Inflammatory Bowel Disease Program Patient Information
Inflammatory Bowel Disease ProgramPatient Information GuidePage #Contents .1Welcome!Welcome Letter .3Important Things to Know Up Front.4Meet Your Crohn’s & Colitis Team.6How to Contact UsCrohn’s & Colitis Clinic Schedule .11Physician and Nurse Contact Information.12Appointment Scheduling and Other Contact Information.13The Basics of Inflammatory Bowel Disease (IBD)Basic Information about Inflammatory Bowel Disease (IBD).14Frequently Asked Questions about Inflammatory Bowel Disease (IBD) .18Testing in IBDColonoscopy and Flexible Sigmoidoscopy .20Upper Endoscopy .21Capsule Endoscopy and Deep Enteroscopy .22Laboratory Tests .23Imaging Tests .25Treatment Options in IBDMedicines5-ASAs .28Azathioprine/Mercaptopurine .32Methotrexate .36Prednisone .41Entocort , Uceris .45Anti–Tumor Necrosis Factor Antibodies (Anti-TNFs) .48Gut-Specific Anti-Adhesion Therapies (Entyvio [Vedolizumab]).53Anti–Interleukin 23 Therapies (Stelara [Ustekinumab]) .58Xeljanz .63Tysabri .67Cyclosporine .71Tacrolimus .74Mycophenolate .77Surgery for Inflammatory Bowel Disease .81Therapeutic Studies in Clinical Research .85Original: September 30, 2009Revised: June 19, 2019Page 1
Inflammatory Bowel Disease ProgramPatient Information GuidePage #Maintaining My HealthMy Information .96Friends and Family Form .96My Appointment Planner .97My Medicines .98Planning for My Next Visit.99Bathroom (Bowel Movements) Tracker .100Prednisone Taper Schedule .101Characteristics of My Inflammatory Bowel Disease.102Surgery on My Gastrointestinal (GI) Tract .103Monitoring My Laboratory Tests .104Preventing Complications by Monitoring My IBD Medicines .105Preventing Infections with Vaccines .105Vaccines .106Smoking and Inflammatory Bowel Disease .109Tuberculosis (TB) and Hepatitis B Testing .109Preventing Skin Cancer .109Preventing Bone Loss .110Preventing Colon Cancer .114Preventing Cervical Cancer (for Women) .116Sexual Health and Childbearing Issues in IBDSexual Health .117Fertility, Pregnancy, and Breast-feeding with IBD . 117Genetic Risk for IBD in Childbearing.120ResourcesUniversity of Michigan Crohn’s & Colitis Program Website .121Crohn’s & Colitis Foundation of America .122Clinical Research at the University of Michigan .123Recommended Books about Inflammatory Bowel Disease .124Useful Websites .127Medical RecordsPlace your test results and other documents here.Original: September 30, 2009Revised: June 19, 2019Page 2
Inflammatory Bowel Disease ProgramPatient Information GuideWelcome to the Crohn’s & Colitis ClinicDepartments of Internal Medicine and PediatricsDivision of GastroenterologyManaging Editor: Kristen Boardman, PA-CContributors: Leslie Aldrich, MD, Grace Elta, MD, John Del Valle, MD, Shail Govani, MD, PeterHiggins, MD, Terry Logan, RN, Beth Manoogian, MD, Swati Patel, MD, Michael Rice, MD,Ryan Stidham, MD, Lisa Sylvest, RN, Akbar Waljee, MDWe are glad you have chosen us to help you manage your inflammatory bowel disease. Thisbinder is a resource that will help you take an active role in your medical care. It will also helpyou understand inflammatory bowel disease and how it will impact your life. We have includedour contact information, as well as pages to record your test results and current medicines. Youwill also find information about treatment options and other helpful resources.The quality of your care is our number one goal. We are a team of physicians, physicianassistants, registered nurses, and medical assistants. We want to partner with you to make sureyou have the best quality of life possible. To do this, we ask you to come to all of your visits andtake your medicines as prescribed by your gastroenterologist.We need to see you at least once every 6 to 12 months and maybe more often, if necessary.Your well-being is our number one concern. If it is easier, you may have some blood tests doneat a lab close to your home. Please ask the lab to fax us the results. If you are not able to attendyour scheduled clinic visits or have lab tests done as needed, we are not able to care for yousafely and your health can be affected. We look forward to getting to know you. We will worktogether toward your goals so that you can live your life to the fullest.Original: September 30, 2009Revised: June 19, 2019Page 3
