Discover and read the best of Twitter Threads about #MondayNightIBD
Most recents (24)
@MondayNightIBD @AaronBlocker_ 1/2 #IBDPoll1️⃣:
📊If you are/were a caregiver for an adolescent/young adult (AYA) with #IBD or are an AYA who transitioned from #PedsGI to adult GI for your #IBD care, how was that transition?
Pls share your #PatientExperience with #MondayNightIBD!!
📊If you are/were a caregiver for an adolescent/young adult (AYA) with #IBD or are an AYA who transitioned from #PedsGI to adult GI for your #IBD care, how was that transition?
Pls share your #PatientExperience with #MondayNightIBD!!
@MondayNightIBD @AaronBlocker_ 2/2 #IBDPoll2️⃣ #MondayNightIBD
Adolescent & young adults (& caregivers) who transtioned from #PedsGI to adult GI for #IBD care:
🚧 What did you find most difficult in the transition?
#Crohns #UlcerativeColitis
Adolescent & young adults (& caregivers) who transtioned from #PedsGI to adult GI for #IBD care:
🚧 What did you find most difficult in the transition?
#Crohns #UlcerativeColitis
@MondayNightIBD @AaronBlocker_ Just to share my personal story, I found my biggest barrier was navigating the different care coordination style amidst a major life transition that coincided with my #PedsGI to adult GI transition! 1/5
@MondayNightIBD 4/#MondayNightIBD
19M presents to GI clinic as a new patient w his grandma. He was dx’d with pan-UC at 12 & has been on adalimumab with reported 6 BMs/day, occasionally with 🩸, but reports this is “his normal”. He has not had any labs, endoscopy, or imaging done in the past…
19M presents to GI clinic as a new patient w his grandma. He was dx’d with pan-UC at 12 & has been on adalimumab with reported 6 BMs/day, occasionally with 🩸, but reports this is “his normal”. He has not had any labs, endoscopy, or imaging done in the past…
@MondayNightIBD 5/#MondayNightIBD
year since moving. He is running low on adalimumab so his grandma scheduled this appointment for him to get refills.
This patient has transitioned to an adult provider, but is early in his transition process. 👀the Transitional care (TC) in IBD🧵👇to learn more
year since moving. He is running low on adalimumab so his grandma scheduled this appointment for him to get refills.
This patient has transitioned to an adult provider, but is early in his transition process. 👀the Transitional care (TC) in IBD🧵👇to learn more
@MondayNightIBD 6/#MondayNightIBD
TC is a PROCESS that occurs throughout adolescence. It is not a singular event. During this process, patients are:
✅ Developing an identity
✅ Becoming 💵 independent
✅ Acquiring skills needed for adult relationships and roles including abstract reasoning
TC is a PROCESS that occurs throughout adolescence. It is not a singular event. During this process, patients are:
✅ Developing an identity
✅ Becoming 💵 independent
✅ Acquiring skills needed for adult relationships and roles including abstract reasoning
@MondayNightIBD 1/Differential of Non-infectious Non -IBD colitis:
🔆 Drug-induced
🔆 Common Variable Immunodeficiency
🔆 Behcet disease
🔆 Segmental Colitis Associated w/ Diverticulosis
🔆 Ischemic Colitis
🔆 Radiation Colitis
🔆 Malignancy
🤔Can you think of other dx?
#MondayNightIBD
🔆 Drug-induced
🔆 Common Variable Immunodeficiency
🔆 Behcet disease
🔆 Segmental Colitis Associated w/ Diverticulosis
🔆 Ischemic Colitis
🔆 Radiation Colitis
🔆 Malignancy
🤔Can you think of other dx?
#MondayNightIBD
@MondayNightIBD 2/Immune Checkpoint Inhibitor Enterocolitis
📌ICI = monoclonal antibodies that reactivate immune response to tumor cells
📌Activation of T‐cells can cross‐react with host antigens
📌Enterocolitis ⬆️anti‐CTLA‐4 > anti‐PD‐1/PD‐L1 agents
📌Diarrhea
⬆️risk perforation if unrecognized
📌ICI = monoclonal antibodies that reactivate immune response to tumor cells
📌Activation of T‐cells can cross‐react with host antigens
📌Enterocolitis ⬆️anti‐CTLA‐4 > anti‐PD‐1/PD‐L1 agents
📌Diarrhea
⬆️risk perforation if unrecognized
@MondayNightIBD @SanjeevaniTomar @halesj126 @JosephHabibi_MD @RomyChamoun @MarcelYibirin @ifrahfatima @GroverDheera @dunleavy_katie @drsophiadar @Spencerkelley7 3/ICI + Diarrhea:
📐R/o infection
🔦C-Scope: appearance of IBD; but mucosa can look normal -> always biopsy; consider EGD +Bx
🔬Path can have chronic IBD changes, crypt apoptosis
💊Depends on severity: budesonide -> IV steroids-> Biologic
✅#IBDAlgorithm👇
📐R/o infection
🔦C-Scope: appearance of IBD; but mucosa can look normal -> always biopsy; consider EGD +Bx
🔬Path can have chronic IBD changes, crypt apoptosis
💊Depends on severity: budesonide -> IV steroids-> Biologic
✅#IBDAlgorithm👇
1/📣#GITwitter last but not least
#ShortBowelSyndrome #MNIBDTweetorial🧵w @valcohranmd @DCharabaty
🤝Role of MDT 4 strongest 💪team
🏥Intestinal rehab. program breakdown
🏆#CME ℹ️bit.ly/40OZTdp
Support by an edu grant from @TakedaPharma
📌Where r u in your career?
#ShortBowelSyndrome #MNIBDTweetorial🧵w @valcohranmd @DCharabaty
🤝Role of MDT 4 strongest 💪team
🏥Intestinal rehab. program breakdown
🏆#CME ℹ️bit.ly/40OZTdp
Support by an edu grant from @TakedaPharma
📌Where r u in your career?
2/#MondayNightIBD #ShortBowelSyndrome #MedTwitter #GITwitter #MedPeds #BonumCE
🟠Earn #CME 🏆on Twitter!
🟠Full CME ℹ️ 🔗bit.ly/40OZTdp
📸 Faculty disclosures & important CME info 👇
🟠Earn #CME 🏆on Twitter!
