Katie Dunleavy Profile picture
Apr 23, 2022 6 tweets 38 min read Read on X
@MondayNightIBD 1/📢#GITwitter"There are two main mistakes in treating #IBD pts - the undertreatment and the overtreatment"-Prof #Rutgeerts!

Let’s talk about surgery & post-op surveillance in #crohns

@GroverDheera and I will #MakeItSimple in prep for #MondayNightIBD w @BattatMD4IBD @DCharabaty Image
@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek 2/ #MondayNightIBD
Journey of #Crohns disease:
🎢 Relapses & remission
🔥 Inflamm can leads to fibrostenosis, fistula and abscess
🚧 25% have complications at dx
✂️ 26% require surgery despite biologics Image
@MondayNightIBD @GroverDheera @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 3/ Today’s focus is on surgery for #Crohns ileal #stricture

🌟 Indications: obstructive symptoms, stricture associated with abscess, suspicion of malignant stricture
🪄 Surgery🚫curative : #Crohns often recurs above IC anastomosis

#MondayNightIBD #Back2Basics
@MondayNightIBD @GroverDheera @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 4/#MondayNightIBD #Back2Basics
Feeling better after Sx✂️ for ileal #CD, now what?

👇🏽Without prophylactic RX, post-op recurrence (POR) & timeline🔮

🔦90% endo recurrence @1yr
😡30% clinical sx @3yr, 60% @5yr
💉45% require rx escalation @5yr
✂️50% require another resection @5yr Image

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More from @dunleavy_katie

Jun 13, 2022
@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
@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 Image
@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 Image
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