Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD)

Crohn’s Disease, Ulcerative Colitis, and IBD Complications

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Crohn’s disease and ulcerative colitis are often difficult to manage. They are best treated by gastroenterologists who specialize in these inflammatory bowel diseases. Duke's team of inflammatory bowel disease specialists helps you manage your IBD, and gets your disease back into remission if you have a relapse.

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Seek Care From an IBD Specialist

Whether your disease is mild or complex, our gastroenterologists who specialize in IBD treatment can work with you to control your disease and its symptoms. We help restore your quality of life and watch for any complications related to the disease or its treatment.

Expertise in Diagnosing and Treating IBD
Doctors from across the region refer their patients to us because of our expertise in diagnosing and treating IBD and its complications. If you are referred to us, we will partner with your current doctors to ensure you receive the best possible care. We also welcome people who are new to the Triangle and want to establish care with an experienced IBD provider.

Experience with Complicated Conditions
Whether you are newly diagnosed with Crohn’s or ulcerative colitis, or are seeking another opinion about your treatment, our IBD providers are ready to see you. We work with people who:

  • Have complex IBD histories
  • Have other medical problems that make their treatment challenging
  • Are not responding to conventional treatments
  • Have developed a complication related to IBD or its treatment and require more comprehensive care

Post-Surgery Treatment
We provide care for people with Crohn’s who have had surgery to remove a piece of intestine or close a fistula. We also help people with ulcerative colitis who have undergone surgery to “cure” the disease by removing their colon. And we can help with managing “pouchitis,” an inflammation of the ileal pouch that may occur after removal of the colon.

Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.

Treatments

Medical Management

Depending on your needs, your medical treatment may range from antibiotics and steroids to immune-suppressing agents, biologics, and other advanced therapies.

Biologics

Biologics are the newest class of medication developed to target and stop inflammation in the body. They may be used to start remission in people with moderate to severe Crohn’s disease or ulcerative colitis. However, these powerful medications are not for everyone. If you are a candidate, biologics may be used to get your disease into remission and to keep it inactive. Our IBD team is equipped to provide the close supervision these medications require, or to assist your local doctor in the process.

Surgical Removal of the Colon, Rectum

Surgical removal of the colon or the colon and rectum may be recommended to treat ulcerative colitis if:

  • Medical therapy is no longer effective
  • You are experiencing significant bleeding
  • You face a risk of cancer

When the entire colon is removed, an opening called a stoma may be created in the abdominal wall, and an external pouch attached, which must be worn at all times.

Surgical Removal of Strictures

For people with Crohn’s disease, surgery is not considered curative, but it may be necessary when complications such as strictures (narrowed areas of the small or large intestine) develop and cause intermittent blockages. The blockages can cause debilitating symptoms, and surgery to remove the narrowed segment and reconnect the intestine can help restore your quality of life. 

Ileal Pouch Anal Anastomosis

A section of small intestine is sewn to form a small pouch that is attached to the rectum on the inside of the body. This enables people to have bowel movements by sitting on the commode rather than having to wear an ostomy bag to collect waste outside the body.

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Advanced Gastrointestinal Endoscopy

In addition to performing common procedures such as colonoscopy and upper endoscopy, our gastroenterologists are experts in advanced endoscopic procedures. These techniques help us detect abnormalities such as bleeding, ulceration, inflammation, and scarring. They ensure you receive an accurate diagnosis and are a key step in determining the most effective treatment plan for you. 

Endoscopic Ultrasound

May distinguish Crohn’s disease from ulcerative colitis. An endoscope fitted with an ultrasound device obtains deep images and may be used to identify fistulas -- connections between the intestines and skin or other organs -- in the rectal area.

Chromoendoscopy

A blue spray dye is used during colonoscopy to highlight abnormal areas of the colon. It can detect an abnormal development of cells called dysplasia -- an early sign of colorectal cancer -- in people who have ulcerative colitis or Crohn’s disease involving the colon.

Capsule Endoscopy

Obtains pictures of the entire small bowel. You'll be asked to swallow a capsule camera about the size of a large vitamin tablet. The camera then travels through the small intestine and transmits photos to a recorder you wear on a belt around your waist. 

Double Balloon Enteroscopy

An inflating and deflating balloon identifies abnormalities as it helps move the endoscope deeply into the small intestine.

Among the Best Hospitals for GI in the U.S.
Where you receive your care matters. Duke University Hospital is ranked among the best in the nation for gastroenterology and GI surgery.

Choose Duke for Your IBD Care

A Team of Experts
Your IBD team may include doctors from many specialties, including gastroenterologists who specialize in diagnosing and managing IBD, colorectal surgeons skilled in minimally invasive techniques and robotic technology, GI-specific radiologists who focus solely on abdominal imaging, and specialized pathologists who examine tissue samples to help your doctors learn what is going on at a microscopic level. We meet regularly to review complex cases and work together to make treatment recommendations.

Comprehensive Care
Because IBD can cause health problems and symptoms in areas outside the gastrointestinal tract, your team may also include specialists in skin and wound care, joint diseases, eye diseases, and bone diseases.

Comfortable Setting
We offer a comfortable setting for tests and consultation. Our IBD specialists see people in Durham and Raleigh, and our infusion centers, located at Duke and at Brier Creek, provide convenient options for the administration of intravenous medicine. The Duke Specialty Infusion Center offers Saturday morning infusions.

Access to Clinical Trials
You may be eligible to participate in studies of new therapies that are not available elsewhere. Some of our patients help further our knowledge and understanding of IBD by letting us collect samples of blood or tissue, or by joining a clinical trial.