Inflammatory Bowel Disease ProgramPatient Information GuideImportant Things to Know Up Front If you are ill or are having side effects between 8:00 AM and 4:30 PM on a weekday call yournurse (see phone number on page 12). If you are thinking of going to the ER, call yournurse first because we will try to see you right away. If you cannot reach us and you areseriously ill, please do not wait until the next day; go to the ER right away. When you call the Crohn’s & Colitis Clinic be prepared to tell us exactly what symptoms youare having or give specific details about your concerns. Please have your registrationnumber and a list of your current medicines. When you call, you will speak with themedical assistant who will give the message to your nurse. We will make every effort to getback to you as soon as we can. Make sure we have your correct phone number so we canreach you. We do not e-mail patients. If you call before 12 NOON with an urgent issue, we will make every effort to return your callby the end of the day. If for some reason you cannot reach us, and you are seriously ill,please do not wait until the next day – go to the ER right away. Routine calls will generally be returned within 2 to 3 days. It is often more effective to send us an electronic message through the Patient Portal. Pleaseinclude a description of your current symptoms, and any specific questions you needanswered. If you have an urgent question after 4:30 PM on a weekday or on the weekend, call thehospital operator at (734) 936-6267 and ask for the gastroenterologist on call. If you arecalling about a child, the phone number is (734) 763-9650. Keep in mind that if you are admitted to the hospital due to a flare of IBD, youroutpatient IBD gastroenterologist will not see you day to day in the hospital. One of theIBD specialists on our team will see you and oversee your care while you are in the hospital.This doctor will be in touch with your outpatient doctor about your care, as needed. Do not wait until your routine appointment if you are sick. Call your nurse, who willwork closely with your doctor and the physician assistant to get an urgent visit scheduled.(UofM patients, not VA).Original: September 30, 2009Revised: June 19, 2019Page 4
Inflammatory Bowel Disease ProgramPatient Information GuideImportant Things to Know Up Front (continued) Always tell us about any new health problems you have or any ER visits or hospital stays.Please try to bring records about your hospital stays to your visits with us. The mostimportant records to bring are the discharge summary and reports of any tests, such asendoscopy, CT, MRI, and blood tests. For medicine refills, call the toll free number listed for your nurse (see page 12) and press 5for the refill line. Please call at least 2 working days before you will run out of yourmedicine (2 weeks for the VA). If you use a mail order service, please call at least 3 weeksbefore you need the refill so there is enough time for your medicine to be mailed. This canoften be done more quickly through the electronic messages of the patient portal. If you have a change in address, phone number, or health insurance, please give the newinformation to Hospital Registration at toll free 1-866-452-9896 Monday to Friday 6:30 AMto 8 PM or Saturday 8 AM to 1 PM. If you are taking an immunosuppressive medicine we needto be able to get a hold of you quickly. For example, the results of your lab tests may indicatethat the dose of your medicine needs to be changed. For this reason, please call your nurse assoon as you can to give us your new phone number. We encourage you and your family to become members of the Crohn’s & Colitis Foundationof America (CCFA) www.ccfa.org. The CCFA is a very helpful resource for anyone livingwith inflammatory bowel disease. Your nurse or doctor can tell you more about this group.Original: September 30, 2009Revised: June 19, 2019Page 5