🟠Full CME ℹ️ 🔗bit.ly/40OZTdp
📸 Faculty disclosures & important CME info 👇
3/#MondayNightIBD
#IBDPoll 1️⃣
➡️50-yo pt w 1y hx of SBS after multiple short bowel resections for stricturing Crohn’s
Labs show dehydration & nutrient deficiencies
U discuss initiating #ParenteralNutrition
➡️You focus on educating pt on which of the possible complications...
#IBDPoll 1️⃣
➡️50-yo pt w 1y hx of SBS after multiple short bowel resections for stricturing Crohn’s
Labs show dehydration & nutrient deficiencies
U discuss initiating #ParenteralNutrition
➡️You focus on educating pt on which of the possible complications...
@MondayNightIBD 1) Recurrencia Post-Quirúrgica (RPQ): Frecuencia
Características tras resección ileocólica y anastomosis:
- Localiz + frecuente: anastomosis o proximal
- Patrón = inicial
RPQ endo: 1a 70%; 3a 85%
RPQ clínica: 1a 20%, 3a 34%; ⏫10% cada año.
sciencedirect.com/science/articl… #MondayNightIBD
Características tras resección ileocólica y anastomosis:
- Localiz + frecuente: anastomosis o proximal
- Patrón = inicial
RPQ endo: 1a 70%; 3a 85%
RPQ clínica: 1a 20%, 3a 34%; ⏫10% cada año.
sciencedirect.com/science/articl… #MondayNightIBD
@MondayNightIBD 2/ Factores de riesgo
✅Características paciente.
✅Características enfermedad
sciencedirect.com/science/articl…
✅Características paciente.
✅Características enfermedad
sciencedirect.com/science/articl…
@MondayNightIBD 3/ Tabaco 🚭🚭
Fumadores tras CIR:
➡️RPQ clínica ✖️2⃣
➡️RPQ quirúrgica a 10 años ✖️2⃣.5⃣
⚠️⚠️ DEJAR EL TABACO ⚠️⚠️
link.springer.com/article/10.100… #MondayNightIBD
Fumadores tras CIR:
➡️RPQ clínica ✖️2⃣
➡️RPQ quirúrgica a 10 años ✖️2⃣.5⃣
⚠️⚠️ DEJAR EL TABACO ⚠️⚠️
link.springer.com/article/10.100… #MondayNightIBD
@MondayNightIBD 2/📣#IBD & meds carry an⬆️risk of #Malignancies, including lymphomas
🔺Who is at risk?
🔺Is it IBD-mediated or drug-related?
🔺What is our prevention & screening🔎strategy?
Thank you for joining this special #MondayNightIBD #Back2Basics @DuekerJeffrey
🔺Who is at risk?
🔺Is it IBD-mediated or drug-related?
🔺What is our prevention & screening🔎strategy?
Thank you for joining this special #MondayNightIBD #Back2Basics @DuekerJeffrey
@MondayNightIBD @DuekerJeffrey @amelia_kellar @DCharabaty @IBD_Afzali @drdani23 @ibddoctor @EdithHoMD @fgomollon @IBD_DrEMF @ibdgijami @MaiaKayalMD 3/ 🔥IBD may carry a unique risk of primary intestinal lymphoma (PILD), but NO🔼risk of extra-intestinal NHL
In CESAME population,
▪️Crude IR of PILD was 0.12/1000 patient-years (py)
▪️All B-cell NH LD
▪️79% ♂️, 11 CD, 3 UC
▪️86% arose in IBD lesions
▪️45% were EBV positive
In CESAME population,
▪️Crude IR of PILD was 0.12/1000 patient-years (py)
▪️All B-cell NH LD
▪️79% ♂️, 11 CD, 3 UC
▪️86% arose in IBD lesions
▪️45% were EBV positive
@MondayNightIBD @DuekerJeffrey @amelia_kellar @DCharabaty @IBD_Afzali @drdani23 @ibddoctor @EdithHoMD @fgomollon @IBD_DrEMF @ibdgijami @MaiaKayalMD @JChristieMD @KDeFelice_IBD @dunleavy_katie @IBDMD @MN_GIMD @SaraElOualiMD @nloganmd @KrugCleveland @PDulaiMD @PriSantiagoMD 4/ Lymphoma in #IBD is mostly linked to IBD therapy, particularly #Thiopurines (6MP, AZA)
🔺⬆️Risk in CD, less evidence with UC
🔺M>F
🔺Risk increases with exposure⏲️, particularly >2 years
🔺Risk decrease after cessation of AZA
🔺⬆️Risk in CD, less evidence with UC
🔺M>F
🔺Risk increases with exposure⏲️, particularly >2 years
🔺Risk decrease after cessation of AZA
🔥Crohn’s Perianal Fistula - #MondayNightIBD w all🌟faculty 🔥 CME 👉 bit.ly/CPF2 🔸Supported by an edu grant from @TakedaPharma 🔸 twitter.com/i/broadcasts/1…
2/#MondayNightIBD #Crohns #PerianalFistula #MedTwitter #GITwitter
✅Answer #IBDPolls👇
🗓 Mark your calendar - Live Q&A @ 8p ET/5p PT
📲Tweet your❓to be addressed Monday!
📸 Faculty disclosures & important CME info👇
✅Answer #IBDPolls👇
🗓 Mark your calendar - Live Q&A @ 8p ET/5p PT
📲Tweet your❓to be addressed Monday!
📸 Faculty disclosures & important CME info👇
3/#MondayNightIBD #GITwitter #MedTwitter
#Crohns #PerianalFistula #CPF
@BonumCe
👇Answer Pre-Polls before watching 👇
#Crohns #PerianalFistula #CPF
@BonumCe
👇Answer Pre-Polls before watching 👇
📣#GITwitter #PedsGI
⚕️Join experts @valcohranmd @Subramanian1MD ⚕️& @DCharabaty addressing the long & the short of:
🎯Optimizing care of #ShortBowelSyndrome
🏆🆓 #CME 🔗bit.ly/3wLGPzF
Supported by an edu grant @TakedaPharma
⚕️Join experts @valcohranmd @Subramanian1MD ⚕️& @DCharabaty addressing the long & the short of:
🎯Optimizing care of #ShortBowelSyndrome
🏆🆓 #CME 🔗bit.ly/3wLGPzF
Supported by an edu grant @TakedaPharma
2/#MondayNightIBD #GITwitter #PedsGI #MedEd #MedTwitter #MNIBDWebinar #BonumCE
Earn 🆓 #CME 🎫
ℹ️ 🔗 bit.ly/3wLGPzF
📸 Faculty disclosures & important CME info 👇
Earn 🆓 #CME 🎫
ℹ️ 🔗 bit.ly/3wLGPzF
📸 Faculty disclosures & important CME info 👇
3/#MondayNightIBD #GITwitter #PedsGI #MedEd #MedTwitter #MNIBDWebinar #BonumCE
🟠Full CME ℹ️ 🔗bit.ly/3wLGPzF
🟠Make sure you answer the pre-polls! 👉 bit.ly/3JOd7BU
🔴 Where are you in your career?
