Ongoing Support: Washington University Physicians

Inflammatory bowel disease (IBD) can appear at almost any age, but for patients, the transition from childhood to adulthood is especially critical in terms of education and compliance, say Washington University physicians. They are working to ensure all IBD patients have the resources they need to feel their best and function normally throughout life.

IBD encompasses two conditions, Crohn’s disease and ulcerative colitis (UC). Both cause chronic inflammation of the digestive tract, but there is a key difference between them: Crohn’s can affect any portion of the tract, while UC is limited to the inner lining of the large intestine.

While they are two distinct issues, the symptoms of Crohn’s and UC can overlap. Both can cause abdominal pain, constipation, diarrhea, rectal bleeding, fever, fatigue, weight loss and other problems. Crohn’s also can cause mouth and tongue sores, as well as anal ulcers and infections. It’s important to see a doctor for a correct diagnosis and personalized treatment plan, says Dr. Matthew Ciorba, chief of the IBD program at Washington University School of Medicine. “We have outstanding resources and expert pathologists, radiologists and surgeons who provide a high level of care in both our child and adult IBD programs,” he says. “We work to ensure the two programs interact closely for a seamless transition from pediatric to adult care.”

Pediatric gastroenterologist Dr. Chip Samson says getting young people to adhere to an IBD treatment plan can be a challenge, so the Washington University team works closely with parents, psychiatric providers and social workers to help kids stay on track with medications and treatments. “At about age 16, we start having one-on-one conversations with them about assuming more responsibility for their health,” Samson says. “With some medicines, for example, they may not notice a big difference if they skip them for a day, so they may assume they don’t really need them. We take an individual approach, making sure each young patient understands how important these medications are.”

Gastroenterologist Dr. Cynthia Cherfane notes that challenges like moving away from home or starting college or a career can have a significant impact on young IBD patients. Stress and anxiety can lead to poor compliance with medicines and doctor visits, so they may need extra care and follow-up during this time. She says the team is establishing a new program to help young patients move smoothly into an adult care plan based on a timeline tailored to their needs. The program includes close communication between pediatric and adult IBD physicians; extra appointment time; advice from IBD nurses; psychiatric services; smartphone apps to help with compliance; and other resources.

Once patients transition into the adult IBD program, they can expect care that’s equally thorough and compassionate, says gastroenterologist Dr. George Christophi. “Genetics play a role in IBD,” he notes. “If your parents have it, your risk of getting it is greater. And we’re seeing an increase in incidence; about one in 250 people have IBD in the U.S. That’s significantly higher than 20 years ago. At Washington University, we take time to educate each IBD patient and establish a rapport to achieve the longterm goal of a high-quality life with limited impact from the disease.”

Washington University Physicians offers a comprehensive program of care and treatment for patients with IBD. Pictured on the cover: Deborah Hiatt-Jensen, ANP; Dr. Cynthia Cherfane; Dr. George Christophi; Dr. Charles Samson; Dr. Elizabeth Utterson. For more information, call 314.747.IBD6 (4236) or visit wuphysicians.wustl.edu/ibd.
Cover design by Washington University Physicians | Cover Photo by Mark Gilliland

Pictured at top: Dr. Matthew Ciobra
Photo: Mark Gilliland