Inflammatory Bowel Disease (IBD), encompassing both Crohn's disease and ulcerative colitis, poses significant challenges in the medical field. Although advancements in treatment have reduced the need for surgery, approximately 15% of individuals with ulcerative colitis still face surgical intervention within a decade of diagnosis. Dr. Abhik Bhattacharya, an assistant professor of medicine in the Division of Gastroenterology at the Icahn School of Medicine at Mount Sinai, provides insights into the complexities and treatment options available for IBD.
Dr. Bhattacharya emphasizes the primary goal of IBD treatment: to prevent surgery due to complications arising from bowel damage. He explains that while multiple treatment options exist, they are not limitless.
“The goal of treatment,” Dr. Bhattacharya said, “is to prevent surgery due to complications of bowel damage.”
IBD treatment involves a range of medications, including biologic drugs like Remicade, Humira, Cimzia, Simponi, Entyvio, and Stelara. Small molecules such as Zeposia and Xeljanz are also part of the therapeutic arsenal. These potent immunosuppressants aim to manage the disorder, which results from an interaction between the gut and brain, manifesting as diarrhea, constipation, bloating, and pain.
“These include, but are not limited to, biologic medications, such as Remicade [infliximab], Humira [adalimumab], Cimzia [certolizumab pegol], Simponi [golimumab], Entyvio [vedolizumab], and Stelara [ustekinumab], or small molecules like Zeposia [ozanimod] and Xeljanz [tofacitinib]. These are potent immunosuppressant medications, and we are constantly developing new medications through clinical trials.”
However, Dr. Bhattacharya cautions about the potential diminishing effectiveness of these medications over time.
“While we do have options when it comes to treatment,” he said, “those options are not limitless, and we don’t want to run through medications. There is good data to support that when […] one set of IBD medications [fails], your response to another type may be less likely.”
The symptoms of IBD can severely impact daily functioning, leading to stress, anxiety, depression, and sleep disturbances.
“The disease can lead to stress, worsening anxiety, depression, and loss of sleep because of the devastating consequences it can have on a person’s daily functioning,” he said. “Symptoms can include bleeding in stools, diarrhea, severe belly pain, unintentional weight loss, fevers, chills, rectal pain, fatigue, and more.”
Despite the challenges, the development of new treatments continues through clinical trials. Organizations like Crohn's & Colitis UK offer valuable information and support for individuals affected by IBD.
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