From Gut-Wrenching Pain to Hope for the Future

UPMC’s Inflammatory Bowel Disease (IBD) Center wields a powerful “triple threat” against IBD; groundbreaking immunology, genetics research, and innovative clinical care

At age 23, John Oliver* is feeling better about the future. Free from the gutwrenching pain of Crohn’s disease since a second bowel resection in 2008 — this time followed by a promising new treatment developed at UPMC using anti-TNF medication — he is now making plans to attend medical school next fall.

“I think the medicine is working. It’s the best I’ve felt and the best I’ve looked,” says John, who earned his biomedical engineering degree from Carnegie Mellon University and a master’s degree in engineering management from Duke University.

His gastroenterologist, Miguel Regueiro, MD, clinical head and codirector of the UPMC Inflammatory Bowel Disease Center, says the future has never looked brighter for IBD patients. “Ten years ago, a diagnosis of IBD was devastating. Now, we have new medicines, a greater understanding of the disease, and better research,” he says.

IBD: Who’s at risk?

Nearly two million Americans live with IBD, which is not to be confused with irritable bowel syndrome (IBS). IBD involves two chronic diseases that cause inflammation of the intestines: ulcerative colitis and Crohn’s disease. Symptoms include abdominal cramps and pain, diarrhea, weight loss, and bleeding. Crohn’s disease can affect any part of the small and large intestines, while ulcerative colitis affects the large bowel alone.

IBD cuts across all ages, genders, and ethnicities, but generally affects Caucasians ages 15 to 35. While the exact cause is not known, experts believe IBD involves a compromised or overactive immune system. Because IBD may run in families, doctors also believe genetics plays a role. While stress and certain foods do not cause IBD, both can make symptoms worse.

Treatment According to Dr. Regueiro, drugs cannot cure IBD, but they can be effective in reducing the inflammation and accompanying symptoms. While some patients have mild symptoms requiring little medication, others have more debilitating flareups, and some patients have severe problems requiring surgery and even transplants.

The primary goal of drug therapy is to reduce inflammation in the intestines. Medications include anti-inflammatory drugs; antibiotics to kill germs in the intestinal track; probiotics to restore good bacteria; corticosteroids to provide short-term relief during flare-ups; and immunosuppressants.

In addition, the IBD Center recently developed a Visceral Inflammation and Pain (VIP) Center to help patients deal with both the physical pain and emotional stress of coping with IBD.

Exciting breakthroughs

The latest generation of drugs, called biologic therapies, are proving very effective in inducing remission so that patients can lead normal lives.

At UPMC, doctors took this approach a step further — as in John’s case — by prescribing biologic anti-TNF therapy after performing surgery to remove the damaged section of the intestine. In use now at other hospitals, this treatment has reduced the recurrence of Crohn’s disease in patients by nearly two thirds.

* John Oliver’s treatment and results may not be representative of similar cases.