🟠Full CME ℹ️ 🔗bit.ly/3wLGPzF
🟠Make sure you answer the pre-polls! 👉 bit.ly/3JOd7BU
🔴 Where are you in your career?
Live Q&A: Best of UEG Week 2022 twitter.com/i/broadcasts/1…
#GITwitter #MondayNightIBD
⭐️⭐️⭐️NOW - Best of #IBD @ #UEGWeek Q&A w all-star faculty ⭐️⭐️⭐️
In collab w @my_ueg
TWEET your❓❓❓below ⬇️
Supported by edu grants from @abbvie & BMS⭐️⭐️⭐️
Join now w/ @CharlieMuz @DCharabaty @Iris_Dotan @MRegueiroMD
📲Tweet your❓below
⭐️⭐️⭐️NOW - Best of #IBD @ #UEGWeek Q&A w all-star faculty ⭐️⭐️⭐️
In collab w @my_ueg
TWEET your❓❓❓below ⬇️
Supported by edu grants from @abbvie & BMS⭐️⭐️⭐️
Join now w/ @CharlieMuz @DCharabaty @Iris_Dotan @MRegueiroMD
📲Tweet your❓below
🙌 @my_ueg X #MondayNightIBD 🙌◦◦◦◦◦◦◦◦◦◦◦◦🎯 Best of #UEGWeek ◦◦◦◦ CME🔗bit.ly/MNIBD-UEG2022 ◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦◦ Support by edu grants from @abbvie & BMS twitter.com/i/broadcasts/1…
2/#MondayNightIBD #UEGWeek
🆓#CME🔗bit.ly/3XgqsH8
📲Tweet your❓for Mon LIVE Q&A @ 2p ET/ 7p GMT/ 8p CEST
📍Where are you in your career?
🆓#CME🔗bit.ly/3XgqsH8
📲Tweet your❓for Mon LIVE Q&A @ 2p ET/ 7p GMT/ 8p CEST
📍Where are you in your career?
3/ #MondayNightIBD X #UEGWeek 2022 Best in #IBD
✨Faculty @Iris_Dotan, @CharlieMuz, @MRegueiroMD, & @DCharabaty ✨
🤝 In collab w/ @my_ueg, @BonumCe
🆓#CME🔗bit.ly/3XgqsH8
📲Tweet you questions👇🏽to be answered LIVE by the experts Monday Jan 30 2pmET/ 7pmGMT/ 8pmCEST
✨Faculty @Iris_Dotan, @CharlieMuz, @MRegueiroMD, & @DCharabaty ✨
🤝 In collab w/ @my_ueg, @BonumCe
🆓#CME🔗bit.ly/3XgqsH8
📲Tweet you questions👇🏽to be answered LIVE by the experts Monday Jan 30 2pmET/ 7pmGMT/ 8pmCEST
@MondayNightIBD @DCharabaty @BonumCe @TakedaPharma 2/ #MondayNightIBD #ShortBowelSyndrome #MedTwitter #GITwitter #MedPeds @BonumCe
🟠Earn #CME 🏆on Twitter!
🟠Full CME ℹ️ 🔗bit.ly/3Hgnpcf
📸 Faculty disclosures & important CME info 👇
🟠Earn #CME 🏆on Twitter!
🟠Full CME ℹ️ 🔗bit.ly/3Hgnpcf
📸 Faculty disclosures & important CME info 👇
@MondayNightIBD @DCharabaty @BonumCe @TakedaPharma 3/#MondayNightIBD
💊💉Meds = important 🛠 in mgmt of #ShortBowelSyndrome
💎Antimotility & antisecretory agents frequently used to control stool loss
💎Incl loperamide, diphenoxylate w atropine, codeine, & tincture of opium
💎Most effective ~30 min B4 meals & @ bedtime 🛏
💊💉Meds = important 🛠 in mgmt of #ShortBowelSyndrome
💎Antimotility & antisecretory agents frequently used to control stool loss
💎Incl loperamide, diphenoxylate w atropine, codeine, & tincture of opium
💎Most effective ~30 min B4 meals & @ bedtime 🛏
@MondayNightIBD @DCharabaty @BonumCe @TakedaPharma 4/Growth factors also available for #ShortBowelSyndrome
🚦Somatropin (rhGH) approved in SBS
🛑Use largely discontinued due to unacceptable toxicity & modest long-term efficacy
#MondayNightIBD
🚦Somatropin (rhGH) approved in SBS
🛑Use largely discontinued due to unacceptable toxicity & modest long-term efficacy
#MondayNightIBD
@MondayNightIBD 1/Welcome back to #MondayNightIBD with our #Back2Basics team! ⭐️🔆📚
We will talk about #Obesity ➕ #IBD
with
@BassiMehak
@ifrahfatima
@MarcelYibirin
#MakeitSimple
w help from #IBDAdvocates🦸♀️🦸♂️
We will talk about #Obesity ➕ #IBD
with
@BassiMehak
@ifrahfatima
@MarcelYibirin
#MakeitSimple
w help from #IBDAdvocates🦸♀️🦸♂️
@MondayNightIBD @BassiMehak @ifrahfatima 2/🎯35% of the 🇺🇸 population is obese= BMI>30, leading to rising healthcare 💲💲.
🎯20-40% of patients with #IBD are obese.
🎯#Obesity assoc. with 34%⬆️ risk of CD, but not UC
🎯Each 5kg/m2 ⬆️ in BMI ➡️with 16% ⬆️ risk of CD
🎯20-40% of patients with #IBD are obese.
