“The good news for patients with IBD is that comprehensive care can make a tremendous difference.”


Lilani Perera, MD


Medical College of Wisconsin gastroenterologist and medical director of the IBD Program


Last summer, Katie’s illness flared up again. She lost weight and


became very malnourished. Her doctor wanted to put her back on prednisone. Katie decided it was time to look at other options.


“I have a couple of friends I met through the Crohn’s & Colitis


Foundation of America,” she said. “They were getting care at Froedtert & The Medical College of Wisconsin, and they always said to me, ‘you can’t believe the care you receive there.’ I decided I wanted to go to Froedtert.”


more options


The IBD Program at Froedtert & The Medical College of Wisconsin is the only comprehensive program for Crohn’s disease and ulcerative colitis in southeastern Wisconsin. Team members, including physicians Daniel Stein, MD, Nanda Venu, MD, and Amar Naik, MD, combine clinical care with ongoing research, so patients have access to the most advanced treatments.


“We now have many more options for treating IBD compared


to 10 or 20 years ago,” Dr. Perera said. Newer therapies include biologic drugs that target the inflammatory process. Specialists have also developed new treatment strategies.


“The traditional approach is called step-up therapy,” Dr. Perera


explained. “Patients begin with the mildest medications, then progress to stronger drugs as needed. In the past five years, we have begun using a different approach called step-down therapy. If a patient is identified initially with very severe disease, we begin aggressively, with stronger agents. The idea is to try to control the disease as soon as possible, because the longer you leave IBD uncontrolled, the higher the risk of complications.”


Some complications of IBD can only be treated with surgery.


According to Lauren Kosinski, MD, Medical College of Wisconsin colorectal surgeon, chronic inflammation of intestinal tissue can lead to severe scarring, which causes areas of blockage called strictures.


“We can treat strictures by removing them, but an alternative


is strictureplasty, a procedure that widens the opening without leading to the loss of small bowel tissue,” Dr. Kosinski said. Surgery is also required to treat fistulas, abnormal ‘bypass’ channels that can form when pressure builds up in the intestines.


For uncontrolled ulcerative colitis, treatment often includes


complete removal of the colon. In these cases, surgeons may be able to construct a new rectum out of a portion of the small intestine, enabling normal bowel function.


Increasingly, Dr. Kosinski said, IBD procedures can be


performed using minimally invasive laparoscopic techniques. “Most people with Crohn’s disease who require surgery will actually need


12 Froedtert Today May 2011 n lilani perera, md


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20