SC Connecticut News

Inflammatory bowel disease (IBD) encompasses conditions causing chronic inflammation in the digestive system, leading to symptoms such as abdominal cramps, pain, and diarrhea. Patients diagnosed with IBD typically have either ulcerative colitis, where inflammation affects the rectum and inner lining of the colon, or Crohn’s disease, which can cause inflammation anywhere in the digestive tract. These conditions affect approximately 1.5 million individuals in the United States.

In a recent interview, Dr. Jill Gaidos, associate professor of medicine specializing in digestive diseases and medical director of the Yale Inflammatory Bowel Disease Program, discussed various aspects of IBD care, including new treatment options and patient management strategies.

Dr. Gaidos shared her journey into IBD care: "During fellowship training, I was asked to cover for another gastrointestinal (GI) fellow in the IBD clinic and knew I found my career path. Since IBD is a chronic condition without a current cure, I’m able to have long-term relationships with my patients, which I enjoy."

Regarding new treatments available for patients with IBD, Dr. Gaidos highlighted recent advancements: "Within the past few years, the Food and Drug Administration (FDA) approved three new drugs for IBD." She mentioned risankizumab (Skyrizi®) for Crohn’s disease, mirikizumab (Omvoh™) for ulcerative colitis, and upadacitinib (Rinvoq®), an oral therapy for both conditions. She emphasized that these therapies have favorable safety profiles but noted that patients using upadacitinib should get vaccinated against shingles due to increased risk.

When determining appropriate medication for each patient, Dr. Gaidos explained that lifestyle compatibility is crucial: "For newly diagnosed patients, we focus on what medication fits best in their lifestyle." She also pointed out the importance of insurance coverage due to high medication costs: "We work closely with our clinical pharmacy team to help get insurance approval or find a patient assistance program."

Addressing common patient concerns about diet and nutrition, Dr. Gaidos stated: "Many patients who come to see me are on very restrictive diets... social media is full of misinformation." She stressed the need for evidence-based nutritional advice and mentioned that dedicated IBD nutritionists assist patients at Yale.

Dr. Gaidos also discussed challenges in treating IBD: "With IBD, there are multiple pathways that can cause inflammation... It would be incredibly useful to have a commercially available lab test that could pinpoint the cause of the inflammation." She noted ongoing research efforts aimed at improving treatment options for complicated forms of Crohn’s disease.

Finally, Dr. Gaidos spoke about where patients should receive treatment: "Most patients with IBD can successfully manage their disorder with a community doctor... Large academic centers like Yale only see about 15% of patients with IBD." She emphasized the importance of trust and open communication between patients and their doctors.

Yale School of Medicine's Section of Digestive Diseases has been influential in research and clinical care related to gastrointestinal and liver disorders since its establishment over 75 years ago.