CENTER FOR INFLAMMATORY BOWEL DISEASES
Medical-Surgery Clinic Offers Single Setting for Addressing IBD Patients’ Surgical Needs
When surgery becomes a potential option for patients with inflammatory bowel disease (IBD), many questions arise. If it’s not clear whether surgery is the best path forward, a thorough discussion of the pros and cons becomes paramount. And when the need for surgery is clear, patients with IBD, their medical providers, and the surgical team must work in tandem to address issues such as medical and nutritional optimization prior to the surgery, surgical planning, and post-surgical management. The combined Medical-Surgery Clinic at the Center for Inflammatory Bowel Diseases provides a single setting where patients with IBD can address all surgery-related needs with a team that includes their IBD physician, surgeon and dietitian. Patients start with a consultation to understand what the surgery will entail and why it is being considered. If they proceed with the surgery, they continue to visit the clinic both before and after the surgery to ensure optimal outcomes. The clinic is headed by Mary R. Kwaan, MD, MPH, a health sciences clinical professor of surgery who specializes in colon and rectal surgery, and Jenny Sauk, MD, director of clinical care for the Center for Inflammatory Bowel Diseases and a health sciences associate clinical professor of medicine. Dr. Sauk points out that there are a number of circumstances in which IBD patients benefit from combined medical and surgical management. “In Crohn’s disease, for example, perianal fistulas can be complex, and having a surgeon and IBD physician reviewing the data together with the patient allows that patient to best understand the sequence of events that need to occur for healing,” she says. Patients with Crohn’s disease may experience symptoms, such as abdominal pain, bloating, and nausea, due to stricturing disease, Dr. Sauk notes, and can benefit greatly from a joint consultation to determine whether continued medical treatment or a surgical intervention is the best approach. Dr. Sauk adds that patients who have had ulcerative colitis for many years may be at higher risk of developing dysplasia in the colon, raising difficult decisions about whether to consider colonic resection or consider further endoscopic surveillance. Joint discussions between the patient, surgeon and IBD specialist are important to determine optimal
strategies for management and ensure that there is clear communication with the patient about management. Often, patients visiting the Medical-Surgery Clinic haven’t decided whether surgery is the right option for them. “By meeting with both the surgeon and their IBD clinician in the same visit, patients can learn about the pros and cons so that they are more comfortable with the idea of surgery when they need it,” Dr. Sauk says. Once the surgery is scheduled, the team works cooperatively with the patient on nutritional optimization and the management of medications, as well as in anticipating potential complications following the procedure. The team works jointly with the patient after the surgery to address issues such as when to resume IBD medications and how to manage any symptoms they experience during their recovery. Seeing their IBD clinician and surgeon together at the same visit is something patients greatly appreciate, Dr. Sauk says. “We have many people who come from far away, and this allows them to have all of their IBD needs taken care of at the same time their peri-surgical needs are being addressed,” she says. “It’s also much more efficient for the patient, IBD provider and surgeon to meet together and come to decisions rather than going back and forth. By the time the patient comes in, we have reviewed the data and are ready for that discussion.”
Mary R. Kwaan, MD, MPH
9
Beyond the Scope
Made with FlippingBook - professional solution for displaying marketing and sales documents online