Treating Crohns and Colitis in the ASC Kimberly M Persley, MD - - PDF document
3/2/2018 Treating Crohns and Colitis in the ASC Kimberly M Persley, MD Texas Digestive Disease consultants TASC Meeting Outline IBD 101 Diagnosis Treatment Burden of Disease Role of ASC Inflammatory Bowel Disease
Kimberly M Persley, MD Texas Digestive Disease consultants TASC Meeting
Indeterminate colitis
Inflammatory bowel disease Dahlhamer J. MMWR 2016;65(42)1166‐69
Ulcerative Colitis Crohn’s Disease Abdominal pain Less frequent frequent Bloody diarrhea frequent
Abdominal mass never frequent Intestinal obstruction never frequent Perianal disease Almost never frequent Fistula never common Effect of smoking protective detrimental Systemic symptoms Less common common
Biologics Cyclosporine 6mercaptopurine azathioprine corticosteroids Budesonide Antibiotics 5ASA Mild Moderate Severe Research
Asacol HD Pentasa Lialda Apriso Balsalazide Sulfasalazine Canasa Rowasa Prednisone Budesonide Remicade Humira Cimzia Entyvio Simponi Stelara Azathioprine 6Mercaptopurine Methotrexate Cyclosporine Mesalamines corticosteroids Biologics Immunosuppressive
Crohn’s Disease
Ulcerative colitis
Crohn’s and Colitis Foundation Website, 2004 data
productivity
$0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000 $18,000 $20,000 annual cost
Annual Cost
CD UC control
steroids
bowel movement a day, abdominal pain and weight loss. She started on Lialda
symptoms.
stricture and active inflammation in the right colon. The stricture dilated.
abdominal pain and diarrhea. Colonoscopy with dilation of stricture
to CRS for limited ileocolonic resection
A gastroscope typically used Biopsies taken Dilation of IPAA Endoscopic Jpouch images
Medicare and Medicaid Services, Office of the Actuary.
Berwick, DM et al. Health Aff (Millwood). 27(3):759‐69. 2008. Berwick, DM et al. Health Aff (Millwood). 27(3):759‐69. 2008.
quality Value = cost
James C. Robinson and Kimberly MacPherson. Health Affairs 2012,31:9