SUMMER 1995 ISSUE
■
SINAI HOSPITAL
Inflammatory Bowel Disease Center
R
mon in people 15 to 30 years old.
Patients with a history of longstand-
ing, extensive ulcerative colitis are at
increased risk of developing colon
cancer. The lED Center has a program
for monitoring these patients to
minimize the risk of an undiagnosed
cancer.
order for members of the patient's
family.
Still, even if the causes of the vari-
ous forms of IBD are not clear, the
symptoms and effects are obvious to
the two million or so people in the Unit-
ed States — including thousands in
southeastern Michigan — who suffer
from IBD: abdominal pain, diarrhea,
Familial Polyposis
bowel obstruction and weight loss. IBD
is rarely fatal, but it can be progressive
Familial polyposis is an inherited
and debilitating. A major purpose of
disease of the colon. Malignancy usu-
the
Inflammatory Bowel Disease Cen-
ally develops before age 40 in nearly
ter is to alter the odds in the patient's
all untreated patients, but may occur
favor.
much earlier. Surgery
"IBD does not have
is often required; the
to
be debilitating if pa-
newer rectal-sparing
tients
are well cared
surgeries can be per-
does not
for,"
says
Jason Bodzin,
formed in most cases.
M.D., the center's
have to be
Surgeons at the IBD
director. "Many people
Center perform these
from this area have
procedures without the
traveled far and wide
need for permanent os-
to other centers — in
if patients
tomy. Genetic counsel-
Cleveland or New
ing is recommended.
Crohn's Disease
York, for example — be-
are well
cause they didn't think
Also known as Regional enteritis.
The causes of IBD
the right treatment for
This condition occurs with about equal
are not well under-
their condition was
frequency in both men and women; it
stood. Medical experts
available here."
usually begins before age 40, with peak
know that they are
The center has a
-Jason
Bodzin,
M.D.
incidence in the 20s. There is a higher
chronic rather than in-
team of experts avail-
incidence of Crohn's Disease among fectious, which means
able for counseling,
Jewish people and others of Semitic
that you can't catch
treatment and support:
origin.
IBD from someone who has it. The
gastroenterologists (physicians who
tendency to develop IBD can be in-
specialize in the digestive system); di-
Ulcerative Colitis
herited. Therefore, they can be passed
eticians; surgeons who specialize in the
Ulcerative colitis can occur in peo-
from one generation to the next, and
variety of new procedures that have
ple of any age, but onset is most corn-
genetic counseling may be in
recently become available for the treat-
ment of various forms of IBD;
enterostomal therapists to work
with those who have had a
portion of their intestine re-
moved; and a psychological sup-
port program.
Dr. Bodzin notes' that many
it &Wm% Disease — affects small intestine, colon, and other sites
of the people that work in
the IBD Center are themselves
• Ulcerative Colitis- affects the rectosigmoid and colon
IBD patients. Individuals with
IBD were encouraged to apply
COMPLICATION
for the positions because it was
felt that they would have a bet-
Effects on the Colon — Crohn's Disease and Ulcerative Colitis
ter understanding of the condi-
Complication
Associated symptoms
tions they were treating as well
Diffuse Disease
diarrhea, bleeding, fever, malaise
as the concerns and feelings of
the patients.
Stricture
distention, pain /cramps, loud bowel
In addition to providing pa-
sounds, changes in bowel habits
tient-centered diagnosis and ser-
vices, the center also conducts
Toxic Disease
high fever, distention, pain
research aimed at-developing
Rectal Disease
urgency, pain, bleeding
new therapies for IBD.
Based on the number of peo-
ple
with IBD now being treated
Effects on the Small Intestine — Crohn's Disease
by participating physicians, the
Complication
Associated symptoms
center is expected to care for
more than 3,000 patients.
