ASGE Annual GI Advanced Practice Provider Course (Virtual) - Day Two

23_Evaluation of IBD - Heagy

Pdf Summary

The document provides an overview of the management of inflammatory bowel disease (IBD), specifically ulcerative colitis and Crohn's disease. It discusses the pathogenesis of these diseases, clinical features, diagnosis, and various management options.<br /><br />Ulcerative colitis is characterized by bloody diarrhea, urgency, abdominal pain, and mucosal involvement limited to the colon. Crohn's disease, on the other hand, involves diarrhea, abdominal pain, weight loss, and can affect the entire digestive tract from the mouth to the anus.<br /><br />Diagnosis of IBD involves evaluating clinical symptoms, conducting endoscopic and radiological tests, and analyzing laboratory markers such as CRP, ESR, anemia, and fecal calprotectin. It's important to rule out other conditions such as enteric infections and C. difficile.<br /><br />The management goals for IBD include inducing and maintaining remission, reducing inflammation, improving quality of life, and preventing hospitalizations and surgeries. Treatment options vary based on the severity and extent of the disease, and may involve medications such as 5-aminosalicylates, corticosteroids, immunomodulators, and biologics. Therapeutic drug monitoring (TDM) is recommended to optimize treatment and avoid treatment failure.<br /><br />The document also emphasizes the importance of regular follow-up for established IBD patients to monitor disease activity, assess medication efficacy, and address extraintestinal manifestations. It highlights the importance of health maintenance interventions, such as cancer screening and vaccination.<br /><br />Additionally, the document provides recommendations for managing flares in IBD patients, including assessing medication compliance, ruling out infections, and adjusting treatment accordingly. Urgent work-in slots are advised for flaring patients.<br /><br />Overall, the document underscores the need for personalized and comprehensive management of IBD to achieve optimal outcomes and improve patients' quality of life.

Keywords

inflammatory bowel disease

ulcerative colitis

Crohn's disease

pathogenesis

clinical features

diagnosis

management options

5-aminosalicylates

corticosteroids

immunomodulators