Inflammatory Bowel Disease Program

Our team-based approach employs a gastroenterologist, physician assistant, and a team of nurses and medical assistants to share the responsibilities of our patients’ medical care. Following evidence-based guidelines, the IBD team will work closely together to plan and coordinate a comprehensive plan of care personalized to each patient, who will have the opportunity to meet the IBD team members during a visit.

The key to effective management of the disease is coordinated care among specially trained, internationally recognized physicians with expertise in inflammatory bowel disease. Our experienced team also includes nutritionists, surgeons, radiologists, and pathologists. Our medical and surgical specialists are available at the same visit to provide comprehensive care. Our enterostomal nurses work with families to manage ostomy care and provide support.

Treatment for ulcerative colitis or Crohn’s disease usually begins with medical therapy. While surgery can be a primary therapy for certain symptoms of IBD, it is usually reserved as a supplement to medical therapy. The goal of GI surgery is to restore function, using bowel-conserving surgery, including minimally invasive surgery where appropriate.

In order to properly diagnose and treat patients with IBD, doctors must perform visual examinations of the gastrointestinal tract through procedures known as endoscopies. The three most common procedures are as follows: colonoscopy, upper endoscopy, and capsule endoscopy. Each procedure visualizes a different section of the gastrointestinal tract.

Colonoscopy—Sigmoidoscopy: These procedures allow doctors to evaluate the entire large intestine and the end of the small intestine called the ileum. In patients with inflammatory bowel disease, a colonoscopy is required for evaluation of the disease activity and for colon cancer screening. Some patients may undergo a sigmoidoscopy, which only views the first third of the large intestine.

Upper Endoscopy (EGD): This procedure allows evaluation of the esophagus, stomach, and duodenum. In patients with inflammatory bowel disease, an upper endoscopy evaluates disease involvement in the upper region of the digestive tract.

Capsule Endoscopy: The newest diagnostic procedure, it allows evaluation of the small intestine not accessible by upper endoscopy and colonoscopy. A tiny camera contained in a capsule passes naturally through the digestive tract while transmitting video images to a data recorder. Images of the small bowel are downloaded to a computer and reviewed by a physician.

Chromoendoscopy: Chromoendoscopy is a technique performed during colonoscopy to enhance the detection of pre-cancerous areas in the colon. It uses a blue dye that temporarily stains the colon wall during colonoscopy, which helps highlight these pre-cancerous areas.

Imaging: Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are specialized radiographic studies that help in the diagnosis and management of Crohn’s disease. These scans are particularly helpful in identifying inflammation and complications of inflammation (such as fistula) in the small intestines. It allows us to visualize deeper areas of the small intestines that are not in reach with traditional upper endoscopy/colonoscopy.

Infusion Centers: The Yale IBD Program offers infusion services at Temple Medical Center at 40 Temple Street in New Haven, adjacent to the IBD program clinical practice. For the patient's convenience, a clinic appointment with a Yale gastroenterologist can be scheduled alongside an infusion therapy appointment.

The Infusion Suite offers infusions for the following:

• Biologic Therapies such as Remicade (Infliximab)
• Intravenous Iron
• Intravenous Fluids