Abscess
fever, mass
Dr. Bodzin is enthusiastic as
Fistula
he describes the IBD Center and
the prospect it offers for im-
Stricture
pain I cramps, nausea and vomiting,
proved patient care. "This is a
distention, loud bowel sounds
new facility where a significant
number of medical and para-
Widespread Inflammation
weight loss, diarrhea, fever,
medical professionals come to-
loss of appetite
gether to provide treatment and
support for IBD patients, most
Effects t the Entire Body
of whom have had a hard time
finding a group like this to help
• Eye infl,ammation • Growth failure in children • Kidney stones • Liver and
them," he said. "We will do our
bile duct inflammation • Gallstones • Skin lesions • Arthritis and joint pains
best to provide the care and ser-
vice they deserve."
ecognizing the need to estab-
lish a focal point of care for the
thousands of people in south-
eastern Michigan who suffer
from inflammatory bowel disease,
Sinai Hospital has established a
center that promotes and facilitates
the diagnosis, care and research
associated with this often debilitating
condition.
By emphasizing this multi-discipli-
nary approach to treatment, the
Inflammatory Bowel Disease Center
(IBD Center) also addresses a very
practical concern of patients by pro-
viding a site where they can receive a
spectrum of treatments in one day
instead of having to visit various spe-
cialists at different locations.
Inflammatory bowel disease (IBD)
is actually a collective term that cov-
ers a number of inflammatory disor-
ders of the gastrointestinal tract.
Among these are the following:
High-Tech Eye Care
is Routine at Sinai
continued from page 2
The in-house research that led to that
unique diagnostic tool sets Sinai apart.
Ophthalmic research at Sinai ranges from
in-depth analysis, which pinpoints a diag-
nosis, to monitoring a drug's effects on a pa-
EXAM VITAL
FOR GLAUCOMA
D'ETECHON
.
"IBD
debilitating
S PEC IAL AD VERT IS EMENT
cared for."
S
inai is at the forefrvnt of detecting and
treating glaucoma, a very common
eye disease that can lead to blindness
if not treated. 'Most patients diggnosedwith
-
glaucoma don't have sy ;pr. g., e,-,--.? 40,3
Marshall Cyrlin, M.D., itito:F
. . . .,_ . ,. _ - - . . ,....,
GlaUCOMCI Service. "It's u, §
- r
- tit,-- 40134
'
--, .
,,,,
as part of an exam for glass
.i 07iti. -fi,,,
problem"
Glaucoma is not a single ds* - -:- rze%
variety characterized by pressure -in.- i
which can damage the optic nerve. .,:„._ --,,
"In most patients who are diagnosede arl
ly, we can prevent total vision loss with life-
long treatment," says Dr. Cyrlin. "Usually
treating the glaUcoma doesn't make you feel
or see better, but you gain the satisfaction
that it is under control."
You are at greater risk for glaucoma
if you: are age 50 or more; have gkuico-
ma in your immediate family; are
African American , are very _ nears ight
tient's eyes. 'The partnership we have with
clinical diagnosis is very significant," says
Lawrence Baitch, 0.D., Ph.D., chief of Neu-
rosensory Services.
State-of-the-art diagnostic procedures in-
clude fluorescein and indocyanin green an-
giography. Dye injected into a patient's arm
highlights blood vessels in the retina so that
specialists can exam it with special cam-
eras. This procedure is especially useful in
diagnosing and treating "macular degen-
eration" or deterioration of the retina. It is
the leading cause of reduced vision in peo-
ple over age 65.
"Diabetic retinopathy is the number one
cause of vision loss for people under age
65," explains Alan Ruby, M.D. But the con-
dition can be treated by experts at Sinai's
Retinal Imaging Center in the Ophthalmic
Diagnostic Center.
One 45-year-old diabetic patient could
only count fingers in a vision test as the re-
sult of complications of diabetic retinopa-
thy. After having surgery to remove scar
tissue and blood, her vision is 20/50. It has
improved so much that she is again able to
drive.
To find the eye care you need, call
SinaiSource at 1-800-248-3627.