Gastroenterology & GI Surgery

Crohn's Disease: Integrating Medical and Surgical Care for a Seamless Experience

Dec. 8, 2023 - Eden McCleskey

The Fondren Inflammatory Bowel Disease (IBD) Program at Houston Methodist Hospital, directed by Dr. Bincy Abraham, is unique in the region for the team's vast experience with difficult and challenging Crohn's disease and colitis cases. Internationally renowned for IBD care and research, the medical and surgical teams are unified in their approach, resulting in superior outcomes for the complicated conditions.

"We have incredible collaboration with gastroenterologists, so our surgeons are very familiar with patients who might benefit from surgery well before we operate," said Dr. Eric Haas, chief of Colon and Rectal Surgery. "And our patients are so well-optimized medically, we're way ahead of the game when it comes to surgery. You put all that together, and the outcomes have been phenomenal."

Further, a close alliance with pediatric colleagues at other institutions helps provide a smooth transition of care for patients entering adulthood, and partnerships with physicians in women's health ease patients' anxieties during pregnancy.

Technology plays an integral role in disease management, including tools like CT, MR enterography for imaging and chromoendoscopy for colorectal cancer surveillance in high-risk Crohn's disease patients. Upper endoscopy and capsule endoscopy allow physicians to explore upper-GI tract and small-bowel involvement of IBD.

Houston Methodist was among the first in the U.S. to introduce intestinal ultrasound for the assessment of IBD activity, and Dr. Abraham was the first physician in the country to use the technology in an adult patient.

If surgery becomes necessary, colorectal surgeons employ advanced robotic approaches that lessen the need for extensive resection and enhance recovery times.

Robotic technologies are used in fistula repair, bowel continuity surgery and strictureplasty, a procedure that preserves the bowel, and reduces the necessity for future surgeries.

"The long-term benefits are substantial," Dr. Haas said. "Recurrent obstruction rates are significantly less, we rarely see a hernia, and the need for colostomy is dramatically reduced."

Clinical differentiators

  • One of the first centers in North America to offer point-of-care advanced transabdominal ultrasound imaging of the bowel
  • State-of-the-art infusion suite conveniently located in office and staffed by experienced infusion nurses
  • Access to the latest Crohn's disease medications
  • Robotic-assisted strictureplasty and bowel continuity surgery, with superior outcomes
  • Tertiary referral center for J pouch surgery boasting some of the highest volumes in the country for robotic-assisted restorative proctocolectomy with J pouch reconstruction

Research initiatives

  • Clinical scientist dedicated to inflammation and microbiome research in patients with colitis and Crohn's disease
  • Site for multi-center clinical trials, offering patients access to new therapies prior to FDA approval
  • Translational research in collaboration with researchers at Texas A&M University and University of Houston, looking at newer inflammatory markers that may guide future innovations in diagnosis and management
  • Bio-repository for long-term, large-scale studies
  • Published studies on relationships between IBD and cardiovascular disease
  • One of several national sites following mothers with IBD through pregnancy and their infants through age 18, monitoring disease presentation and progress
  • Stem cell therapy for perianal fistulas, a partnered effort between medicine and surgery
  • Natural orifice robotic surgery to avoid colostomy and abdominal wall incision during complex IBD procedures
  • Robotic approaches for minimally invasive restorative J pouch surgery

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Crohn's Disease IBD