Back to Basics in IBD With Tenzin Choden, MD

Dr Choden, assistant professor at the University of Chicago, discussed how the treatment of IBD has shifted significantly in the last decade treating not only for patients to feel better clinically, but also with the goals of improving objective markers of inflammation.

IBD Treat-to-Target Care Extends Beyond Symptom Improvement

• Inflammatory bowel disease (IBD) treatment goals have shifted over the past decade to include symptom improvement and objective inflammation assessment through stool and serum testing, imaging, and endoscopy.
• Complete remission is the goal to avoid cumulative inflammatory burden that can lead to worse outcomes.
• Treat-to-target care in clinic involves immediate treatment for active symptoms, continuous monitoring of response, and treatment adjustments as needed to improve symptoms and control inflammation.

Hello, my name is Tenzin Choden. I am an assistant professor of medicine at the University of Chicago Inflammatory Bowel Disease Center. So I'm here today at the AIBD NP/PA Institute. And we started off the morning with a back to basics in IBD talk. The Back to Basics talk was a broad overview of inflammatory bowel disease. We talked a little bit about the epidemiology of IBD, how we diagnose IBD, what are the clinical and endoscopic findings, and we also talked a little bit about our main goals and our targets of treatment now in IBD. So I think one of the biggest takeaways from my talk this morning is really about how the treatment of IBD has shifted significantly in the last decade. We are now treating not only for patients to feel better clinically, meaning not only just that their symptoms are improved, but we have higher goals of improvement of objective markers of inflammation, such as stool testing or serum testing, imaging, as well as endoscopy.

We want to make sure that the disease is in complete remission so that we can avoid ongoing inflammatory cumulative burden that can lead to worse outcomes. So what this might mean is that when you have a patient coming in to see you in clinic and they're having active symptoms, it's very important that we start treatment immediately, but not only that, that we're continuously monitoring them so that we are adhering to what we call treat to target. It's a continuous cycle of implementation of a treatment, monitoring to see that that treatment is helping, if not adjusting our treatment and continuing in that cycle so that we're continuously improving the patient's symptoms, but also progressing in that work, starting to control the amount of inflammation that's happening.