🎯#Obesity assoc. with 34%⬆️ risk of CD, but not UC
🎯Each 5kg/m2 ⬆️ in BMI ➡️with 16% ⬆️ risk of CD
@MondayNightIBD @BassiMehak @ifrahfatima @kzhuangmd @agoldowskymd @IBD_FloMD @IBD_Afzali @babudayyeh @BolandBrigid @amjohnsonMD @PopovVioleta @RobertoSimonsMD @LauraChiuMD 3/ ☸️Outcomes of pts with #Obesity & #IBD
⚠️ Little data & conflicting results, but overall: ⬇️ IBD outcomes
⬇️Remission rates
⬆️Flares
⬇️QoL
⬆️Unplanned healthcare utilization.
⬇️Time to 1st surgery in CD
⬆️ Risk of surgery & hospitalization in UC
⚠️ Little data & conflicting results, but overall: ⬇️ IBD outcomes
⬇️Remission rates
⬆️Flares
⬇️QoL
⬆️Unplanned healthcare utilization.
⬇️Time to 1st surgery in CD
⬆️ Risk of surgery & hospitalization in UC
@MondayNightIBD 1. Welcome back to #MondayNightIBD with our #Back2Basics team! ⭐️
Let’s prepare for the HOLIDAY season!! 🎉✈️
#TravelingWithIBD #TravelingWithOstomy #IBDHolidays with @GroverDheera @MarcelYibirin #MakeitSimple
w help from #IBDAdvocates
Let’s prepare for the HOLIDAY season!! 🎉✈️
#TravelingWithIBD #TravelingWithOstomy #IBDHolidays with @GroverDheera @MarcelYibirin #MakeitSimple
w help from #IBDAdvocates
@MondayNightIBD @MarcelYibirin @Empoweringpts9 @aboutIBD @ownyourcrohns @Youcantmakethi4 @Spencerkelley7 @RomyChamoun @ibdtweets @JosephHabibi_MD @dunleavy_katie @yaransarkis 2. ✈️Why is it important to talk about this
🗳️In a survey of #IBD pts in 2018
⚠️47% ✈️abroad w/o health insurance
⚠️63% didnt’ know to avoid live virus vaccine
⚠️92% didnt know high altitude can➡️flare
⚠️Most unaware of resources like “Can’t wait card” & IBDPassport.com
🗳️In a survey of #IBD pts in 2018
⚠️47% ✈️abroad w/o health insurance
⚠️63% didnt’ know to avoid live virus vaccine
⚠️92% didnt know high altitude can➡️flare
⚠️Most unaware of resources like “Can’t wait card” & IBDPassport.com
@MondayNightIBD @MarcelYibirin @Empoweringpts9 @aboutIBD @ownyourcrohns @Youcantmakethi4 @Spencerkelley7 @RomyChamoun @ibdtweets @JosephHabibi_MD @dunleavy_katie @yaransarkis @BassiMehak @snehadave98 @Clin_Med @IBDPassport @ibdesis @IBD_FloMD @ibdgijami @mlatorremd @MadhuraB_ @nataliesparacio 3. ✈️Why is it important to talk about this?
🧑🍳Change in diet & alcohol 🍸consumption & sleep 😴habits, missing meds can ➡️ GI symptoms or a flare 🔥
🥳Holidays can trigger or⬆️ anxiety & depression☹️
🔑Prepping ahead of time and advice from the medical team can go a long way!
🧑🍳Change in diet & alcohol 🍸consumption & sleep 😴habits, missing meds can ➡️ GI symptoms or a flare 🔥
🥳Holidays can trigger or⬆️ anxiety & depression☹️
🔑Prepping ahead of time and advice from the medical team can go a long way!
@MondayNightIBD 1a.
Welcome to an extra spooky #MNIBD #Back2Basics
🎃👻🎃👻🎃👻🎃👻🎃👻🎃
@JosephHabibi_MD and I will be discussing common myths in #IBD and doing our best to debunk them. Topics include:
🎃 Diet and supplement myths
🎃 Pregnancy and fertility myths
🎃 More surprise myths🔮
Welcome to an extra spooky #MNIBD #Back2Basics
🎃👻🎃👻🎃👻🎃👻🎃👻🎃
@JosephHabibi_MD and I will be discussing common myths in #IBD and doing our best to debunk them. Topics include:
🎃 Diet and supplement myths
🎃 Pregnancy and fertility myths
🎃 More surprise myths🔮
@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD 1b.
Shout out 📣 to all of the amazing #IBD #PatientAdvocates who helped make this happen:
@aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4
Shout out 📣 to all of the amazing #IBD #PatientAdvocates who helped make this happen:
@aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4
@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena 1c.
See if you can find all of the spooky #IBD words in our #MondayNightIBD word search 👇
🎃👻🎃👻🎃👻🎃👻🎃👻
See if you can find all of the spooky #IBD words in our #MondayNightIBD word search 👇
🎃👻🎃👻🎃👻🎃👻🎃👻
@MondayNightIBD @DCharabaty @TakedaPharma 2/ #MedTwitter #GITwitter #MedPeds @BonumCE
🟠Earn #CME 🏆on Twitter!
🟠Full CME ℹ️ 🔗bit.ly/3SZrpB4
📸 Faculty disclosures & important CME info 👇
🟠Earn #CME 🏆on Twitter!
