Here is the link to the podcast and show notes of #138 Inflammatory Bowel Disease: Crohn’s and Ulcerative, FEBRUARY 4, 2019 By DR PAUL WILLIAMS from The Curbsiders. The show notes and podcast are outstanding [I always say that but they always are].
The clinical information begins at 11:25.
The show notes should be reviewed in their entirety as they are full of pearls.
I’ve put in the time stamps for my convenience:
Intro and background
- 00:00 Sponsor: MKSAP 18
- 00:32 Disclaimer, Intro, guest bio
- 04:05 Guest one-liner, Adam’s movie rec – RBG (documentary), career advice, Paul’s movie rec – Edge of Tomorrow
- 09:25 Sponsor: ACP’s MKSAP 18
- 11:25 Definitions and pathophysiology of inflammatory bowel disease (IBD)
- 13:40 A case of ulcerative colitis; Classic symptoms; Initial approach and basic differential diagnosis
- 19:10 Smoking and ulcerative colitis
- 21:17 Initial workup for suspected IBD; Fecal calprotectin
- 25:50 A bit more on CRP and IBD
- 26:55 When to refer for colonoscopy
- 27:58 Back to the case; a typical colonoscopy reports in ulcerative colitis (UC)
- 30:33 Extraintestinal manifestations of UC
- 34:50 Initial counseling for newly diagnosed IBD; natural history of IBD, prognosis
- 39:50 Treatment of ulcerative colitis
- 43:02 Some specifics on steroids, plus topical therapies
- 47:05 A case of Crohn’s disease; initial approach and differential diagnosis
- 50:25 Initial diagnostic testing; colonoscopy findings in Crohn’s; IBD trivia
- 53:58 Treatment of Crohn’s disease
- 58:26 Specifics about biologic therapy for IBD; Endpoints
- 62:25 Steroid sparing agents, immunomodulators like azathioprine, 6-mercaptopurine
- 64:48 Can drug therapy be stopped or tapered in IBD?
- 66:50 Prognosis in Crohn’s and initial patient counseling
Primary Care considerations
- 68:35 Surveillance endoscopy,
- 71:47 Do diet and lifestyle changes for IBD work? What about pregnancy?
- 76:31 Immunizations
- 79:25 Bone health, osteoporosis and IBD, screening for iron and nutritional deficiencies
- 82:27 Take home points
- 86:28 Outro