UPMC On Topic
Inflammatory Bowel Disease
Miguel Regueiro, MD
Director, Inflammatory Bowel Disease Center
Inflammatory bowel disease is a disease that encompasses two primary diseases: one is Crohn’s disease and the other is ulcerative colitis. It can be very hard to deal with. Many people feel that their self-worth or their self-image is changed by this. It clearly has carried a stigma in one’s mind and in the country as far as having this diagnosis. So clearly, it cannot manifest with physical symptoms but often can manifest with emotional symptoms as well.
The UPMC Inflammatory Bowel Disease Center really has looked to revolutionizing the treatment of Crohn’s and ulcerative colitis. We look to try to better diagnose earlier and make accurate diagnosis of the disease and then with a variety of treatments from antiinflammatories to what we call biologic or immunologic treatments, we look at really targeting the disease at the root of the problem to completely heal the inflammation and essentially put people into remission.
Our inflammatory bowel disease center is quite large, it encompasses a variety of physicians who are gastroenterologists, surgeons, nutritionists. We incorporate pediatricians because oftentimes it’s a disease that affects young patients and they transition to adulthood. We’ve even incorporated the intestinal transplant, Starzl Transplant Institute into this. And now we’ve even included mental health specialists, that really look at not only the physical aspects of the person but the whole emotional well-being as well.
The one aspect of research that I’ve been most excited about in the last two to three years has really been looking at patients who require surgery for Crohn’s disease, who historically have come to not only one surgery but two, three, four, five, sometimes even six surgeries in their lifetime. What we’ve researched here at the UPMC Inflammatory Bowel Disease Center is using a specific class of medicine after surgery to prevent recurrence and almost giving the patient, if you will, brand new looking intestines. We can almost not tell that they’ve ever had Crohn’s disease before, they don’t go to more surgery and their Crohn’s disease doesn’t seem to come back.
We’ve been trying to prevent surgery and inflammatory bowel disease as a primary outcome and we think that if we get to the disease early enough, if we see that patient with inflammatory bowel disease at an early enough time in their diagnosis, when the inflammation hasn’t caused scarring or hasn’t caused irreversible damage to the bowel, that we can treat that patient, reverse the inflammation which consequently would prevent surgery down the line. Twenty to thirty years ago, unfortunately, this was a fairly hopeless situation in the sense that we had very limited treatment and very limited understanding of the diagnosis. Now we have over 25 different treatment medicines, we have much better diagnostic interventions, and we’re able to impact patients with these treatments in a way that we’ve never been able to do before.
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