Inflammatory Bowel Disease ProgramPatient Information GuideMeet Your Crohn’s & Colitis TeamOur doctors possess exceptional clinical skills and have a genuine interest in your treatment.Dr. Shrinivas BishuDr. John Del ValleDr. Peter ologyDr. Ryan StidhamDr. Jami KinnucanDr. Beth ManoogianDr. Muza-MoonsDr. Michael gyGastroenterologyGastroenterologyDr. Shirley CohenMekelbergGastroenterologyDr. Akbar WaljeeVA GastroenterologyDr. Jeremy AdlerPediatricGastroenterologyOriginal: September 30, 2009Revised: June 19, 2019Dr, Kelly CushingGastroenterologyDr. Haley NeefDr. George ologyPage 6
Inflammatory Bowel Disease ProgramPatient Information GuideAdditional Inpatient DoctorsDr. Michelle AndersonDr. Matt DiMagnoDr. John KaoDr. Raani PungliaDr. Liz SpeliotesDr. Erik ologyColorectal Surgery FacultyDr. John ByrnDr. Karin HardimanDr. Samantha HendrenDr. Arden MorrisDr. Scott nal: September 30, 2009Revised: June 19, 2019Page 7
Inflammatory Bowel Disease ProgramPatient Information GuideWe are proud to have two of the best physician assistants (PAs) to better serve your needs.Kristen Boardman, PA-CChristine Erickson, PA-COur medical assistants (MA’s) will help you schedule your appointments and make sureyou are ready for your first IBD visit.Danielle Burton, MAIBrittney Banks, MAOur registered nurses (RNs) are very knowledgeable and caring. They will help you manageyour disease.Kathy Palm, RNDonna Heisey, RNTeresa Stevens, RNOriginal: September 30, 2009Revised: June 19, 2019Valerie Hockman, RNTracy Krupp, RNPage 8
Inflammatory Bowel Disease ProgramPatient Information GuideOur GI Behavioral Psychologists can help you with relaxation and stress-relieving techniques todeal with the struggles of IBD.Dr. Megan RiehlDr. Christina JagielskiOur FODMAPS Dieticians can help you learn to manage your symptoms through your dailydiet.Emily Haller, RDNAmanda Dixon, RDNOriginal: September 30, 2009Revised: June 19, 2019Page 9
Inflammatory Bowel Disease ProgramPatient Information GuideClinical Research Staff for Dr. Peter HigginsCharlie Bourque, Clinical Coordinator for Dr. Ryan StidhamOriginal: September 30, 2009Revised: June 19, 2019Page 10
Inflammatory Bowel Disease ProgramPatient Information GuideCrohn’s & Colitis Clinics Taubman Health Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109 Brighton Center for Specialty Care, 8001 Challis Road, Brighton, MI 48116 Northville Health Center, 39901 Traditions Drive, Suite 210, Northville, MI 48168 West Ann Arbor, 380 Parkland Plaza Ann Arbor, MI 48103In addition to our clinic at Taubman Health Center, the following providers have a clinic at thefollowing locations:TC: Dr. Bishu, Dr. Higgins, Dr. Stidham, Dr. Manoogian, Dr. Del Valle, Christine Erickson,PA-CNHC: Dr. Bishu, Dr. Kinnucan, Dr. Muza-Moons and Dr. ManoogianBCSC: Dr. Muza-Moons and Dr. CushingWAA: Dr. Rice and Kristen Boardman, PA-CDayMondaytoFridayPediatric Clinic LocationC.S. Mott Children’s HospitalOriginal: September 30, 2009Revised: June 19, 2019PhysicianJeremy Adler, MD, MScHaley Neef, MDGeorge Zacur, MD, MSAvailabilityEvery dayPage 11
Inflammatory Bowel Disease ProgramPatient Information GuideCrohn’s & Colitis ClinicPhysician and Nurse Contact InformationHow to Contact Your Doctor: To contact your doctor, call the nurse who works with yourdoctor. Look at the table below to determine who your nurse is and which phone number to 631Kathy Palm, RN734-936-05011-888-229-7631Teresa Stevens, RN734-936-05011-888-229-7631Tracy Krupp, RN734-936-05011-888-229-7631Valerie Hockman, RN734-936-05011-888-229-7631Jami Kinnucan, MDDonna Heisey, RN734-936-05011-888-229-7631Beth Manoogian, MDTeresa Stevens, MD734-936-0501Valerie Hockman, RN734-936-05011-888-229-7631Kathy Palm, RN734-936-05011-888-229-7631Tracy Krupp, RN734-936-05011-888-229-7631Susan Manor, RN734-845-34691-800-361-8387Shrinivas Bishu, MDJohn Del Valle, MDShirley Cohen-Mekelburg, MDKelly Cushing, MDPeter Higgins, MD, PhD, MSMichelle Muza-Moons, MD, PhDMichael Rice, MDRyan Stidham, MDAkbar Waljee, MD, MScJeremy Adler, MD, MSc (Pediatric)Haley Neef, MD (Pediatric)George Zacur, MD, MS (Pediatric)Original: September 30, 2009Revised: June 19, 2019NurseValerie Hockman, RNVeterans Affairs Ann ArborRonna Johnson, RN1-888-229-7631Extension 53469734-763-9650Ronna Johnson, RN734-763-9650Ronna Johnson, RN734-763-9650Page 12