🟠Full CME ℹ️ 🔗bit.ly/3SZrpB4
📸 Faculty disclosures & important CME info 👇
@MondayNightIBD @DCharabaty @TakedaPharma @BonumCe @jantchou @NavreetChowlaMD @BattatMD4IBD @dr_rdvenkatesh @StacyKahn_MD @ashishpatelpch @ConradCole10 @Leicnut 3/ #Parenteralnutrition is used in cases w GI dysfunction
➡️replace nutrients ➡️essential components pt would otherwise be unable to absorb from their 🥪🍜🍱
In pts w #ShortBowelSyndrome, PN is given @ home🏠 usually @ nt🌛
#MondayNightIBD
➡️replace nutrients ➡️essential components pt would otherwise be unable to absorb from their 🥪🍜🍱
In pts w #ShortBowelSyndrome, PN is given @ home🏠 usually @ nt🌛
#MondayNightIBD
@MondayNightIBD @DCharabaty @TakedaPharma @BonumCe @jantchou @NavreetChowlaMD @BattatMD4IBD @dr_rdvenkatesh @StacyKahn_MD @ashishpatelpch @ConradCole10 @Leicnut 4/@AmerGastroAssn Clin Practice Update on #ShortBowelSyndrome #ParenteralNutrition
🌟Best practices
💎 Pref of tunneled CVCs
💎Micronutrient deficiencies monitoring
💎PN volume/contents based on pt weight, labs, stool/ostomy & urine output, signs of dehydration
#MondayNightIBD
🌟Best practices
💎 Pref of tunneled CVCs
💎Micronutrient deficiencies monitoring
💎PN volume/contents based on pt weight, labs, stool/ostomy & urine output, signs of dehydration
#MondayNightIBD
@MondayNightIBD 1/ 📣 #GITwitter #IBDTwitter
It’s a new🔥#Back2Basics session with #GI #Fellow @JosephHabibi_MD
Let’s talk AZA/6-MP in IBD
✅#IBDPolls 1️⃣&2️⃣👆🏽
✅Role as Mono/combo therapy
✅Escalation consideration
✅TPMT & NUDT15 testing
✅Side effects & counseling
It’s a new🔥#Back2Basics session with #GI #Fellow @JosephHabibi_MD
Let’s talk AZA/6-MP in IBD
✅#IBDPolls 1️⃣&2️⃣👆🏽
✅Role as Mono/combo therapy
✅Escalation consideration
✅TPMT & NUDT15 testing
✅Side effects & counseling
@MondayNightIBD @NavreetChowlaMD @MilestoneIBD @IBD_FloMD @tinahamd @DrCoreySiegel @HorstIBDDoc @MLongMD @LauraRaffalsMD @doc_ibd @IBDBen 2/ AZA trials in IBD:
🔹Corticosteroids needed to induce remission
🔹Takes ~12 wks for AZA/6MP to become effective, so taper steroids accordingly
🔹AZA/6-MP effective for maintenance of remission (mainly in UC); Not effective for induction
🔹Corticosteroids needed to induce remission
🔹Takes ~12 wks for AZA/6MP to become effective, so taper steroids accordingly
🔹AZA/6-MP effective for maintenance of remission (mainly in UC); Not effective for induction
@MondayNightIBD @NavreetChowlaMD @MilestoneIBD @IBD_FloMD @tinahamd @DrCoreySiegel @HorstIBDDoc @MLongMD @LauraRaffalsMD @doc_ibd @IBDBen @IBDHorizons @IBD_Houston @IrisWangMD @LoriPlung @vaibhav_manu @KatieFalloonMD @amneethansmd @ManuelBragaMD @Chatterjee_MD @SuhaAbushamma 3/ AZA in today’s practice
1⃣CS-sparing monotherapy for maintenance of moderate IBD
2⃣Combo w/ TNFi to
↑ TNFi levels
↓ Ab formation
2nd MOA for severe/complex IBD not responsive to mono💉
Perianal Crohn’s
...⏬
1⃣CS-sparing monotherapy for maintenance of moderate IBD
2⃣Combo w/ TNFi to
↑ TNFi levels
↓ Ab formation
2nd MOA for severe/complex IBD not responsive to mono💉
Perianal Crohn’s
...⏬
@MondayNightIBD 1/ Hello and Welcome to today's #MondayNightIBD #Back2Basics!
Classifications are💎in IBD‼️Why⁉️:
🔹Clear assessment of disease location/extent/behavior
🔹Objective measure of flare severity
🔹Objective measure of endoscopic activity
➡️Determine treatment and prognosis‼️
Classifications are💎in IBD‼️Why⁉️:
🔹Clear assessment of disease location/extent/behavior
🔹Objective measure of flare severity
🔹Objective measure of endoscopic activity
➡️Determine treatment and prognosis‼️
@MondayNightIBD @MN_GIMD @JosephHabibi_MD @DCharabaty @RomyChamoun @AllonKahn @drsusankais 2/ Classifications in CD:
1⃣Montreal Classification🟰Clinical Classification:
🔹A=Age at dx, L=Location in GI tract, B=Behavior (cf. Slide)
⚠️Behavior pearls:
🔻B1 can progress into B2 or B3
🔻Pts can present with B2 or B3 or both
🔻Perianal disease possible with any B phenotype
1⃣Montreal Classification🟰Clinical Classification:
🔹A=Age at dx, L=Location in GI tract, B=Behavior (cf. Slide)
⚠️Behavior pearls:
🔻B1 can progress into B2 or B3
🔻Pts can present with B2 or B3 or both
🔻Perianal disease possible with any B phenotype
