IBD in Practice: Challenges in Diagnosis, Options in Management

Program Overview

Inflammatory bowel diseases (IBD) are complex disorders and this is reflected in the wide variation in clinical practice in terms of diagnosis and management.^1,2 Diagnosis is particularly challenging due to the heterogeneity of symptoms and overlap of symptoms with other IBD.³ Data also show that there are frequently significant delays in the diagnosis of IBD.² This activity will begin with a comprehensive review of effective diagnosis of IBD, including assessment of disease severity and extent, identification of complications, and distinguishing between Ulcerative Colitis (UC) and Crohn's disease.

The medical management of IBD is a rapidly evolving field with many areas of debate such as the benefits of “top down therapy” versus the traditional “step-up” approach in Crohn's disease and the role of combination treatment.³ Furthermore, the emergence of biologic therapy in recent years has dramatically changed expectations with respect to patient outcome and quality of life in IBD. However, these agents bring new challenges to physicians such as decisions about the optimal time to initiate therapy, switching between agents, and the need to monitor for increased risk of malignancy and infection. In the second part of this activity, faculty will review the current treatment options and treatment pyramids for UC and Crohn's disease, discuss new developments and give direction on the implications of emerging data.

Finally, this activity will focus on the practical application of information given in the first half of the program by using 4 patient cases to illustrate effective diagnosis and management and look at the nuances and “gray areas” of treatment.

1. Altschuler A, Collins B, and Lewis J. Gastroenterologists' attitudes and self reported practices regarding inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 992 999.
2. Carter MJ, Lobo AJ, and Travis SPL. Guidelines for the management of inflammatory bowel disease in adults. Gut 2004; 53: 1 16.
3. Lichtenstein G, Hanauer S, Sandborn W, et al. Management of Crohn's disease in adults. Am J Gastroenterol 2009; 104: 465 83.

Format: Online Webcast
Duration: 1 hour

Intended Audience
Clinical gastroenterologists in academia, private, and community practice; gastroenterology trainees; other GI healthcare providers

Activity Director
Dr Gary Lichtenstein, MD
Professor of Medicine
Director, Center for Inflammatory Bowel Disease
Division of Gastroenterology
University of Pennsylvania School of Medicine
Philadelphia, PA

Faculty
Dr David Rubin, MD
Associate Professor of Medicine
Co-Director, Inflammatory Bowel Disease Center
University of Chicago Medical Center
Chicago, IL

Dr Faten Aberra
Assistant Professor of Medicine
Division of Gastroenterology
University of Pennsylvania School of Medicine
Philadelphia, PA

Dr Mark Osterman
Assistant Professor of Medicine
Division of Gastroenterology
University of Pennsylvania School of Medicine
Philadelphia, PA

Editor
James Shiffer, RPh,CCP
Medical Director
MedEd Architects , LLC
Chicago, IL

Content Independence
This CME activity is funded through educational grants from Abbott Laboratories, Inc; Centocor Ortho Biotech, Inc; Shire Pharmaceuticals; UCB, Inc.  The content was developed independently by the contributing faculty or editor and has undergone peer review by the activity director or editor. All materials appear with permission of the author(s). The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantors.

Policy Disclosure
In accordance with AGA Institute policies, be advised that one or more presentations in this CME activity might contain references to off-label or unapproved uses of drugs or devices. The use of these agents outside currently approved labeling is considered experimental, and the manufacturers' prescribing information for these products should be consulted.

This CME activity was planned and produced in accordance with Accreditation Council for Continuing Medical Education (ACCME) Essential Areas and Policies

Disclosures
In accordance with the ACCME's Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any financial relationship(s) or other relationship(s) held within the past 12 months. The AGA Institute implements a mechanism to identify and resolve all conflicts of interest prior to delivering the educational activity to learners.

Activity Director

• Gary Lichtenstein, MD
  There are no relevant financial relationships to disclose.

Faculty

• Dr Faten Aberra, MD
  Advisory Committee/Review Panel:  UCB, Inc.

• Dr David Rubin, MD
  Advisory Committee/Review Panel: Abbott Laboratories, Inc;Cornerstones Health, Inc; Centocor Ortho Biotech, Inc;Elan Pharmaceuticals; Millenium Pharmaceuticals; Optimer Pharmaceuticals; Procter and Gamble Pharmaceuticals; Takeda Pharmaceutical Company Limited; UCB, Inc.
  Consulting: Given Imaging; Optimer Pharmaceuticals.
  Grant/Research Support: Elan Pharmaceuticals; Prometheus Laboratories, Inc; Salix Pharmaceuticals.
  Speaking and Teaching: Cornerstones Health, Inc; Schering Plough Canada, Inc.

• Dr Mark Osterman, MD
  Advisory Committee/Review Panel: Elan Pharmaceuticals; UCB Inc.  

Editor
James Shiffer, RPh, CCP
There are no relevant financial relationships to disclose.