Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative Colitis)

How is inflammatory bowel disease diagnosed?
An accurate diagnosis of inflammatory bowel disease is an essential step to choosing the best possible treatment plan. There is no single test that diagnoses inflammatory bowel disease. Our nationally recognized team of physicians uses the most advanced diagnostic endoscopic procedures and imaging techniques to accurately diagnose inflammatory bowel disease.

On your first visit, your physician will review your prior work-up and decide if further investigation is needed. Here at University of Minnesota Medical Center, we offer a wide array of minimally invasive diagnostic, endoscopic procedures including upper and lower endoscopy, capsule endoscopy (“pill camera”), deep enteroscopy, chromoendoscopy and MRI enterography or CT enterography. The combination of these endoscopic procedures and imaging tests help us determine the correct diagnosis and burden of the disease. This information is essential to design a personalized treatment plan.

Scheduling a visit: what should I do before my visit?
Before your visit, obtain reports of any prior procedures (colonoscopies, endoscopies or surgeries) and imaging reports (CT or MRI scans). If you have been seen by a gastroenterologist, obtain a report of that visit and send us those medical records.

Our team aims to make patient education a priority. Please write down your visit expectations and any questions you may have. It is important to us that we meet your expectations and answer all of your questions. Our goal is to develop a personalized treatment plan to get your disease into remission the safest way possible.

What to expect on your first visit
On your first visit you will meet with the office staff to review your medications, allergies and history. If you sent your records ahead of time your physician reviewed them prior to your visit. Your physician will sit down with you to take a detailed history of your previous medical and surgical therapies. To assess your current disease activity, your physician will order the necessary blood tests and diagnostic endoscopic procedures, if you have not had any. With all of this information, your physician will work with you to develop a personalized treatment plan to get your disease under control.

We believe that inflammatory bowel disease affects all aspects of a person’s life. Using our team-based approach we will work to develop a personalized treatment plan for you. Call 612-624-9709 to schedule an appointment with an expert today.

What are the treatments for inflammatory bowel disease?
To learn more about IBD medications, please visit the Crohn’s and Colitis Foundation of America website.

Medical treatments
Currently there is no cure for inflammatory bowel disease. Most patients require medications to get their disease under control and prevent flares of symptoms or other complications. There are multiple types of medications than can be used for disease control. Some people will need minimal medications, while others will need more than one medication at a time. Our specialists will work closely with you to determine the safest, optimal medical approach to control your inflammatory bowel disease.

Common classes of medications include:

• Mesalamine based medications
• Steroids
• Immunomodulators
• Biologics
• Clinical trials for new medical therapies   

Endoscopic treatments
Beyond the standard endoscopies and colonoscopies used to diagnose inflammatory bowel disease, we work in collaboration with the advanced endoscopy team at the University of Minnesota, we offer the potential for non-surgical options in special cases. This includes chromoendoscopy to detect and resect precancerous lesions in the colon associated with colitis and dilating (stretching out) scar tissue that can form from long standing inflammation.

Surgical treatments
While medications can often control inflammatory bowel disease, some people will need surgery. Sometimes surgery is urgent for acute complications, but more often it can be planned for instances where medical treatment is no longer effective. Our collaborative multidisciplinary approach ensures that surgery is performed only when it is the best option.

The colorectal surgical team specializes in surgery for people with Crohn’s disease and ulcerative colitis. Using minimally invasive therapies, our surgeons have expertise in bowel-sparing procedures such as strictureplasty for Crohn's disease. In addition, we have a large experience with ileoanal reservoirs (J-pouches), which creates a new rectum from small intestine and avoids the need for a permanent stoma (bag). Our doctors and surgeons work closely to coordinate the timing of your surgery as well as managing your medications around the time of surgery.

Alternative and complementary medical therapies
Complementary and alternative medicines are unlikely to be the sole treatment for your IBD; however they can help to work with your other medications to get your disease under control. Examples of some therapies your provider may recommend in addition to standard treatments include:

• Acupuncture
• Curcumin
• Mind-body techniques
• Probiotics
• Nutrition for inflammatory bowel disease   

Currently there is no known diet that causes inflammatory bowel disease, nor is there any one diet than can cure inflammatory bowel disease. We generally recommend patients eat a well balanced healthy diet. Nutritional deficiencies are common and supplementing your diet with a multivitamin can be beneficial. Your doctor will routinely test for certain nutritional deficiencies such as iron, vitamin B-12 and vitamin D and recommend supplementation if needed. Please consult our inflammatory bowel disease physician team before altering your diet.

The microbiome and inflammatory bowel disease
Recently, a substantial amount of research has been devoted to understanding the role of the microbiome (the bacteria in your intestine) in inflammatory bowel disease. Many diets and pre/pro-biotics may have their beneficial effect based on changing the intestinal microbiome. Currently fecal transplantation is not approved. You can talk to your IBD provider to see if there are any clinical trials that you might be appropriate for. To learn more, please visit the University of Minnesota's Microbiota Therapeutics Program.

Lifestyle modification
While there is no single cause for inflammatory bowel disease, and thus no single cure, there are many lifestyle modifications that can help reduce and control the symptoms of inflammatory bowel disease. Often your doctor will recommend these changes in conjunction with a more standard medical therapy. Lifestyle modifications can include:

• Alternative and complementary therapies
• Stress reduction
• Regular exercise
• A balanced, healthy diet
• Smoking cessation   

Inflammatory Bowel Disease Preconception and Pregnancy Planning Clinic (IPREPP Clinic)

The decision to become pregnant, if you suffer from IBD, may be difficult for many women because of safety concerns related to both the disease and the medications used for treatment. IBD can cause increased risks during pregnancy, for both the infant and mother. 

At our IPREPP Clinic, we offer a multi-disciplinary clinic that combines the expertise of gastroenterology and maternal fetal medicine providers. Our IPREPP Clinic is the only of its kind in the Midwest and one of only a few in the world that offer this type of expertise and counseling for women with IBD. 

Women often receive conflicting advice from their gastroenterologist and obstetrician on how to treat their IBD during pregnancy, or while trying to become pregnant. At our IPREPP Clinic, you’ll see a gastroenterologist who specializes in treating women with IBD during pre-conception and pregnancy. You’ll also see a maternal fetal medicine provider. Both providers will then meet with you together to discuss their recommendations. 

Our IPREPP Clinic providers will talk with you about:

• Fertility 
• Pregnancy and delivery
• Planning for treatment of flares
• Safety of your IBD medications
• Possible risks to your baby
• Genetic counseling
• Breastfeeding
• Newborn care
• Nutrition
• Monitoring your overall health

We want to address any concerns you have and help you find answers about safely managing your IBD during pregnancy. Women with IBD that receive preconception counseling can reduce their risks of complications during pregnancy.

Appointments at IPREPP Clinic: 612-676-4342. Located in the Maternal-Fetal Center in the Riverside Professional Building.