@MondayNightIBD @MN_GIMD @JosephHabibi_MD @DCharabaty @RomyChamoun @AllonKahn @drsusankais @AdvaniRashmiMD @DVinsard @SanjeevaniTomar @BassiMehak @GroverDheera 3/ Crohn's disease activity index (CDAI) 🟰 Clinical score
🔹Assess disease activity
🔹Quantify symptoms
🔹8 variables
🔹Index score
🔻<150: Remission
🔻221-450: Mod to Severe
🔹Assess disease activity
🔹Quantify symptoms
🔹8 variables
🔹Index score
🔻<150: Remission
🔻221-450: Mod to Severe
@halesj126 @MondayNightIBD @dunleavy_katie @SanjeevaniTomar @yaransarkis @RomyChamoun @BassiMehak @JosephHabibi_MD @DCharabaty @DSTEINGIMD @BeniwalPatelMD #CDI treatment:
💎🚫 oral 💊 metronidazole in #IBD
💎@AmCollegeGastro 👇
bit.ly/ACG-Guideline-…
💎IDSA : fidaxo > vanco
💎IBD pts might require a longer course
Non-severe:
💊 fidaxo x 10d
OR
💊 vanco x 14-21d
Severe:
💊 fidaxo x 10d
OR
💊 vanco x 21d
➕/➖ 💉 metronidazole
💎🚫 oral 💊 metronidazole in #IBD
💎@AmCollegeGastro 👇
bit.ly/ACG-Guideline-…
💎IDSA : fidaxo > vanco
💎IBD pts might require a longer course
Non-severe:
💊 fidaxo x 10d
OR
💊 vanco x 14-21d
Severe:
💊 fidaxo x 10d
OR
💊 vanco x 21d
➕/➖ 💉 metronidazole
@halesj126 @MondayNightIBD @dunleavy_katie @SanjeevaniTomar @yaransarkis @RomyChamoun @BassiMehak @JosephHabibi_MD @DCharabaty @DSTEINGIMD @BeniwalPatelMD @AmCollegeGastro #CDI treatment cont’d:
Fulminant:
💊 vanco
➕
💉 metronidazole
➕
Vanco enema if ileus
Additionally:
✳️ supportive cares
✳️ 🔪 consult
✳️ 🤔 #FMT 💩🔦
Fulminant:
💊 vanco
➕
💉 metronidazole
➕
Vanco enema if ileus
Additionally:
✳️ supportive cares
✳️ 🔪 consult
✳️ 🤔 #FMT 💩🔦
@halesj126 @MondayNightIBD @dunleavy_katie @SanjeevaniTomar @yaransarkis @RomyChamoun @BassiMehak @JosephHabibi_MD @DCharabaty @DSTEINGIMD @BeniwalPatelMD @AmCollegeGastro As the saying goes an algorithm is worth a 1000 words and fortunately, we have the great @wabillin algo on how to approach CDI in IBD
@MondayNightIBD @Spencerkelley7 1/
👋 to this week’s #MondayNightIBD with the #Back2Basics #B2B team
🦠 Today we are discussing #Cdifficile infection in #IBD
Stay tuned to 📝 more about #CDI :
➡️ #IBD vs. general 👩👨🦱
➡️ diagnosis
➡️ treatment options
👋 to this week’s #MondayNightIBD with the #Back2Basics #B2B team
🦠 Today we are discussing #Cdifficile infection in #IBD
Stay tuned to 📝 more about #CDI :
➡️ #IBD vs. general 👩👨🦱
➡️ diagnosis
➡️ treatment options
@MondayNightIBD @Spencerkelley7 @dunleavy_katie @SanjeevaniTomar @yaransarkis @RomyChamoun @BassiMehak @JosephHabibi_MD @DCharabaty @DSTEINGIMD @BeniwalPatelMD 2/
#CDI in #IBD compared to general 👩👨🦱
⬆️⬆️ common (5-8x 🔺)
⬆️ community-acquired
⬆️ w/o antibiotic 💊 exposure
⬆️ colonization
⬆️⬆️ recurrence ☹️
⬆️ colectomy risk 🔪
🚨 often no pseudomembranes on 🔦
🚨 can happen post-colectomy 🔪 in #smallbowel or #IPAA
#CDI in #IBD compared to general 👩👨🦱
⬆️⬆️ common (5-8x 🔺)
⬆️ community-acquired
⬆️ w/o antibiotic 💊 exposure
⬆️ colonization
⬆️⬆️ recurrence ☹️
⬆️ colectomy risk 🔪
🚨 often no pseudomembranes on 🔦
🚨 can happen post-colectomy 🔪 in #smallbowel or #IPAA
@MondayNightIBD @Spencerkelley7 @dunleavy_katie @SanjeevaniTomar @yaransarkis @RomyChamoun @BassiMehak @JosephHabibi_MD @DCharabaty @DSTEINGIMD @BeniwalPatelMD 3/
Testing for #CDI ⬇️
💩 GDH:
✅ detects organism
⬆️ sensitive
⬇️ specific
💩 PCR:
✅ detects genes that code for toxin
🚫 detect toxin
⬆️ sensitive
⬆️ specific
🚨 can over-diagnose
💩 EIA for toxin A/B:
✅ detects toxin
⬆️ specific
⬇️ sensitive
🚨 can under-diagnose
Testing for #CDI ⬇️
💩 GDH:
✅ detects organism
⬆️ sensitive
⬇️ specific
💩 PCR:
✅ detects genes that code for toxin
🚫 detect toxin
⬆️ sensitive
⬆️ specific
🚨 can over-diagnose
💩 EIA for toxin A/B:
✅ detects toxin
⬆️ specific
⬇️ sensitive
🚨 can under-diagnose
@MondayNightIBD @JosephHabibi_MD @VictorChedidMD @ManuelBragaMD @doctornikkid @agoldowskymd @DougSimonetto @dr_chhabrag @DrMalSimons @TolgaGidenerMD @HowardTLeeMD 1/🏳️🌈🏳️⚧️#LGBTQ+ includes many diverse groups.
🔖Helpful reference from @FenwayHealth: lgbtqiahealtheducation.org/publication/lg…
🔑Caveats:
👥Definitions vary across communities
💬Terms change frequently
⭐️If unsure, ask what terms someone would like you to use.
🔖Helpful reference from @FenwayHealth: lgbtqiahealtheducation.org/publication/lg…
🔑Caveats:
👥Definitions vary across communities
💬Terms change frequently
⭐️If unsure, ask what terms someone would like you to use.
