IBD for the non-gastroenterologist

Published on May 30, 2021   43 min

Other Talks in the Category: Clinical Medicine

This is Dr. Sunanda Kane, Professor of Medicine at Mayo Clinic College of Medicine in Rochester, Minnesota. And we're going to be talking about Inflammatory Bowel Disease and What the Internist Should Know. Why should we be talking about inflammatory bowel disease to the internist?
Well, from 1998 to 2005, there was a 450% increase in visits to primary care by Crohn's patients and 350% by ulcerative colitis patients. In that timeframe, there has been a decrease in the use of steroids and hospitalizations for Crohn's patients as well as for ulcerative colitis patients.
This means that primary care physicians are doing a very good job of treating these patients and keeping them off of steroids and keeping them out of the hospital. There is an increasing incidence and prevalence of inflammatory bowel disease as well. A systematic review with information dating back to the 1920s, showed a time trend analysis where 75% of Crohn's studies and 60% of ulcerative colitis studies had an increasing incidence of statistical significance. The highest annual incidence of ulcerative colitis at 24 per 100,000 person years is in Europe and actually there is an incidence now for Asia at 6.3 per 100,000. The highest annual incidence for Crohn's disease is about 13 people per 100,000 in Europe and 5 now in Asia. I often get asked about genetic testing. Is inflammatory bowel disease a genetic disorder? Well, there are now greater than 100 genes associated with Crohn's disease that have been identified. These are candidate genes not causative genes. And the genetic information we have has come from families with IBD, not single cases. So while genetic testing is commercially available, it needs to be in conjunction with counseling