This takes a toll on people with IBD. “A lot of my patients who are parents cannot do many things they like to do,” he said. “They cannot go to a kid’s school activity, or the kids cannot go to a play date. They try to live their life in a way that restricts everybody’s freedom, and that can be very, very devastating. Not only for the patient, but everyone.”

To reach a diagnosis, a gastroenterologist will employ a combination of bloodwork, imaging (like CT or MRI scans) and a review of the patient’s medical history and symptoms.

Medical therapies

The first step in treating inflammatory bowel disease is medical therapy.

• Anti-inflammatories soothe inflammation in the stomach lining.
• Corticosteroids dampen the immune response that causes inflammation.
• Biologics block immune system proteins such as integrin and interleukin that can trigger intestinal inflammation.

Medications may be enough to treat inflammatory bowel disease. But if the patient isn't finding relief, said Dr. Remzi, it's important to move on to other treatments — the sooner, the better. “One therapy is okay; two or three therapies is okay,” he explained. “But four, five or six different drugs in a long period of time where the patients come to us sicker than usual with weight loss and several restrictions, makes surgery very difficult on our patients.”

Surgical options

If your symptoms don't respond to medications, your surgeon will work with you to determine which of the many procedures for inflammatory bowel disease is right for you. Surgeries include:

• Strictureplasty: This procedure corrects the narrowing of the intestine known as a stricture. Surgeons reshape and widen the intestine to improve the passage of digested food and stools.
• Ostomy surgery: Surgeons create an opening in the abdomen (called a stoma) to which they attach the large or small intestine; this allows urine and feces to be captured in a colostomy or ileostomy bag (outside of the body). Ostomies and ostomy bags can be temporary or permanent. 
• Proctocolectomy: This involves the removal of the colon and rectum — the last two sections of your large intestine. Subtotal proctocolectomy removes only parts of these sections.
• Bowel resection surgery: A surgeon removes the diseased sections of the intestine and closes the gap by joining healthy sections.
• J-pouch surgery (ileoanal anastomosis): In this two-part procedure, the surgeon performs a proctocolectomy to disconnect the intestine from the anus, and then attaches the small intestine to the anus.

Full recovery from surgery typically takes anywhere from four to 12 weeks.

“Subspecialization in the setting of inflammatory bowel disease is the most important factor that impacts the outcome of treatment,” Dr. Remzi noted.

Despite being relatively new, the Center has already accepted patients from 30 states around the country, Dr. Remzi said, “including Alaska.”

The Center also supports the research efforts of The Feinstein Institutes for Medical Research, Northwell’s research body, through the Center's tissue bank: Dr. Remzi explained that the bank allows him and colleagues to store stool, urine and biopsy samples collected from patients, which Feinstein Institutes' researchers can tap for research on IBD.

One such study, conducted by pediatric gastroenterologist Benjamin Sahn, MD, investigated vagus nerve stimulation as a potential treatment for inflammatory bowel disease in children. The study found that stimulating the nerve via the ear reduced inflammation in 64% of the children in the trial.

Dr. Remzi is hopeful that studies like these will continue to push inflammatory bowel disease care forward. “It may not be an immediate answer for today,” he said, “but it may serve a dramatic answer in five to ten years’ time.”