Inflammatory Bowel Disease ProgramPatient Information GuideCrohn’s & Colitis ClinicAppointment Scheduling and Other Contact InformationAppointment SchedulingLocalToll-FreeAdult Crohn’s & Colitis Clinic734-647-59441-888-229-7408Pediatric Crohn’s & Colitis Clinic734-763-9650––Medical Procedures Unit 00––Crohn’s & Colitis sten Boardman, PA-C734-936-05011-888-229-7631Christine Erickson, PA-C734-936-0501Clinical Research StaffLocalE-mailJennifer Dixon734-615-4843higginsSCteam@umich.eduKelli l AssistantDanielle Burton, MAPhysician AssistantTasneem Tweel734-647-2564higginsSCteam@umich.eduZachary Beringer734-647-4548higginsSCteam@umich.eduAngela Theil734-998-1147higginsSCteam@umich.eduKimberly -3911cabjr@umich.eduCharlie BourqueOriginal: September 30, 2009Revised: June 19, 2019Page 13
Inflammatory Bowel Disease ProgramPatient Information GuideBasic Information about Inflammatory Bowel Disease (IBD)What is inflammatory bowel disease?Inflammatory bowel diseases are a collection of conditions causing chronic inflammationprimarily affecting the small intestine and/or colon (also known as the large intestine). The causeof IBD is not completely understood, but is believed to be related to a combination of genetic,bacterial (microbiome), and immune system factors. Current theories suggest that individualswith IBD have an immune system that has developed an aggressive response to innocuousintestinal bacteria. More than 160 genes have been linked to an increased risk or severity of IBD,however no single gene is clearly causative. While the most common area of involvement is theintestines, other regions including the skin, joints, and eyes can be affected by IBD.There are three different types of inflammatory bowel disease.1. Ulcerative colitis affects only the colon.2. Crohn’s disease most often affects the end of the small intestine, but it can affect any region.3. Indeterminate colitis is when features of both Crohn’s disease and UC are present.What is ulcerative colitis (UC)?Ulcerative colitis starts in the rectum and can affect the entire colon or only part of it. It may becalled proctitis if only the rectum
Ryan Stidham, MD, Lisa Sylvest, RN, Akbar Waljee, MD We are glad you have chosen us to help you manage your inflammatory bowel disease. This binder is a resource that will help you take an active role in your medical care. It will also help you understand inflammatory bowel d
A bowel resection is performed to surgically remove a disease part of the bowel. Common indications for the surgery are blockage of the bowel (intestinal obstruction) due to scar tissue or tumours, bleeding or infection due to diverticulosis, inflammatory bowel disease such as Cro
Crohn's disease Inflammatory bowel disease - Crohn's disease; Regional enteritis; Ileitis; Granulomatous ileocolitis; IBD- Crohn's disease Last reviewed: October 29, 2012. Crohn's disease is a form of inflammatory bowel disease (IBD). It usually affects the intestines, but may occur anywhere from the mouth to the end of the rectum (anus).
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8.5 Standards for documentation of bowel management (conducted by professional or agency carer) 9. Who can give neurogenic bowel care? Knowledge required Skills required - independently or under direction 10. What interventions can be used for management of neurogenic bowel dysfunction? 10.1 Establishing a bowel management routine or programme
Stepping into the Future of IBD Care. OUR VISION Dear friends and colleagues, It is a great pleasure for us to welcome you to Hyderabad on 3rd - 5th April 2020, for the International Symposium on Inflammatory Bowel Disease. Inflammatory Bowel disease including Crohns disease & ulcerative colitis are
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