Inflammatory Bowel Disease Program

Inflammatory bowel diseases (IBDs), including Crohn’s disease and ulcerative colitis, are chronic inflammatory diseases of all or part of the digestive tract. Most IBDs affect young people in the prime of their social, professional and emotional life. These diseases can ...

About

At Carilion Clinic, we offer the most comprehensive platform of services, including diagnostic services and medical, surgical and interventional treatments, to treat each patient with individualized care based on their condition. In order to provide each patient with the best treatment plan possible, the IBD team includes adult and pediatric gastroenterologists, surgeons, radiologists, pathologists, stoma care specialists and nutritonists. The specialists in our IBD program are dedicated to research, clinical trials and education, allowing patients access to a variety of treatment options.

We follow patients from the initial diagnosis to treatment, monitoring, surveillance, surgery and post-surgery with a comprehensive and individualized IBD care program. We strive to achieve the best in clinical care and academic excellence in IBD; to improve patients' quality of life through early disease detection and non-invasive disease monitoring; and to find the cause and cure for Crohn's disease and ulcerative colitis.

Our Approach

The Role of Surgery

Patients with IBD are often referred to a surgeon, even if no operation is anticipated. Procedures are performed for IBD for specific reasons, such as excessive bleeding, bowel obstructions or bowel perforations. Surgery might also be performed if a patient's symptoms are debilitating and cannot be controlled with medication; and to prevent cancer, especially with ulcerative colitis.

Only a thorough discussion with the IBD gastroenterologist and the IBD surgeon can help determine if a patient will be better served with an operation or by continued medical treatment.

Our goal is to relieve your symptoms and give you the highest quality of life possible. At Carilion Clinic's IBD Center, we have over 30 years of experience in IBD surgery and offer patients all of the surgical options that are available today. This includes the pouch procedures for ulcerative colitis and the full range of options for patients with Crohn's disease.

The Role of Radiology

Radiology plays an important role in the initial diagnosis and clinical management of IBD, particularly in Crohn's disease. We offer radiology services using the latest imaging techniques to help diagnose and manage IBD.

Patients with IBD might require a series of radiology tests, starting with traditional imaging techniques, such as a barium small bowel enteroclysis, the upper GI series and follow through, the double contrast barium enema and defecography.

Depending on the need, more advanced imaging techniques may be ordered. These advanced tests study the human body through the acquisition of "layers of body" converted to images. They include computed tomography (CT) scan, magnetic resonance imaging (MRI) and ultrasound. In particular, MRI of the small bowel (also called MR enterography) and of the pelvis offer crucial detail to the treating gastroenterologist and surgeon.

These techniques allow us to clearly identify not only the disease extent and the stage, but also the degree of activity (inflammation) of the intestinal wall and the possible associated complications.

We are proud to offer expertise and experience in these advanced and minimally invasive diagnostic techniques.

The Role of Pathology

The pathologist works very closely with the gastroenterologist, radiologist, surgeon and other specialists of the IBD team.

The role of the pathologist in the care of patients with IBD involves initial tissue diagnosis, monitoring of disease progression and assessment of tissue response to one or more of the various treatment methods. The pathologist provides microscopic examination of the tissue biopsy taken during the endoscopic procedure performed by the gastroenterologist. Microscopic tissue examination is also used to determine long-term consequences of IBD, including pre-cancer and cancer that affects the colon.

The pathologist also plays a key role in the assessment and management of the disease by providing a series of follow-up tissue examinations. Follow-up tissue biopsies, along with the patient's symptoms and endoscopy findings, allow our team of specialists to monitor the disease more closely and adjust the patient's treatments accordingly. Throughout the stages of assessment and treatments, the pathologist performs a series of tissue studies to clarify the history of the disease and consult with the team of specialists to identify the best treatment based on the results of the tissue studies.

Pediatric Gastroenterology

A big challenge with any chronic disease that begins in childhood can be the adjustment from pediatric to adult care. Our partnership with Carilion’s Pediatric Gastroenterology enables us to maximize communication to facilitate this smooth transition.