis. This time her testing was felt to be most suggestive of ulcerative colitis, not Crohn’s disease, as the cause of Strom’s condition.

“For patients like Ann, it is important to seek out help as they are not alone in their struggles,” said Dr. Bruining. “There are many treatment options available for patients with IBD.”

Though hopeful that this diagnosis was the correct one, towards the end of her freshman year of college Strom was still plagued by fatigue and abdominal pain.

“I was kind of at the end of the line when it came to medication options,” said Strom. “I could go back on high dosages of medication that caused really bad side effects that I hated in high school, or another option would be to have surgery.”

After much deliberation, Strom chose surgery. She completed a series of three surgeries, with a final take-down procedure in Oct. 2009.

Since then, Strom is back to her “new normal.”

“I’ve been feeling the best I’ve felt since I was 14 years old,” said Strom.

For more information about IBD, visit mayoclinic.org/IBD.

October 15th, 2014 · Leave a Comment

Proactive Monitoring

By Margaret Shepard

Edward Loftus Jr., M. D., discusses a recently published article in Inflammatory Bowel Diseases that looks at proactive Infliximab drug monitoring in patients. Infliximab treats Crohn's diseases and more recently, ulcerative colitis.

The recently published paper looks at proactive monitoring, instead of reactive monitoring which physicians have been doing. A physician at Bethel Decan Medical Center in Boston looked at 48 patients starting in 2009. The patients' blood levels were proactively checked regardless of the patients' condition. A control group of 78 patients either had a reactive approach or no drug monitoring at all.

A vast majority of patients did receive some adjustment in therapy. This resulted in patients staying on Infliximab for a longer period of time. 10% of the patients in the proactive arm resulted in less discontinuing Infliximab.

Read the full article online here.

For more information about IBD, visit mayoclinic.org/ibd.

Dr. Loftus is a gastroenterologist at Mayo Clinic.

Tags: Edward Loftus, IBD, monitoring

October 9th, 2014 · Leave a Comment

Crohn’s Disease and Remission with Vedolizumab

By Margaret Shepard

Edward Loftus Jr., M. D., discusses a recent article published in Gastroenterology looking at how well vedolizumab works with Crohn’s disease patients who have already been on an anti-TNF agent.

 

The study specifically examined the question of how well vedolizumab in patients with Crohn's disease who have already been on a different type of anti-TNF agent. The trial enrolled over 400 patients and 3/4 of the patients had to have previously failed one anti-TNF agent. About half of the patients enrolled failed two anti-TNF agents and a small percentage failed all three anti-TNF agents. The primary end point of the clinical trial was looking at the clinical remission rate at week six. Clinical remission was defined as a Crohn's disease activity index of 150 or less.

The patients in the trial received the drug at weeks 0, 2, and 6, and were followed until week 10.

The primary end point of the clinical trial was not met. About 15% of patients receiving vedolizumab and 12% receiving the placebo met the primary end point, and the results weren't significantly significant. However, at week 10, the remission rates were significantly different; the placebo rate stayed the same and the vedolizumab remission rate went up significantly.

The message from this study is that vedolizumab does work in patients that have failed other anti-TNF agents with significant difference showing up after week 10.

Read the full study online here.

For more information about IBD, visit mayoclinic.org/ibd.

Dr. Loftus is a gastroenterologist at Mayo Clinic.

Tags: Crohn's disease, Edward Loftus, Gastroenterology, Vedolizumab

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