Curtis Hayes was in terrible pain when he came to Georgetown's Center for Inflammatory Bowel Disease.
Diagnosed with Crohn's disease five years earlier, the teen from Landover, MD, was experiencing a flare-up of the chronic disorder, which involves inflammation of the gastrointestinal tract.
"He was unable to eat, with severe abdominal pain, vomiting and weight loss," says Dr. Aline Charabaty, a gastroenterologist who specializes in the treatment of Inflammatory Bowel Disease (IBD), including Crohn's disease.
Treatment of the complex and chronic disorder is focused on eliminating its symptoms and then maintaining symptom- free periods of remission, by suppressing inflammation within the GI tract.
Diagnostic tests on the college student revealed intestinal blockages caused by both inflammation and strictures (narrowing) of the small bowel. Within a few days, a regimen of anti-inflammatory medications reduced the obstruction, which eliminated the pain and allowed Hayes to begin eating again—and to return home.
"I'm doing great now, working and going to school," he says. "I can eat normally, and I feel like I have a normal life again."
Hayes returns to Georgetown periodically for intravenous administration of the antiinflammatory agent Remicade, and he will eventually undergo surgery to eliminate the strictures in his small intestine.
"IBD is a chronic and challenging disease, and affects about a million Americans a year," says Dr. Charabaty. "At Georgetown, we've developed a holistic approach to treating IBD, to take care of the medical aspects of the disease and assist patients in dealing with the way it affects their social, sexual and personal lives. We believe in building lasting relationships with our patients, to help them lead healthy, productive lives."
The term IBD encompasses three disorders of the GI tract, which is the complex network of tubes and organs that's responsible for digesting food, absorbing nutrients and disposing of waste. Crohn's disease can affect the GI tract anywhere from the mouth to the anus, including the small and large bowel. Ulcerative colitis involves inflammation of the large bowel (colon), beginning at the rectum. Indeterminate colitis is inflammation of the colon that can't be characterized as either Crohn's disease or ulcerative colitis.
IBD, which affects an equal number of men and women, occurs most frequently between the ages of 15 and 35. Genetics plays a role in the development of the disorder. Five to 10 percent of IBD patients have a parent, sibling or child who has been diagnosed with the disease. The symptoms of IBD include abdominal pain, persistent diarrhea, bowel urgency and incontinence, blood or mucus in the stool, fever and loss of appetite and weight.
Possible complications of these disorders include the development of abnormal tracts between the bowel and other organs (fistulae), strictures of the GI tract, and abscesses, all of which can require surgery.
"Georgetown has excellent IBD surgeons, including Dr. Stephen Evans, our Chief of Surgery," says Dr. Charabaty. "This is important because up to a third of IBD patients will need surgery at some point, to remove obstructions or diseased areas that haven't responded to treatment."
Complications of IBD can also occur outside the GI tract, in the eyes, joints, skin, liver and kidneys. Specialty care for these conditions is available through Georgetown's departments of Ophthalmology, Rheumatology and Dermatology, as well as the International Center for Liver Diseases.
Because the symptoms of IBD are similar to those of other GI disorders such as irritable bowel syndrome or colorectal cancer, sophisticated tests are required to diagnose and determine the extent of the disorder. In addition to its expertise in performing endoscopies and colonoscopies, Georgetown is the only hospital in the area that offers video-capsule endoscopy of the small bowel, which uses a miniature video camera to examine areas that can't be reached with an endoscope and diagnoses the extent of bowel disease.
The treatment of IBD is focused on suppressing intestinal inflammation to induce and then maintain remission. The 5-ASA (aminosalicylate: anti-inflammatory agents) medications, which can be administered orally or rectally, are often effective in treating mild to moderate IBD. Remicade has proven effective in treating ulcerative colitis, Crohn's disease and fistulae.
Acute flare-ups of IBD can be treated with short-term administration of corticosteroids or antibiotics.
As a leading research hospital, Georgetown also provides IBD patients with access to clinical trials of new treatments, including a Phase III study of Sargramostim that is open for enrollment to patients with Crohn's disease. Dr. Charabaty is the principal investigator for the trial of the immune-boosting medication, which has already demonstrated safety and efficacy in several earlier studies.
"The eight-week trial is investigating a new concept for treating IBD, by promoting patients intestinal immunity to help them fight the disease," says Dr. Charabaty. "The trial provides an alternative for patients with moderate to severe Crohn's, especially for those who have failed other treatment regimens or developed side effects to existing medications."
For more information about Georgetown's Center for Inflammatory Bowel Disease or to schedule an appointment with Dr. Charabaty or one of our GI specialists – or to participate in our Phase III study, call Georgetown MD at 202-342-2400 to speak with one of our nurse counselors.