@MondayNightIBD @JosephHabibi_MD @VictorChedidMD @ManuelBragaMD @doctornikkid @agoldowskymd @DougSimonetto @dr_chhabrag @DrMalSimons @TolgaGidenerMD @HowardTLeeMD @FenwayHealth 2/Ask all patients verbally or on registration form:
✅Pts expect to be asked
✅Pts think it's important for HCP to know
✅Gender identity & sexual orientation affect care
⚠️Don't assume pronouns from appearances
@theNASEM👉
nap.nationalacademies.org/catalog/26424/…
✅#Genderbread👇
✅Pts expect to be asked
✅Pts think it's important for HCP to know
✅Gender identity & sexual orientation affect care
⚠️Don't assume pronouns from appearances
@theNASEM👉
nap.nationalacademies.org/catalog/26424/…
✅#Genderbread👇
@MondayNightIBD @JosephHabibi_MD @VictorChedidMD @ManuelBragaMD @doctornikkid @agoldowskymd @DougSimonetto @dr_chhabrag @DrMalSimons @TolgaGidenerMD @HowardTLeeMD @FenwayHealth @theNASEM 3/#LGBTQ+ health #disparities
Access
-13% LGB+ ppl uninsured
-25% trans ppl had insurance deny gender-affirming care in last yr
Discrimination
-33% trans ppl had neg experience/harassment/refusal in healthcare in last yr
-LGBTQ+ ppl delay/avoid care b/c fear of discrimination
Access
-13% LGB+ ppl uninsured
-25% trans ppl had insurance deny gender-affirming care in last yr
Discrimination
-33% trans ppl had neg experience/harassment/refusal in healthcare in last yr
-LGBTQ+ ppl delay/avoid care b/c fear of discrimination
@dunleavy_katie @MondayNightIBD @DCharabaty @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak @LancetGastroHep @ifrahfatima @SanjeevaniTomar @PriSantiagoMD @LindaNguyenMD @alex_ford12399 @kanikasehgal_ @AdvaniRashmiMD @ManasiAgrawalMD @WalterChanMD @stevenbollipo @AmyOxentenkoMD @Gut_BMJ @GuildConference @JosephCAhnMD @MarkPimentelMD @BethRosenRD @drjshapiro @mgrover_gi @GIdietitian @KewinSiah @NEJM @RomeGastroPsych @RomeFoundation @IrisWangMD @JBrandlerMD @LinChangMD @IFFGD @nataliesparacio @GIreview @Empoweringpts9 @FrontGastro @BeyderLab @AliRezaieMD @JPandolfinoMD @DarrellPardi @GuiRamosMD 7/12 #MondayNightIBD
MultiD Rx of #IBS in #IBD
🩺target predominant symptom(s)- pain, diarrhea, constipation, bloating
🌱supplements: peppermint oil, #probiotics
🥑diet: ⬇️FODMAP, Mediterranean
💊antibiotics, panc enzymes, neuromodulators, secretagogues
🧠CBT, hypnotherapy
MultiD Rx of #IBS in #IBD
🩺target predominant symptom(s)- pain, diarrhea, constipation, bloating
🌱supplements: peppermint oil, #probiotics
🥑diet: ⬇️FODMAP, Mediterranean
💊antibiotics, panc enzymes, neuromodulators, secretagogues
🧠CBT, hypnotherapy
@dunleavy_katie @MondayNightIBD @DCharabaty @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak @LancetGastroHep @ifrahfatima @SanjeevaniTomar @PriSantiagoMD @LindaNguyenMD @alex_ford12399 @kanikasehgal_ @AdvaniRashmiMD @ManasiAgrawalMD @WalterChanMD @stevenbollipo @AmyOxentenkoMD @Gut_BMJ @GuildConference @JosephCAhnMD @MarkPimentelMD @BethRosenRD @drjshapiro @mgrover_gi @GIdietitian @KewinSiah @NEJM @RomeGastroPsych @RomeFoundation @IrisWangMD @JBrandlerMD @LinChangMD @IFFGD @nataliesparacio @GIreview @Empoweringpts9 @FrontGastro @BeyderLab @AliRezaieMD @JPandolfinoMD @DarrellPardi @GuiRamosMD 8/12 #MondayNightIBD
#SIBO is common in #IBD, especially
👩🦰F>M
🔥CD>UC
✂️prior surgeries
📿strictures
🧪⬇️albumin
🦥⬇️transit times
Testing (🌬️or🦠) and treating improves symptoms & outcomes!
Treatment
⛽️hydrogen▶️rifaximin
🐄methane▶️rifaximin+neomycin
🩺See ACG guidelines!
#SIBO is common in #IBD, especially
👩🦰F>M
🔥CD>UC
✂️prior surgeries
📿strictures
🧪⬇️albumin
🦥⬇️transit times
Testing (🌬️or🦠) and treating improves symptoms & outcomes!
Treatment
⛽️hydrogen▶️rifaximin
🐄methane▶️rifaximin+neomycin
🩺See ACG guidelines!
@dunleavy_katie @MondayNightIBD @DCharabaty @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak @LancetGastroHep @ifrahfatima @SanjeevaniTomar @PriSantiagoMD @LindaNguyenMD @alex_ford12399 @kanikasehgal_ @AdvaniRashmiMD @ManasiAgrawalMD @WalterChanMD @stevenbollipo @AmyOxentenkoMD @Gut_BMJ @GuildConference @JosephCAhnMD @MarkPimentelMD @BethRosenRD @drjshapiro @mgrover_gi @GIdietitian @KewinSiah @NEJM @RomeGastroPsych @RomeFoundation @IrisWangMD @JBrandlerMD @LinChangMD @IFFGD @nataliesparacio @GIreview @Empoweringpts9 @FrontGastro @BeyderLab @AliRezaieMD @JPandolfinoMD @DarrellPardi @GuiRamosMD 9/12 #MondayNightIBD
Anxiety, depression, & #PTSD are very common in #IBD and are associated with worse disease outcomes, ⬆️🏥utilization, & ⬇️quality of life.
🔍screen for ψ disorders
💊neuromodulators can treat IBD/IBS and ψ symptoms
🧠CBT, GDH
🤝refer to #GastroPsych
Anxiety, depression, & #PTSD are very common in #IBD and are associated with worse disease outcomes, ⬆️🏥utilization, & ⬇️quality of life.
🔍screen for ψ disorders
💊neuromodulators can treat IBD/IBS and ψ symptoms
🧠CBT, GDH
🤝refer to #GastroPsych
@MondayNightIBD @DCharabaty 1/12
📣#GITwitter #IBDTwitter
Welcome back to #MondayNightIBD #Back2Basics w @dunleavy_katie @john_damianosMD
🎯How do you approach a pt w #IBD in remission who has new or persistent #GI symptoms?
Check out our review📜
practicalgastro.com/2022/05/18/rec…
#NeuroGI #GastroPsych #DGBI
📣#GITwitter #IBDTwitter
Welcome back to #MondayNightIBD #Back2Basics w @dunleavy_katie @john_damianosMD
🎯How do you approach a pt w #IBD in remission who has new or persistent #GI symptoms?
Check out our review📜
practicalgastro.com/2022/05/18/rec…
#NeuroGI #GastroPsych #DGBI
@MondayNightIBD @DCharabaty @john_damianosMD 2/12 #MondayNightIBD #B2B
👩🏼⚕️have been studying “IBS-type symptoms” in #IBD for 30 yrs. But there is more work to be done to help characterize cohort & dz mechanism!
It’s important bc:
👨👩👧👦Affects pts QoL, mental health, sleep
🥼Causes ⬆️HC utilization, ⬆️MD visits & 💊narcotics
👩🏼⚕️have been studying “IBS-type symptoms” in #IBD for 30 yrs. But there is more work to be done to help characterize cohort & dz mechanism!
