Crohn's Disease
Definition
Crohn's disease is a chronic inflammatory bowel disease that affects the lining of the digestive tract, causing inflammation, ulcers, and abdominal pain. It can involve any part of the gastrointestinal tract from the mouth to the anus, but most commonly affects the small intestine and the beginning of the large intestine.
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Inflammatory Bowel Disease Program
In 2001, the Yale Inflammatory Bowel Disease Program was formed to address the challenges faced by patients with complex, lifelong, gastrointestinal, inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis. Our team-based approach employs a gastroenterologist, physician assistant, and a team of nurses and medical assistants to share the responsibilities of our patients’ medical care. Following evidence-based guidelines, the IBD team will work 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. 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. 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 evaluation of 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: The newest diagnostic procedure, it allows evaluation of 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. Images of the small bowel are downloaded to a computer and reviewed by a physician. Chromoendoscopy: Chromoendoscopy is a technique performed during colonoscopy to enhance the detection of pre-cancerous areas in the colon. It uses a blue dye that temporarily stains the colon wall duPediatric Inflammatory Bowel Disease Program
An estimated 80,000 children suffer from inflammatory bowel disease (IBD) in the United States, and the disease is on the rise. We offer comprehensive care to children with IBD—which includes Crohn’s disease and ulcerative colitis—focusing specifically on young patients and their unique needs. We are dedicated to improving the physical and psychological health—and promoting optimal growth—for all children and adolescents with IBD. We are also proud that our remission rates in patients are higher than the national average. At our weekly clinic at Yale New Haven Children’s Hospital, patients can meet with IBD specialists, surgeons, nurses, social workers, and nutritionists who are ready to care for them with the most advanced available technology and medication. If surgery is needed, our skilled surgeons use methods, including laparoscopy, that allow for smaller incisions and quicker recovery. We have a transition plan for patients who are 21 and are ready to move into our IBD program for adults.Pediatric Inflammatory Bowel Disease Program
We provide comprehensive surgical care for children with inflammatory bowel disease.Our innovative surgeons have extensive experience in the latest surgical technologies and the most delicate surgical situations. We understand that inflammatory bowel disease can present challenges for children. We want to help each child meet and overcome those challenges by exploring how his or her condition affects daily life. We focus on education and making each child’s parent his or her best advocate.