May 14, 2013

Digestive Health Center manages lifestyle, disease
The new center is a one-stop shop for patients, bringing together gastroenterologists and surgeons in one clinical practice.

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Laura Chambless was just 24 when she was diagnosed with ulcerative colitis, a disease that took over her life for more than a year. The severity of Chambless’ symptoms meant she could not go to school, work or out with her friends.

“It dictates every part of your day,” she said. “Nothing is predictable. You have to be near a restroom at all times.”

Ulcerative colitis is an inflammatory condition of the large intestine that causes alterations in bowel function, abdominal pain and bloody diarrhea. While it can affect anyone, it is more common in people younger than 30 and older than 50. According to the Crohns and Colitis Foundation of America, as many as 700,000 people in the United States suffer from the disease.

Treating the disease and its symptoms means helping patients manage their lifestyle because what people eat and drink, and how they live directly impacts most digestive diseases.

The newly created University of Alabama at Birmingham Digestive Health Center’s top priority is helping patients effectively manage their lifestyle and digestive disease. It is a one stop shop bringing together gastroenterologists and surgeons in one clinical practice, streamlining coordination of care between the two connected disciplines and simplifying access to numerous clinical subspecialties, including nutrition and pain management, that are key to lifestyle management and improving disease treatment or control.

“It’s really a natural for GI medicine to pair with GI surgery,” said Mel Wilcox, M.D., center co-director and director of the UAB Division of Gastroenterology and Hepatology. “Much of what we do in gastroenterology involves surgery for patient management. A number of patients who have likely surgical conditions are first seen by a gastroenterologist who decides if the patient needs surgery.”

The newly created University of Alabama at Birmingham Digestive Health Center’s top priority is helping patients effectively manage their lifestyle and digestive disease. It is a one stop shop bringing together gastroenterologists and surgeons in one clinical practice, streamlining coordination of care between the two connected disciplines and simplifying access to numerous clinical subspecialties, including nutrition and pain management, that are key to lifestyle management and improving disease treatment or control.  
“Having access to nutrition, psychology and pain services for patients, when needed, is very important” said John Christein, M.D., center co-director and associate professor in the UAB Section of Gastrointestinal Surgery. “These are especially important because many benign GI diseases are chronic illnesses, and patients such as those with inflammatory bowel disease or chronic pancreatitis, rely on these specialties to help maintain a good quality of life.”

The center sees patients with all types of benign and malignant GI diseases, including esophageal, stomach, gallbladder and bile duct, small intestine, colon, anorectal, pancreatic and liver disorders, as well as tumors of the GI tract. It offers the latest in treatments, including therapeutic gastrointestinal endoscopy, novel laparoscopic surgical techniques and state-of-the-art medical therapy for IBD, as well as the opportunity for patients to participate in clinical trials.

For Chambless, her disease progressed so quickly that she ended up on the fast track for surgery. No medication or lifestyle change could effectively treat her ulcerative colitis or even its symptoms. Just a year after diagnosis, her colon was removed by UAB GI surgeon Jamie Cannon, M.D.

“We have very good medical therapies for ulcerative colitis,” Cannon said. “Most people respond well, but for some, they either never work, quit working or have too many side effects. For Laura, medication was not working, and the best option was surgery.”

The team of physicians and nurses at the center helped give Chambless a better understanding of her changing lifestyle after surgery. Once her colon was removed, she lived for several months with an ileostomy until Cannon completed the third phase of her surgery, a j-pouch, which gave Chambless almost normal bowel function.

“Dr. Cannon spent so much time with me, and with my family, explaining what I could expect and what I could be prepared for,” Chambliss said. “It is a huge surgery, and there are a lot of questions that come up after: could I eat or drink anything I wanted; was this pain or that twinge normal? You just want to make sure you’re o.k., and what I appreciated most from the doctors and nurses at the center was that they took the time to explain every aspect of every question I asked and helped me understand my ‘new normal’.”

An added benefit of the new center is more convenient access to both specialties on the same day for patients like Chambless, who traveled from Montgomery, Ala., for treatment.

“A lot of our patients come from a far distance to see us, so if we can offer what they need while they are here, and they don’t have to come back for another appointment to see a surgeon or another physician, then we think that is a great benefit for our patients,” Wilcox said.

Christein added that both specialties working together in the clinic also benefits the patient’s quality of life because it expedites care, allowing doctors to come to a diagnosis more quickly; they can formulate a treatment plan sooner with medicine, surgery and any other services the patient may need.

“Most of what we treat is benign disease, and because a benign digestive disease could be a long-term issue, quality of life is important,” he said.

Cannon said the new center also is a benefit for physicians; the decision to transition from treating with medications to doing surgery can be a difficult one to make, and it requires collaboration between the various specialists. The center allows ease of collaboration and is a win-win for physicians and patients.

“It is a real advantage when we’re working with diseases such as ulcerative colitis or Crohns disease,” she said. “Since we started the Digestive Health Center, all I have to do is step out in the hall and have access to inflammatory bowel disease specialists who can immediately come in the room, and we can evaluate the options together with the patient.”

Chambless, who is back in school and will begin graduate school this summer, said she is grateful to Cannon and others at UAB for making her feel normal again.

“I can go to school and not think about it, and I can pretty much eat whatever I want,” Chambless said. “But the biggest thing for me is being able to live my life without really having to think about it every second of the day, and just being free to go and do as I please.”
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