Crohn's & Colitis Congress 2022: Combating Challenges for Pediatric Patients

Announcer:
Welcome to Crohn’s & Colitis Foundation Perspectives on ReachMD. Here’s your host, Dr. Jennifer Caudle.

Dr. Caudle:
For ReachMD, I'm your host, Dr. Jennifer Caudle.  And joining me today to talk about the key takeaways from the Fifth Annual Crohn's & Colitis Congress, which is a partnership with the Crohn's & Colitis Foundation and the American Gastroenterological Association, is Dr. Ashish Patel.  Dr. Patel is a Division Chief of Gastroenterology and Hepatology at Phoenix Children's Hospital. 

Dr. Patel, welcome. 

Dr. Patel:
Thanks for having me.  I really appreciate it. 

Dr.Caudle:
So as a pediatric IBD specialist, Dr. Patel, what sessions at this year's congress were you most interested in? 

Dr. Patel:
Well, the congress overall was great.  And I know many of us were hoping to attend it in person, and it had to be moved to virtual because of COVID. But the talks that really led or really drew my interest were around the pediatric inflammatory bowel disease tract, tackling challenges in IBD care.  As a pediatric gastroenterologist, we see firsthand the struggles this chronic disease causes for our patients and families.  If you get a chance to review any of these talks, I would most definitely recommend Dr. Michael Dolinger and Dr. Marla Dubinsky's talk regarding the utilization of point-of-care abdominal ultrasound to evaluate and monitor pediatric inflammatory bowel disease.  Dr. Dolinger discussed the value of this noninvasive radiation-free test and showed correlation with endoscopy and compared it to other noninvasive markers like CRP and calprotectin.  He also talked about a potential new outcome,  transmural healing, which can be measured real-time with this tool.  The additional value is that by providing this at an office visit, it actually improves the medical literacy of our families and allows for real-time shared decision-making.  I'm personally looking forward to bringing this technology to our pediatric IBD program at Phoenix Children's Hospital. 

Another talk that I'd like to bring your attention to was by Dr. Joel Rausch, and Dr. Joel Rausch spoke about the de-escalation of therapy in pediatric inflammatory bowel disease.  He showed very nicely the concerns our families and patients have around chronic therapy, including the perceived benefit of medication waning over time and the fear risks could be cumulative over time and the use of therapy reinforcing a patient's chronic condition, as well as the cost and inconvenience of treatment as well as often isolating these patients.  He framed this discussion of de-escalation nicely around the open discussion of risk and benefit to our patients and the overall hope we all have for durable steroid-free remission with mucosal healing. 

A couple of other talks I'd like to mention included Dr. Jennifer Dotson's talk on psychosocial concerns, an obesity in IBD review by Dr. Amanda Johnson, and a talk by Dr. Amy Taylor on PSC and IBD. 

Dr. Caudle:
And why were those sessions important to you in your clinical practice? 

Dr. Patel:
These sessions really highlighted the struggles that we as pediatric gastroenterologists face every day with the kids and families we take care of, so it's really nice to see the congress focus on these topics that practitioners can actually learn and actually take to the bedside.  There were great talks on transitions and vaccines in IBD in some of these sessions as well, and it really helps us because we always want to push the envelope for excellent care and provide our patients and families the ability to be successful in their care.  These talks really reminded me how it's a partnership with your patients and families, and I was really excited to hear all the new developments. 

Dr. Caudle:
Understood.  And now from your perspective, Dr. Patel, how do you see the role of dietary therapy in IBD treatment expanding in the years to come? 

Dr. Patel:
Well, dietary therapy has been a hot topic and a hot discussion for a while, and as a self-proclaimed IBD-ologist, I think we are just at the cusp of understanding the role diet can play in the treatment of this disease.  We've learned a lot through the last few years, both from the literature and from our own experience, from the utilization of enteral nutrition diets using formula to the specific carbohydrate diet and now things like the Crohn's disease exclusion diet and Mediterranean diets and their value in potentially helping to treat this disease.  I think as we learn more about the different phenotypes of disease that we uniformly call Crohn's disease or ulcerative colitis, we will find more roles for dietary management.  And as we expand our understanding of the microbiome, maybe we can deliver diet as a true personalized treatment option. 

Dr. Caudle:
And before we close, Dr. Patel, was there a session that you found especially impactful or one that you plan to take what you learned and implement those lessons into practice? 

Dr. Patel:
Certainly.  I think you heard me talk with a lot of excitement on that first talk around abdominal ultrasound, right?  So really after listening to that talk, I immediately called my radiology team here at PCH and said, "How do I do this?  What do I need?"   We sent a message to Dr. Dubinsky and Dr. Dolinger, who immediately got back to us.  "And what kind of equipment are we looking at?" "How can we learn how to do this technique to bring this technology to our patients?"  Just think about a technology that gives you real-time information, there's no radiation, it's noninvasive, and you're able to do it literally at the room side, in the room with your patient and family.  I know that the team at Mount Sinai is planning an international conference this fall to help, hopefully, teach a wider audience how to successfully implement this tool, and I look forward to attending that as well. 

Dr. Caudle:
That's excellent.  Well, I think those are all very important lessons that we can take with us.  And that brings us to the end of today's program.  I'd like to thank Dr. Ashish Patel for sharing his thoughts on the 2022 Crohn's & Colitis Congress.  Dr. Patel, thank you so much for your time today. 

Dr. Patel:
Thanks so much.  Have a great day. 

Dr. Caudle:
For ReachMD, I'm your host, Dr. Jennifer Caudle.  And if you couldn't join the sessions live, all congress content is available on demand through December 31, 2022.  Find out more by visiting crohnscolitiscongress.org.  Thanks for joining us.

Announcer:
This episode was brought to you in collaboration with the Crohn’s & Colitis Foundation and the American Gastroenterological Association. To learn more about the Crohn’s & Colitis Congress, please visit crohnscolitiscongress.org. Thanks for listening.