Inflammatory bowel disease is a blanket term that encompasses conditions that are characterized by long-term inflammation of the digestive tract. The two main forms of IBD are Crohn’s disease (CD) and ulcerative colitis (UC). IBD is a complex condition, so treating the disease and managing its symptoms will usually involve a team of different kinds of healthcare providers.
Some of the types of healthcare professionals who support a patient in diagnosing, treating, and managing IBD may include:
- Primary care provider
- Gastroenterologist
- Rheumatologist
- Colorectal surgeon
What is a primary care provider’s role in treating IBD?
Primary care providers are medical professionals who focus on providing preventative, non-emergency healthcare to patients on an on-going basis.1,2 Primary care providers also diagnose common health conditions and provide patients with referrals to specialists when their problems are more complicated. Examples of primary care providers are:
- Internists
- Family practitioners
- Pediatricians
- Nurse practitioners or physician assistants
The first step in managing IBD is to have the condition diagnosed correctly. Primary care providers are often the first to recognize that IBD may be causing a patient’s symptoms. They will then begin the process of finding out if the symptoms are the result of CD, UC, or some other cause.
To begin, the primary care provider will typically take the patient’s medical history, learn more about the symptoms, and perform a physical examination. If the primary care provider still suspects that the patient may have IBD, then laboratory tests may be ordered to analyze the patient’s blood and stool. If the results of those tests also suggest that the patient’s symptoms are related to IBD, then the patient may be referred to a medical specialist called a “gastroenterologist.”
After diagnosis, primary care providers continue to play important roles in helping to support the patient, monitor the disease, and manage the treatment regimen.
What is a gastroenterologist’s role in treating IBD?
A gastroenterologist is a medical specialist who has completed extensive training to diagnose and treat conditions related to the digestive tract and the liver.3 They have an in-depth understanding of all parts of the digestive tract and how they function together. Some gastroenterologists further specialize in certain types of gastrointestinal conditions, such as Crohn's disease and ulcerative colitis.
Depending upon patients’ laboratory and examination results, primary care providers may refer patients to a gastroenterologist for further diagnosis and treatment. Gastroenterologists are trained to perform specialized “endoscopy” procedures to look inside a patient’s body using a tiny camera attached to a thin, flexible tube. They are also specially trained to interpret what they observe.
Endoscopy can be used to:
- Help diagnose the cause of a patient’s symptoms
- See where the inflammation or other symptoms are located
- Assess the severity of the disease
- Take biopsies, which are tiny samples of tissue from inside the body
- Monitor the progress of the disease during flare-ups and remission
After diagnosis, the gastroenterologist works with the patient to create an individualized treatment plan to manage symptoms and provide the best possible quality of life.
What is a rheumatologist’s role in treating IBD?
Rheumatologists are physicians who specialize in the diagnosis and treatment of diseases that affect the body’s connective tissue.5,6 Some patients with IBD develop a form of chronic, inflammatory arthritis called enteropathic arthritis. Enteropathic arthritis is a type of spondyloarthritis that seems to be specifically common in patients with diagnosed inflammatory bowel disease, such as CD or UC. Spondyloarthritis is a type of arthritis that typically affects the spine, but can affect the arms and legs in some people. Rheumatologists help IBD patients experiencing symptoms associated with arthritis to diagnose, treat, and manage their symptoms.
What is the colorectal surgeon’s role in treating IBD?
Most people with IBD will eventually have one or more surgeries to help treat the disease and its complications. This means that colorectal surgeons are an important part of the team of health care providers involved in treating a person with IBD. Colorectal surgeons are specialists in conditions that affect the lower part of the digestive tract, including the large intestine (colon), rectum, and anus. Many people with IBD have disease that affects one or more of those three areas, which can cause complications that may need surgery to treat. These complications include abscesses, fistulas, strictures, and bowel perforation.