“Suffering in silence” is commonly shared by those afflicted with Crohn’s disease or ulcerative colitis. Sufferers opt not to mention their physical pain to friends, family, or coworkers, much less seek expert medical attention before something like an ER visit or hospitalization occurs. They bend to social stigma against acknowledging and discussing “bathroom diseases.”
But as World IBD Day on May 19th approaches, those with inflammatory bowel disease (IBD) face a brighter future. New diets and therapies are being explored. New medications are becoming available. New clinical trials are underway.
We are moving closer to a “precision medicine” approach – individualized treatment, customized according to each patient’s genetic and microbiome data – that holds the promise of truly living a more normal life.
Treating Crohn’s and Colitis
New medical treatments already are available for both Crohn’s disease and ulcerative colitis patients. In addition to anti-tumor necrosis factor (anti-TNF) drugs, we now have new biologic agents with novel active ingredients, such as vedolizumab (Entyvio) and ustekinumab (Stelara). These can be especially helpful for patients who have not responded well to anti-TNF drugs.
We also now have, for the first time for IBD patients, a small molecule inhibitor called tofacitinib (Xeljanz), which can be taken by mouth by patients with ulcerative colitis.
Dietary IBD therapy is drawing interest and is now being studied in greater detail. For example, now underway is a randomized, controlled trial of the specific carbohydrate diet vs. a Mediterranean-style diet in patients with Crohn’s disease.
There is also a lot of interest in manipulating the microbiome in order to treat IBD. We now have some evidence that stool or fecal microbiota transplantation (FMT) can help some patients with ulcerative colitis.
Another area of hope: identifying disease exacerbation even before patients notice symptoms of a flare-up. This involves combining data points, including lab values and patient symptoms entered via an app. Some patients could even test themselves at home.
Science and Art of Managing IBD
Still, IBD management is both science and art. Specialists such as myself identify appropriate therapy by reviewing individual patient data and applying our many years of clinical experience.
It still can take time to find the best treatment for a particular patient – but with a “precision medicine” approach, we can more quickly find targeted therapy that minimizes or eliminates adverse effects.
There definitely is more hope, now and on the horizon, for Crohn’s and colitis sufferers.
On Saturday, May 18th, the annual Austin Take Steps Walk to raise awareness about Crohn’s disease and colitis begins at The Long Center at 11 a.m. As a member of the Crohn’s and Colitis Foundation Central Texas Chapter Leadership Board, I hope you will take advantage of this opportunity to meet other patients and caregivers.
If you would like to make an appointment with a skilled gastroenterologist, fill out our simple online form today. Our team has years of experience diagnosing and treating those who have inflammatory bowel disease and other GI tract issues, and we can help get you on the path to health and wellness.
