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Inflammatory Bowel Disease at Atlantic Digestive Health Institute

Inflammatory bowel diseases (IBD) are chronic, autoimmune conditions, affecting primarily the gastrointestinal tract however other distant organs can be involved. There are two types of IBD: Crohn’s disease and ulcerative colitis. Crohn’s disease can affect any part of the gastrointestinal tract while ulcerative colitis is limited to the large bowel (colon).  

Crohn's Disease or Ulcerative Colitis?

Some patients have large bowel inflammation where we cannot reliably tell apart Crohn’s disease and ulcerative colitis and we use the term IBD- unclassified colitis. In terms of IBD, colitis can exist as either Crohn’s colitis or ulcerative colitis. This may be confusing since any form of large bowel (colon) inflammation is referred to as colitis. 

Infectious agents, lack of blood supply, diverticular inflammation, food allergies, medications can also cause colon inflammation we call colitis. It is important to realize that sometimes two or more of these causes of colon inflammation may exist along with the IBD.  

IBD impacts the lives of more nearly two million patients in the United States. Our Inflammatory Bowel Disease Center of Excellence at Morristown Medical Center is the premier adult center for those suffering with Crohn’s disease and ulcerative colitis. 

In addition to IBD we treat other immune mediated gut disorders such as: 

  • Celiac sprue       
  • Eosinophilic esophagitis and gastroenteritis 
  • Microscopic colitis 
  • Autoimmune enteropathy 
  • Cancer treatment induced enteritis and colitis  
  • Immune deficiency related gastrointestinal disorders 

How We Diagnose Inflammatory Bowel Disease

Inflammatory Bowel Disease is diagnosed using a combination of laboratory (blood and stool markers) endoscopy, radiology and pathology tests. Other infectious, nutritional, immune, neurologic, psychiatric issues can be present and need to be evaluated to fully understand the presentation of IBD.  

Endoscopic assessment includes: 

  • Upper endoscopy (EGD) 
  • Lower endoscopy ( colonoscopy)
  • Small bowel endoscopy using a smart pill size device that records video (video capsule endoscopy, VCE)
  • Small bowel endoscopy that can reach far into the gut (single or double balloon endoscopy)
  • Endoscopic ultrasound (especially for those with anal fistulas, abscess),
  • Endoscopy of the “pipes” draining the bile form the liver or juice from the pancreas (ERCP) 

All patients with IBD have a risk of large bowel (colon) cancer related to inflammation, disease duration as well as family history, nutrition and associated liver disease (primary sclerosing cholangitis, PSC). Early cancerous lesions are often invisible with the use of a regular endoscopy instrument. Our center uses advanced techniques that involve spraying a dye on the surface of the bowel (chromoendoscopy) or using a laser device that functions as microscope for live views of your cells in the bowel (confocal laser endomicroscopy, pCLE).  

Imaging methods often times require special protocols. Instead of plain CT scan or MRI we use a variation called CT enterography or MR enterography. The assessment of anal complications requires MRI with a fistula protocol and for those with associated liver disease (primary sclerosing cholangitis, PSC) there is a special MRI called MRCP.  

Many patients with IBD have metabolic problems which include fatty liver. We offer a non-invasive test (Fibroscan) that measures the amount of fatty tissue and scar in the liver.  Learn more >

How We Treat Inflammatory Bowel Disease

Although there is no cure for IBD, many treatments can reduce and control the symptoms of the disease, which can include:

  • Persistent diarrhea
  • Abdominal pain
  • Anal discomfort
  • Bloody stools
  • Weight loss 
  • Fatigue

Symptoms other than gastrointestinal (extraintestinal) include:

  • Inflammation of the eyes, mouth ulcers
  • Joint pain
  • Back pain
  • Skin lesions

Gastrointestinal symptoms often do not correlate with the severity of disease and not uncommonly the extraintestinal symptoms are important clues that lead to IBD diagnosis before any gastrointestinal symptoms appear.  

Medical therapy is increasingly complex; however we allow ample time to our patients to understand risk and benefits and help them to make informed decisions. We employ cutting-edge biologic therapies and small molecules to promote long lasting remission and improve quality of life.

Our collaborative approach allows a seamless transition from surgery to medical management. The IBD team utilizes immune markers to customize these therapies instead of randomly offer therapy choices. 

Learn more about digestive diseases at Atlantic Health System > 

Our Medical Team

Medical therapy is increasingly complex; however we allow ample time to our patients to understand risk and benefits and help them to make informed decisions. We employ cutting-edge biologic therapies and small molecules to promote long lasting remission and improve quality of life.

Our collaborative approach allows a seamless transition from surgery to medical management. The IBD team utilizes immune markers to customize these therapies instead of randomly offer therapy choices. 

Our nutritionists, dieticians and behavioral specialists complement these interventions with personalized advice that complete the circle of care. Whenever approved medical and surgical therapies are failing, we provide numerous opportunities to participate in clinical trials.  

Often, IBD patients are affected by recurrent bowel infection with Clostridium Difficile bacteria. Some of these patients require restoration of gut microbiome. Our center developed a program of fecal microbiota transplantation complemented by dietary advice and immune boosting strategies to overcome this infectious disease. 

Research and Clinical Trials

We have a multidisciplinary team consisting of expert gastroenterologists, colorectal surgeons, nutritionists, behavioral health specialists, pathologists, radiologists and clinical pharmacists.   Our IBD team provides a one stop shop and offer meaningful experiences such as tandem appoints with the IBD gastroenterologist and colorectal surgeon. 

We provide second opinion consultations that help streamline your IBD care, while maintaining patient relationship with the primary gastroenterologist. Our IBD transition program allows pediatric patients to seamlessly integrate in the adult care and provide opportunities for a whole family approach in collaboration with the IBD Pediatric Center at Morristown. 

Research

We employ advance care plans that draw upon the latest research in the areas of gut immune system, gut microbiome, nutrition, exercise and psychological well-being. We are actively involved in cutting edge clinical and translational research that enable us to pioneer new therapies and help patients regain health, vitality and quality of care. Find out more >