Treatment of inflammatory bowel disease

  Inflammatory bowel disease is a specific chronic inflammatory bowel disease, or IBD for short, which mainly includes Crohn’s disease (UC) and ulcerative colitis (CD), with common manifestations such as recurrent abdominal pain, diarrhea, and mucus and blood stools. Currently this disease cannot be cured and requires long-term medication and nutritional support to maintain relatively good physical condition; if serious complications such as intestinal obstruction and perforation occur they need to be treated by surgery.  Due to the relatively late appearance of this disease and the variety of symptoms, many doctors do not have a thorough understanding of the disease, and most patients may have developed to moderate to severe disease at the time of diagnosis, making treatment very difficult. At the 3rd Annual Meeting of the Asian Inflammatory Bowel Disease Society (AOCC) held in Beijing recently, the chairman of the conference, a renowned gastroenterologist and former head of the Inflammatory Bowel Disease Group of the Chinese Medical Association’s Digestive Diseases Branch, said that it is because inflammatory bowel disease is very complex that multidisciplinary joint treatment is needed to achieve good treatment results.  Inflammatory bowel disease, especially Crohn’s disease, is complex and variable, especially in China, and the symptoms are very similar to intestinal tuberculosis, leukoaraiosis (rare in Western countries), lymphoma, etc. Therefore, the difficulty of diagnosis is further increased, and many patients have been transferred to multiple departments, and the disease has often reached a moderate to severe stage before being diagnosed. Therefore, the diagnosis of IBD cannot be made only by gastroenterology colonoscopy, but also requires multidisciplinary collaboration among pathology, radiology, ultrasound, and immunology; it cannot be solved by medical medication alone, but also relies on surgical treatment; in the case of minor patients, the involvement of pediatrics is also crucial.  The multidisciplinary treatment of inflammatory bowel disease requires a department as the main body, if other departments have patients with suspected inflammatory bowel disease, they will be referred to the specialized team of gastroenterology, and after this team receives the diagnosis, they will further contact the relevant departments to do joint diagnosis; in terms of treatment, the inflammatory bowel disease team has very close cooperation with gastroenterology and anorectal surgery – the time of consultation as well as surgery. The consultation and the timing of the operation, the preparation before the operation, the post-operative follow-up, how to prevent recurrence, a series of issues, will be given to patients with detailed planning.  For patients with inflammatory bowel disease, the IBD Center of Zhongshan Sixth Hospital also issues special consultation cards with unlimited registration numbers, which can be registered at any time during the time of the specialized outpatient clinic; for patients who come from abroad and need to be hospitalized, priority bed arrangements will be made; if patients are discharged from the hospital with stable conditions, they can also receive guidance on medication and review on a special online platform, and can be contacted at any time if they have special conditions. It can be said that multidisciplinary treatment greatly saves patients’ consultation cost and time, reduces the difficulty of diagnosis, and improves the efficiency of treatment.  Multidisciplinary treatment is especially suitable for patients treated with biological agents. Biological agents are very effective in early inflammatory bowel disease, especially in children and young patients; once intestinal complications such as intestinal infection, abscess, obstruction and stricture occur, biological agents cannot be used, but will aggravate the disease. Therefore, it is crucial for patients’ disease control to catch the treatment timing by early diagnosis with the help of multidisciplinary combination of surgery, imaging and pathology.