FOR IMMEDIATE RELEASE: August 25, 2004
Contact: Bill Seiler bseiler@umm.edu
Ellen Beth Levitt eblevitt@umm.edu 410-328-8919

EXPANDED INFLAMMATORY BOWEL DISEASE PROGRAM OPENS AT THE UNIVERSITY OF MARYLAND MEDICAL CENTER

Crohn’s and ulcerative colitis expert will head program

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UM Inflammatory Bowel Disease Program

Raymond K. Cross, Jr., M.D., has been appointed director of the newly expanded, comprehensive Inflammatory Bowel Disease (IBD) Program at the University of Maryland Medical Center. Dr. Cross, an assistant professor of medicine at the University of Maryland School of Medicine, says the multi-disciplinary program includes a variety of gastrointestinal specialists in medicine, surgery and radiology who are dedicated to accurately diagnosing and managing IBD and helping to improve patients' quality of life. IBD is a chronic inflammatory condition of the intestines.

The University of Maryland IBD program is part of the medical center's recently named AeroDigestive Center. The center brings together a wide-ranging team of experts to treat digestive system illnesses, from voice and swallowing disorders to heartburn, indigestion and IBD, which includes ulcerative colitis and Crohn's disease.

"One goal of the IBD program is to schedule patient visits quickly and, if patients need to see a variety of specialists, they can do that during the same visit," says Dr. Cross, who is also chief of the Inflammatory Bowel Disease Section at the Veterans Affairs Medical Center in Baltimore. He adds that this approach is unique among academic medical centers. The IBD program also offers access to the latest medical and surgical therapies, including minimally invasive techniques.

IBD disorders affect more than 1 million people in the United States. The cause of these complex ailments is unknown. Symptoms include diarrhea, abdominal pain, and fistulas, which are tiny channels or cracks that can result from inflammation.

IBD is often first diagnosed in young adults, and is characterized by flare-ups of disease followed by periods of remission. However, some patients suffer from continuously active disease.

Patients in the University of Maryland IBD program benefit from advanced diagnostic capabilities, including magnetic resonance imaging, capsule endoscopy, virtual colonoscopy, and endoscopic ultrasound. State-of-the-art treatment options include minimally invasive surgery. The program also has an on-site infusion center.

According to Dr. Cross, a major focus of the program is to increase the patient's quality of life. This is done, in part, by closely monitoring the side effects of medications, and, in some cases, reducing the number of medications to the minimum necessary to get results. "I am willing to stop medications to see if symptoms might improve," says Dr. Cross.

He recently presented a study of patients with Crohn's disease at the American College of Gastroenterology, which showed that patients who were taking more than five IBD medications were more likely to have symptoms of disease while experiencing a lower quality of life. Ten percent of the patients in this group got better simply by eliminating medications.

Surgery, especially minimally invasive surgery, may also make it possible to reduce or eliminate medications. A member of the IBD team, Adrian E. Park, M.D., head of General Surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine, says surgery is often perceived as an end-of-the-line treatment. But he adds, "Surgery sometimes needs to be considered earlier rather than later, especially among people who have severe, unrelenting symptoms from their disease." Dr. Park says his first choice for surgery is to consider a minimally invasive approach, because it promotes quick recovery and reduces the chances of complications.

Scientists are looking at several possible causes of IBD, including genetics, immune response, lifestyle and diet. IBD occurs more often in northern climates and in affluent communities, and, until recently, has rarely been seen in developing countries, especially those in southern climates.

Dr. Cross says one theory suggests that the high rate of parasitic infections found in developing countries may stimulate a type of immune response that protects against IBD. "In northern climates, where we don't have parasites and we have good sanitation, the immune response to various pathogens is different," says Dr. Cross. "That difference may predispose a person to IBD."

The University of Maryland IBD program is conducting research studies that may someday result in better treatment options and more effective ways to manage the disease. One study, now in an early, pilot stage, will test whether a connection to specialists by video and telephone links can be an effective tool to help patients and their doctors better monitor their conditions, adjust medications and manage side effects.

Dr. Cross is a graduate of Washington and Jefferson College and the University of Pittsburgh School of Medicine. He completed an internal medicine residency and gastroenterology fellowship at the University of Maryland Medical Center. He received additional training in IBD at the Medical College of Wisconsin.

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