Study finds fewer IBD patients require surgery

CALGARY- When Myrna Fink was first diagnosed with inflammatory bowel disease almost 40 years ago, her treatment options were limited.

“There was really only steroids, anti-inflammatories to keep the inflammation at bay and surgery,” Fink recalls.

Over the years, she has had surgery three times for her Crohn’s disease. Crohn’s disease and ulcerative colitis are inflammatory bowel diseases that are often diagnosed when patients are in early adulthood. With IBD, the patient’s immune system attacks their gastrointestinal tract.

“You can go a period of a number of weeks, months or years without any sort of symptoms and then you can suddenly have a flare up,” explains Alexandra Frolkis, a MD/PhD candidate with the University of Calgary. “If medication can’t get you back into remission, you might have to have surgery.”

From 1950-1970, surgery for IBD was almost unavoidable. Today, things have changed. In a study published in the journal Gastroenterology Frolkis has found surgery rates among IBD patients have fallen over the last several decades.

“So for somebody diagnosed in the 1970s, their five-year risk of surgery is 32 per cent, but for someone diagnosed now that risk is more like 24 per cent,” Frolkis says.

Drug therapy for IBD has improved significantly within the last decade. A new class of drugs called biologics is now common practice for IBD patients. Drugs like Humira and Remicade target inflammatory pathways and have helped keep many IBD patients away from the OR.

Last year, Fink’s 27-year-old son Blair was also diagnosed with Crohn’s disease and earlier this year, he suffered a serious flare up.

“I was hospitalized for six days and put on immune suppressants and the new biologic drugs,” he explains. “I was able to recover without needing surgery.”

The decrease in surgical risk comes as IBD cases continue to rise. Alberta has one of the highest rates of IBD worldwide with nearly 800 new cases diagnosed every year.

“These individuals are predominately young,” says Dr. Gil Kaplain, a gastroenterologist at the University of Calgary. “If we can avoid surgery, that means there are less hospitalizations, people don’t have to take time off work to recover from operations and it means an improved quality of life.”