Inflammatory Bowel Disease Program

Our team-based approach employs gastroenterologist, physician assistants, and a team of nurses and medical assistants to share the responsibilities of our patients’ medical care. Following evidence-based guidelines, our team works closely together to plan and coordinate a comprehensive plan of care personalized to each patient, who will have the opportunity to meet the IBD team members during a visit.

The key to effective management of the disease is coordinated care among specially trained, internationally recognized physicians with expertise in inflammatory bowel disease. Our experienced team also includes nutritionists, surgeons, radiologists, and pathologists. Our medical and surgical specialists are available at the same visit to provide comprehensive care. Our enterostomal nurses work with families to manage ostomy care and provide support.

We also incorporate intestinal ultrasound into the care of our IBD patients. This imaging technique lets us assess how well treatments are working and how the disease is progressing while the patient is in the clinic instead of waiting for results from labs, colonoscopy, or imaging. This approach can save patients time and potentially reduce or eliminate the need for more costly imaging or other procedures.

Treatment for ulcerative colitis or Crohn’s disease usually begins with medical therapy. While surgery can be a primary therapy for certain symptoms of IBD, it is usually reserved as a supplement to medical therapy. The goal of GI surgery is to restore function, using bowel-conserving surgery, including minimally invasive surgery where appropriate.

In order to properly diagnose and treat patients with IBD, doctors must perform visual examinations of the gastrointestinal tract through procedures known as endoscopies. The three most common procedures are as follows: colonoscopy, upper endoscopy, and capsule endoscopy. Each procedure visualizes a different section of the gastrointestinal tract.

Intestinal Ultrasound: This new, non-invasive tool allows us to give patients up-to-date information about the effectiveness of treatments and their disease progression.

Colonoscopy—Sigmoidoscopy: These procedures allow doctors to evaluate the entire large intestine and the end of the small intestine called the ileum. In patients with inflammatory bowel disease, a colonoscopy is required for evaluation of the disease activity and for colon cancer screening. Some patients may undergo a sigmoidoscopy, which only views the first third of the large intestine.

Upper Endoscopy (EGD): This procedure allows us to evaluate the esophagus, stomach, and duodenum. In patients with inflammatory bowel disease, an upper endoscopy evaluates disease involvement in the upper region of the digestive tract.

Capsule Endoscopy: This diagnostic procedure allows doctors to evaluate the small intestine not accessible by upper endoscopy and colonoscopy. A tiny camera contained in a capsule passes naturally through the digestive tract while transmitting video images to a data recorder and then reviewed by a physician.

Imaging: Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are specialized radiographic studies that help in the diagnosis and management of Crohn’s disease. These scans are particularly helpful in identifying inflammation and complications of inflammation (such as fistula) in the small intestines. It allows us to visualize deeper areas of the small intestines that are not in reach with traditional upper endoscopy/colonoscopy.

Infusion Centers: The Yale IBD Program offers infusion services at Temple Medical Center at 40 Temple Street in New Haven, adjacent to the IBD program clinical practice. For the patient's convenience, a clinic appointment with a Yale gastroenterologist can be scheduled alongside an infusion therapy appointment.

The Infusion Suite offers infusions for the following:

• Biologic Therapies such as Remicade (Infliximab)
• Intravenous Iron
• Intravenous Fluids