USF Health expands care for IBD patients

USF Health is expanding care within its digestive diseases program, creating a new center focused fully on inflammatory bowel disease (IBD).

The USF Health Inflammatory Bowel Disease Center – the only one of its kind on the West coast of Florida – includes a team of experts providing comprehensive, personalized care to help patients manage this incurable disease and improve their quality of life.

Central to the IBD Center is multidisciplinary care, pulling expertise from a range of specialties to help treat and manage various comorbidities IBD patients may experience. And, as this region’s only academic physician group, USF Health is able to offer the newest treatment options and clinical research.

“Our IBD team is comprised of expert gastroenterologists, advanced colorectal surgeons, and specialized nurse practitioners who work collectively to address the various needs of our IBD patients” said Renée Marchioni Beery, DO, assistant professor of medicine and medical director of the USF Health IBD Center.

“What sets this team apart is its intense focus on IBD as a complex and multifaceted disease that often requires care from multiple providers across different specialties. We approach complex medical and surgical issues, provide high-quality continuity of care, and house a growing research program with clinical trials and data registries that offer the latest advances in the field.”

IBD affects nearly 2 million Americans and encompasses two main conditions, Crohn’s disease and ulcerative colitis. The disease is characterized by chronic inflammation of the gastrointestinal tract with periods of relapse and remission.

Expanding the IBD program builds upon USF Health’s established strengths in its nationally renowned Division of Digestive Diseases and Nutrition. The new Center will continue to care for complex IBD cases, including those associated with Crohn’s disease, ulcerative colitis, perianal disease, pouchitis and cuffitis, and ostomy-related complications.

Combining experts from multiple specialties, the USF Health IBD Center team includes expert gastroenterologists, leading colorectal surgeons, advanced practice providers, and specialized dieticians, who provide guidance on medical and surgical interventions, nutritional counseling, ostomy care, social services, and other resources to address and manage the needs of the whole person.

“The concept behind creating our Center is to provide a true medical home for these complex patients,” said Mark Moseley, MD, MHA, CPE, FACEP, chief clinical officer for USF Health and associate dean for Clinical Affairs at the USF Health Morsani College of Medicine.

“Our goal is to ensure that patients never need to leave Tampa Bay to receive the highest quality care. Our experts have the requisite experience and expertise to care for IBD patients in an academic environment that supports education and the discovery of new therapies for these challenging diseases.”

Many patients suffering from IBD will find the need to consult with a surgical specialist, known as a colorectal surgeon. Surgical procedures are sometimes necessary to relieve conditions that are not adequately managed by medication alone. The multidisciplinary team in the USF Health IBD Center has extensive knowledge in IBD-related surgical procedures and interventions, as well as years of practice dedicated to complex IBD cases, and thus provides individualized care toward optimizing timing of surgical intervention.

“At USF Health, we have a team of colorectal surgeons who have specific expertise in managing the surgical aspects of IBD,” Jorge Marcet, MD, professor of surgery and director of Colon and Rectal Surgery in the USF Health Morsani College of Medicine, and co-director of the USF Health IBD Center with Dr. Marchioni.

“Our highly trained surgeons are experts in minimally invasive surgical procedures that reduce pain and hospital stay, and enhance the recovery of patients so they may return sooner to healthier, more productive, and happier lives. The surgeons and gastroenterologists of the USF Health IBD Center, along with other members of the team, meet regularly at the IBD Multidisciplinary Conference to discuss and coordinate patient care. Working in a multidisciplinary team setting, we are better able to understand and manage the intricacies of care and to offer the best possible outcomes to our patients.”

In addition to advanced clinical care, the Center will house a robust research program, offering cutting-edge clinical trials to better understand and manage IBD, and to speed innovations that will help more patients on their paths to wellness.

Among many other attributes for the clinical team is the fact that USF Health’s partner and primary teaching hospital, Tampa General Hospital, is ranked #22 in the nation for gastroenterology and GI surgery by U.S. News & World Report.

USF Health is already a leader in other digestive disease-related areas, including advanced endoscopy, small bowel/lower gastrointestinal motility, liver disease, and the Joy McCann Culverhouse Center for Swallowing Disorders – all of which support the efforts of the IBD Center and its patients.

The USF Health IBD Center team draws physician referrals from around the United States for patients who have not found relief from past treatments for their digestive issues. IBD is a complex disease and often requires care from multiple providers in different specialties, Dr. Marchioni said.

“Patients in our program are able to have continuity of care as we work closely and collectively with the colorectal surgeons, both in clinic and during our conferences,” she said.

“The Center will provide patients with the resources they need to successfully manage their conditions and maintain a healthy quality of life. Our patients are the core of our program, the heart of all that we do. As such, we strive to create individualized treatment plans focused on overall wellness with our patients’ priorities at the forefront.”

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Facts about inflammatory bowel disease
  • IBD includes two main conditions, Crohn’s disease and ulcerative colitis. The disease is characterized by chronic inflammation of the gastrointestinal tract with periods of relapse and remission. IBD may also manifest symptoms outside the bowel involving the eyes, skin, and joints.
  • Common IBD symptoms include persistent diarrhea, abdominal pain, rectal bleeding/bloody stools, weight loss, and fatigue.
  • The exact cause of IBD is unknown but relates to the immune system responding incorrectly to various triggers, including environmental triggers, causing dysbiosis of the gut microbiome and gastrointestinal tract inflammation in genetically predisposed hosts.  As there is a genetic component, someone with a family history of IBD may be increasingly likely to develop this condition.
  • IBD hits nearly every demographic – the old and the young, male and female, all races, and all socioeconomic groups.
  • IBD should not be confused with irritable bowel syndrome (IBS), despite sharing some similar symptoms. However, patients with IBD may have IBS overlap. IBS is not caused by overt inflammation, and the tissues of the bowel are not damaged the way they are in IBD. Treatment of IBS and IBD are therefore different.
  • Celiac disease also has similar symptoms to IBD, but the cause of celiac disease is known to be very specific – it’s an autoimmune disease characterized by an inflammatory response to gluten, a protein component of most grains including wheat, barley, rye and triticale. Symptoms of celiac disease typically resolve after starting a gluten-free diet.
  • IBD is diagnosed using a combination of upper/lower endoscopic procedures with biopsies and imaging studies (abdominal MR enterography or computed tomography). Stool samples are also collected to make sure diarrheal symptoms are not being caused by an infection, and bloodwork is ordered to assess for inflammation, anemia, and/or vitamin or mineral deficiencies.
  • Treatment for IBD varies and can include medications, such as aminosalicylates, corticosteroids (in the short-term), immunomodulators, biologic agents and small molecules that have been approved for use in this population. There are also recommended IBD healthcare maintenance items and vaccinations to prevent acquisition of common infections, which are both particularly important in immunosuppressed patients. Severe IBD may require surgery to remove damaged portions of the gastrointestinal tract, although advances in medical treatments have helped to decrease or delay the need for surgical interventions.