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Hello, I am Dr. Sunanda Kane,
professor of medicine and gastroenterologist at Mayo Clinic in Rochester,
Minnesota in the United States.
Today we're going to talk about inflammatory bowel
disease (IBD) for the non-gastroenterologist.
Today, our learning objectives include: understanding the changing epidemiology of IBD;
recognizing some common mimics, of Crohn's disease in particular;
appreciating the therapeutic monitoring for IBD;
and being comfortable with non-therapeutic management issues in the IBD patient.
Why should we talk about IBD at all for the non-gastroenterologist?
It's very interesting that there was a nice epidemiologic study done looking
at the care of IBD patients from 1998 through 2005.
During this time, there was a 450 percent increase in visits to
primary care physicians by Crohn's patients, and
350 percent by ulcerative colitis patients.
The decrease in Crohn's disease patients for 5-ASA use was seven percent,
steroid use was decreased by 36 percent in Crohn's and 27 percent in ulcerative colitis.
The good news here was a decrease in hospitalizations by
33 percent in Crohn's patients and almost the same in ulcerative colitis,
then the decrease in surgery didn't change for Crohn's,
but there was a 50 percent decrease in surgery rates for ulcerative colitis over
this timeframe when there was a parallel in increased visits to primary care physicians.
Clearly, there is a signal here that primary care is as important as,
if not more important
than, the care from a gastroenterologist in terms of outcomes and treatment.