It’s important bc:
👨👩👧👦Affects pts QoL, mental health, sleep
🥼Causes ⬆️HC utilization, ⬆️MD visits & 💊narcotics
@MondayNightIBD @DCharabaty @john_damianosMD @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak 3/12 #MondayNightIBD Persistent/New GI Sx in #IBD
1⃣R/o active🔥/#IBD complication (abscess, stricture):🔦, 🩻, CRP, FCP, ⚠️R/o infx like C. Difficile!
2⃣🤔Consequences of✂️: adhesion, bile acid diarrhea
3⃣🤔 #DGBI
🚩25% pts w #IBD in endo remission have #IBS @LancetGastroHep
1⃣R/o active🔥/#IBD complication (abscess, stricture):🔦, 🩻, CRP, FCP, ⚠️R/o infx like C. Difficile!
2⃣🤔Consequences of✂️: adhesion, bile acid diarrhea
3⃣🤔 #DGBI
🚩25% pts w #IBD in endo remission have #IBS @LancetGastroHep
@MondayNightIBD @DCharabaty @abbvie @JanssenUS @TakedaPharma 1/ #IBDPoll1️⃣ 30M non-smoker w stricturing #Crohns ileocolitis dx 1 year ago is now s/p ileocecal resection due to refractory symptoms despite adalimumab.
What would you recommend post-surgery? #MondayNightIBD
🔦= C-scope
🔥= Active disease
Metronid= Metronidazole
What would you recommend post-surgery? #MondayNightIBD
🔦= C-scope
🔥= Active disease
Metronid= Metronidazole
@MondayNightIBD @DCharabaty @abbvie @JanssenUS @TakedaPharma 2/ #IBDPoll2️⃣ The pt was started on IFX 4 weeks post-op, but now presents @ 8 weeks post op w #Diarrhea 6-8 loose BM/day, no abdo pain, no blood. Stool Cdiff & Cx negative. FCP, CRP nml,
What’s next ? #MondayNightIBD
What’s next ? #MondayNightIBD
@MondayNightIBD @DCharabaty @abbvie @JanssenUS @TakedaPharma 3/ #IBDPoll3️⃣ Pt is dx w #BAD w 7C4 level 80ng/mL, & started cholestyramine. Now presents w abdo pain, MRE multiple SB #Strictures ➡️Sx complicated by leaks & more✂️. Now w foul smelling diarrhea, Wt loss, dry mouth, orthostasis. CLN & Stool studies nml.
What’s next?
What’s next?
@dunleavy_katie @MondayNightIBD @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 @1yr @5yr @charlie_lees @P_DeepakIBDMD @EdwardLoftus2 @drvishal82 @guthealthmd @GuiRamosMD @MRegueiroMD @JanDabritz @MatthieuAllez @AmerGastroAssn @AGA_Gastro @ibdleuven @JeanFredericCo1 @SeverineVermei1 @GianlucaPellino @fgomollon @bverstockt @mchiorean4 @Gut_BMJ @BenClickMD @IBDcanruti @ASGEendoscopy @PeyrinBiroulet @BrunoSilva_MD @MatFume 7/⬆️the risk of POR❓
Patient factors:
💎👨>👸
💎 >15 🚬/day
💎Young age at the time of ✂️ (<30 y)
Disease &💊factors:
💎Short disease duration before ✂️
💎>2 prior ✂️
💎Penetrating disease
💎SB resection >50 cm
💎➕ disease at resection margin
💎➖of post✂️ anti-TNF therapy
Patient factors:
💎👨>👸
💎 >15 🚬/day
💎Young age at the time of ✂️ (<30 y)
Disease &💊factors:
💎Short disease duration before ✂️
💎>2 prior ✂️
💎Penetrating disease
💎SB resection >50 cm
💎➕ disease at resection margin
💎➖of post✂️ anti-TNF therapy
@dunleavy_katie @MondayNightIBD @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 @1yr @5yr @charlie_lees @P_DeepakIBDMD @EdwardLoftus2 @drvishal82 @guthealthmd @GuiRamosMD @MRegueiroMD @JanDabritz @MatthieuAllez @AmerGastroAssn @AGA_Gastro @ibdleuven @JeanFredericCo1 @SeverineVermei1 @GianlucaPellino @fgomollon @bverstockt @mchiorean4 @Gut_BMJ @BenClickMD @IBDcanruti @ASGEendoscopy @PeyrinBiroulet @BrunoSilva_MD @MatFume 8/⬇️the risk of POR❓
🧬Older patient (>50 y)
🧬Nonsmoker
🧬1st Sx for a short segment of fibrostenotic disease (<10 to 20 cm)
#B2BPearl #MondayNightIBD No difference in recurrence between Eastern and Western countries‼️
Take a look!
pubmed.ncbi.nlm.nih.gov/30126030/
🧬Older patient (>50 y)
🧬Nonsmoker
🧬1st Sx for a short segment of fibrostenotic disease (<10 to 20 cm)
#B2BPearl #MondayNightIBD No difference in recurrence between Eastern and Western countries‼️
Take a look!
pubmed.ncbi.nlm.nih.gov/30126030/
@dunleavy_katie @MondayNightIBD @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 @1yr @5yr @charlie_lees @P_DeepakIBDMD @EdwardLoftus2 @drvishal82 @guthealthmd @GuiRamosMD @MRegueiroMD @JanDabritz @MatthieuAllez @AmerGastroAssn @AGA_Gastro @ibdleuven @JeanFredericCo1 @SeverineVermei1 @GianlucaPellino @fgomollon @bverstockt @mchiorean4 @Gut_BMJ @BenClickMD @IBDcanruti @ASGEendoscopy @PeyrinBiroulet @BrunoSilva_MD @MatFume 9/💎How to⬇️ POR risk?💊✂️
#B2BPearl Risk stratify pt & manage accordingly
💊Post-op
👉Nitroimidazole x3mos, if low risk
👉TNFi, start wk4, if high risk
✂️Kono-S anastomosis + extended mesenteric resection
🔦CLN at 6mos, adjust Rx per Rutgeerts score
pubmed.ncbi.nlm.nih.gov/34977147/
#B2BPearl Risk stratify pt & manage accordingly
💊Post-op
👉Nitroimidazole x3mos, if low risk
👉TNFi, start wk4, if high risk
✂️Kono-S anastomosis + extended mesenteric resection
🔦CLN at 6mos, adjust Rx per Rutgeerts score
pubmed.ncbi.nlm.nih.gov/34977147/
