Inflammation is an elusive disease – especially when it comes to diagnosing disorders related to it. Conditions linked to the GI tract can be perplexing, leaving both specialists and patients with many unanswered questions. According to the Crohn’s & Colitis Foundation, Inflammatory Bowel Disease (IBD) – or chronic inflammation in the digestive tract – plagues 1.6 million Americans. An umbrella term, IBD can either be classified as one of two disorders: Ulcerative Colitis, long-lasting inflammation, and ulcers in the large intestine and rectum, or Crohn’s Disease, which is marked by inflammation in the lining of the digestive tract.
Dr. Scott Becker and IBD
According to Dr. Scott Becker, a seasoned gastroenterologist with over 28 years of experience under his belt, detecting which disease a person has posed problems. Becker practices medicine at Austin Gastroenterology in Texas, where he diagnoses and treats a variety of gastrointestinal woes, including IBD. Symptoms of IBD include diarrhea, abdominal pain, rectal bleeding, bloating, constipation, fever, skin rash, and weight loss (to name a few). However, many of these symptoms are symbiotic – with about 15 percent of IBD sufferers not fitting into one disease category or the other.
The main predicament with treating patients diagnosed with IBD is that the insurance companies employ a “step therapy” method for funding medications. Essentially, they wait to see if one drug fails before approving coverage of more expensive (and in many cases more effective) medications. Unfortunately, in several cases, these risky cost-saving policies can actually end up costing people their lives. According to a study conducted by the Crohn’s & Colitis Foundation, 40% of the 2,602 responses indicated that negative impacts resulted from the wait-and-see viewpoint of “Step Therapy”. It’s not a patient-centric approach, but rather a cost-centric one.
Becker touts the use of drug-level and antibody testing (biomarkers) to discover whether a patient shows signs of Crohn’s or Ulcerative Colitis – and thus, prescribe more effectively. Today’s modern-day blood tests can precisely record the levels of antibodies, the proteins produced by the immune system to ward off disease. The use of these methods has helped immensely in getting people on the right medications, faster. As a result, approximately 50% of Becker’s patients respond to the first drug that is prescribed to them.
Medications for IBD
Another conundrum Gastroenterologists face is the dark side of using immune system suppressors, the drugs commonly used to treat IBD. Remicade and Azathioprine suppress the amount of TNF (Tumor necrosis factor) and the body’s immune system overall. To truly comprehend this concept, consider what inflammation really is – the body’s way of fighting off disease by removing negative stimuli, and triggering the healing process. While these immune inhibitors are highly effective for reducing the swelling associated with IBD, they put the body at greater risk for developing Lymphoma (lymph node cancer). In many cases, doctors feel the risk is worth the reward – as the chances of developing cancer are very small – 6-9 in 10,000, as opposed to the 2-3 in 10,000 risks for the average Joe.
These immune suppressants respond very well, and in many cases, can prevent the need for surgery altogether. Many doctors (Becker included) are treating more cases of IBD with stronger treatments earlier on. It seems to be the wave of the future, and will hopefully help more people with bowel disorders to obtain a better quality of life. Now, getting the insurance companies on board from the get-go is the next major step. For more information about IBD treatments, or to schedule a consultation with Dr. Becker’s team, contact Austin Gastroenterology for an appointment at the location nearest you.