John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. 🦠Microbiome, brain-gut axis, diet, IBS, IBD, motility, #MedEd🇬🇷

Oct 24, 2021, 13 tweets

It's #IBD time! Here's Crohn disease in the treatment naive patient with @YNHH @YaleDigestive @JillGaidosMD.

Loving the YALE representation here with the all⭐️ YALE IBD CREW @Badr_AlBawardy @JCPetrov @loulev_md @NadeenHussainMD

@AmCollegeGastro #ACG2021 #GITwitter

Let's dive in!

When choosing an initial therapy for Crohn disease, need to take into account
🔺disease ACTIVITY
🔻disease SEVERITY

@JillGaidosMD "I want first and foremost for your symptoms to improve. I also want your inflammation to resolve."

Even when inflammatory activity is low, intestinal damage can continue to progress. We should target disease severity early, ideally at time of diagnosis.

Treatment options in Crohn disease.

1. Give treatments enough time
2. Optimize dose

Selecting Crohn disease treatment

Treatment of Crohn disease by patient characteristics

Shared decision making is important in selecting #IBD therapy

Case conclusions

Need to continue long-term monitoring for objective measures of inflammation. This allows for dose optimization or switching therapies, to prevent steroids, hospitalization, surgery, and other complications.

💎s from @JillGaidosMD on selecting therapy for Crohn disease

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