Corey Siegel, MD, on Outside-the-Box Therapeutic Options for IBD

Dr Siegel previews his address at the Advances in Inflammatory Bowel Diseases regional meeting on March 6 on options for treating inflammatory bowel diseases, ranging from hyperbaric oxygen to combining biologics and more.

Corey Siegel, MD, is director of the Inflammatory Bowel Disease Center at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

TRANSCRIPT:

Hi, I'm Corey Siegel from the Dartmouth-Hitchcock Medical Center, and I'm giving you a preview of a talk I will be giving at AIBD Regionals on outside-the-box therapeutic options for patients with inflammatory bowel disease.

We'll cover a number of topics during this talk. I will give you a few highlights here around combining biologics, using hyperbaric oxygen to treat both Crohn's disease and ulcerative colitis, the data around cannabis and CBD so that you can be prepared for your patients questions, and also some new uses of exclusive enteral nutrition for adult patients with IBD.

With combining biologics, it's obviously not well studied, but it's really compelling to think about using different mechanisms hitting different targets. I'll talk to you about what we know about safety and efficacy in which biologics you might find more success with and even some tips on how to get around this with your payors.

Hyperbaric oxygen is something that's been used for years to treat wound healing and also for perianal disease and Crohn's disease. We've used this in a novel way for inpatients with ulcerative colitis. I will be happy to share you results of a randomized controlled trial that we did and also give some data about overall safety and efficacy of cross both Crohn's disease and ulcerative colitis as well.

Many of our patients are asking us about cannabis and CBD. I thought I would help arm you with how you can respond to your patients with the data that we know clinically and some recommendations on how to have conversations with your patients about using these as potential complementary therapies as opposed to using them instead of biologic therapies that many of our patients often ask us about.

One thing I've really changed in my practice over the past few years is using exclusive enteral nutrition. This can be a great tool to keep your patients off of corticosteroids to bridge them to a new therapy and also bridge them to surgery.

I'll show you data around that that it's not just something that works in pediatrics. It works in adults as well. That can be very successful. I'll give my experiences on how we use that in clinical practice.

In summary, we should never feel stuck inside the box. Sometimes, we need to think outside the box when our patients use up the typical medications that they've used. Also, they're pushing us now and asking about data for complementary therapies, and reminding ourselves that complementary therapies should be complementary.

They shouldn't be one or the other, but we can often combine these different ideas to really treat our patients most effectively. If you can be open-minded and know the data, you'll have much more effective conversations with your patients so that you can make good shared medical decisions about these new ideas. Looking forward to seeing you at AIBD, and thank you for your interest.