IBD for the non-gastroenterologist

Published on May 30, 2021   43 min

A selection of talks on Clinical Practice

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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.