IBD (Inflammatory Bowel Disease) Treatment
Doctor Marcus Franz MCs
Gastroenterology and hepatology
Hematology and internal oncology
Dr. Franz, how common are chronic inflammatory bowel diseases?
It is estimated that between 40,000 and 80,000 people are affected in Austria and more than ten million worldwide. The trend is rising, since IBD is now also increasing in many Asian countries. In Crohn's disease or Morbus Crohn (MC) as well as in ulcerative colitis (UC), there is inflammation - of the intestinal mucosa in case of UC, of the entire intestinal wall in case of MC, the cause is still unclear.
While in MC the inflammatory activity occurs in the entire gastrointestinal tract, from the oral cavity to the anus, the inflammatory process in CU begins in the rectum and can continuously spread from there to varying degrees until it affects the entire colon.
What are the symptoms of IBD?
The most common symptoms - which often occur intermittently - include tiredness and lack of appetite, anemia, diarrhea of varying degrees and severity, vomiting, fever and always cramping abdominal pain. Both diseases can take a chronic active course and are associated with weight loss, anemia and weakness. If IBD is not treated or treated too late, the intestines can be progressively and irreversibly damaged by the inflammatory processes. The risk of carcinoma is also increased in both forms of IBD.
How is the diagnosis carried out?
The diagnostic process of IBD is often lengthy - in Austria it takes about 2 years (!) from the onset of the first symptoms to the final diagnosis. The necessary examinations include endoscopy (gastroscopy and colonoscopy), stool lab findings, laboratory tests, ultrasound. An MRI or CT should also be performed for the initial diagnosis. Some patients also suffer from joint or eye problems (e.g. iridocyclitis), in these cases an ophthalmologist and an orthopedist are also involved in the diagnostic process.
What therapy options are available today?
The range is very large, from anti-inflammatory drugs as cortisone as standard medication, which is usually administered in the acute phase, to state-of-the-art infusion and injection therapies - so-called "biologicals" - which often have to be administered only every 8-12 weeks. Biologicals that are injected subcutaneously (under the skin) can also be self-administered by patients.
Once the diagnosis has been made, appointments are initially required every 8-12 weeks, in case of a successful therapy course follow-up controls should be done every 6-12 months. Follow-up appointments can sometimes also be made online via video conference. Endoscopic check-ups should be carried out every 1 ½ - 2 years due to the increased risk of carcinoma.
When is an operation necessary?
Surgical interventions are necessary only in rare cases. In the case of Crohn's disease, the operation should be carried out at the latest possible time, or only if conservative therapy was not effective (in approx. 10% of cases). In the case of ulcerative colitis, surgery is only performed for toxic megacolon, a rare but dangerous complication.
At the Confraternität Private Hospital operations are performed exclusively by trained and experienced IBD surgeons. It is important to know that a stoma (artificial anal sphincter) is almost never required after an IBD operation.
What are the chances of success?
In 70-80% of cases, biologicals can achieve that patients become symptom-free or have only minor symptoms. A noticeable improvement can be achieved in any case. More and more young people are also affected by IBD. Patients from the age of 14 can also be treated in the Confraternität Private Hospital.
What are the advantages of diagnostics and treatment in the Confraternität Private Hospital:
- the endoscopy department is embedded in the hospital setting and thus offers more security
- polyps can be removed immediately (even large ones that require an inpatient or day-clinic stay)
- during each examination, tissue samples are taken and then examined for cell changes by a renowned pathological laboratory
- excellent surgeons with many years of experience are available for surgical interventions in the gastrointestinal area
- psychological backup is provided for difficult cases.
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