Center for Inflammatory Bowel Disease

Introduction

Patient care at our department

The peak ages for patients with IBD are 20–24 and 25–29 years in ulcerative colitis and 20–24 and 15–19 years in Crohn’s disease among male and female patients, respectively. Several patients develop the disease in their student years or middle age; hence, we prioritize outpatient treatment for them to be treated without hospitalization as much as possible. However, surgery may have to be prioritized depending on the condition, and we work closely with the gastrointestinal surgery department for treatment. Additionally, some female patients are about to become pregnant or give birth; thus, we provide concurrent consultations with the obstetrics and Gynecology Department and the Perinatal Maternal And Child Center. IBD cannot be healed completely due to its intractable nature, thereby placing a heavy mental burden on patients. Additionally, support from the mental clinic is available on a case-by-case basis. Moreover, concurrent consultations are offered with the Gastroenterology and Hepatology Departments although basic medical care is provided for pediatric patients.

Target diseases and treatment

The following diseases are representative examples of diseases managed at the IBD Center.

Ulcerative colitis

Ulcerative colitis is a disease that involves erosions and ulcerations in the mucous membrane of the large intestine. The lesions continuously form from the rectum to the mouth. It frequently occurs in young to middle-aged people, but recently, the number of patients with ulcerative colitis aged > 65 years increased.

Crohn’s disease

Crohn’s disease involves longitudinal ulcers (vertical ulcers that occur in the longitudinal direction of the intestine) and cobblestone-like changes in the digestive tract from the mouth to the anus. Compared to ulcerative colitis, it occurs in young to middle-aged people. Consumption of large amounts of animal fats worsens inflammation; hence, patients with severe clinical symptoms should refrain from consuming animal fats. Japan is characterized by a high incidence of complications, such as perianal abscesses and anal fistulas.

Intestinal Behçet’s disease

Behçet’s disease is characterized by symptoms, including aphthous stomatitis, vulvar ulcers, skin symptoms, and eye lesions, as well as deep ulcer formation (punched-out ulcer) that digs under the intestinal wall, mainly at the transition area between the ileum and cecum (ileocecal area).

Eosinophilic esophagitis and gastroenteritis

This is a disease in which eosinophils, which cause allergies, cause inflammation and ulcers in the esophagus and gastrointestinal tract, despite no specific allergic cause. Many other diseases, such as nonspecific multiple small intestinal ulcers and Mediterranean fever, exist so please consult us.

About treatment

The basic treatment to suppress inflammation is oral medication (mesalazine, thiopurine, and adrenal cortical hormones). We treat patients, who have inflammation that does not improve even with these medications, with antibody preparations (subcutaneous injections and drips) and low molecular weight compounds (oral agents). The indications differ based on the disease, and the treatment is selected according to the patient’s condition (nutritional status, age, etc.). In general, medical treatment takes precedence, but surgery may be performed if no response to medical treatment.

Medical record

Medical staff

Outpatient clinic

To medical institutions

To the regional medical institutions

Both the Saitama Medical Center and Kawagoe Clinic treat patients with IBD. Please refer adult and pediatric patients to the Gastroenterology and Hepatology Outpatient Department and the Pediatrics Department, respectively. Kawagoe Clinic primarily manages patients with mild symptoms who can visit the clinic.

To medical students and residents

We are looking for doctors capable of IBD treatment. Many patients with IBD visit our center. We look forward to doctors who will join us in IBD treatment and research.