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.