Endoscopy as Treatment for IBD
By Brenda Lange
Columbia’s Inflammatory Bowel Disease Center offers new ways to treat inflammatory bowel disease and ileal pouch disorders.
Led by founder and medical director Bo Shen, MD, the center performs more therapeutic endoscopic procedures than any other institution in New York or the United States to manage Crohn’s disease and ulcerative colitis, two types of IBD.
Patients with IBD are often treated medically at first, but within five to 10 years many will develop structural complications, such as strictures and fistulas, that require surgery to remove part or all of the small and/or large intestine. Internal pouches are sometimes created to provide a reservoir for feces when the large intestine is removed due to medically refractory ulcerative colitis or colitis-associated tumor. Post-surgical complications are common and some require subsequent surgeries, carrying high risk of disease recurrence.
In many cases, therapeutic endoscopy is more effective than medical therapy and less invasive than surgery for these complications, says Dr. Shen, professor of medicine and the Edelman-Jarislowsky Professor of Surgical Sciences.
Dr. Shen innovated therapeutic endoscopy while practicing at the Cleveland Clinic and in 2019 brought his expertise to Columbia where he created the Interventional IBD Center.
Dr. Shen’s first interventional endoscopy was designed to treat complications—strictures, fistulas, or bleeding of ileal pouch disorders—from previous surgeries. He then expanded into techniques for any patient with structural complications from IBD or colorectal diseases before and after surgery.
“Endoscopy is the tool we use to deliver the therapy to the disease, to reach the different parts of the GI tract without having to use more invasive surgical methods,” he says. The center performs about 1,200 endoscopic procedures each year, and the procedures often defer the need for surgical treatments.
At Columbia, Dr. Shen has created a collaborative approach to bring the best care possible to patients. His team includes experts in adult and pediatric gastroenterology, colorectal surgery, GI radiology, GI pathology, GI oncology, clinical nutrition, obstetrics & gynecology, and wound and ostomy care. Particularly complicated cases are discussed each month by the IBD Board, made up of two dozen specialists from Columbia and Cornell. “The best treatment plan is devised collaboratively,” says Dr. Shen. “Patients come to us from all over the world because we offer the expertise and treatment patients need.”
Dr. Shen also works to educate other physicians and potential patients about the value of the endoscopic approach. He founded the Global Interventional IBD Group, Special Interest Group of Interventional IBD in the American Society for Gastrointestinal Endoscopy, and the International Ileal Pouch Consortium to train others in this approach to treating IBD. He has authored over 600 peer-reviewed scientific articles and many books on IBD and lectures extensively across the country and abroad.
In 2023, in recognition of his contributions to the management of complex IBD and pouch disorders, Dr. Shen was awarded a Distinguished Clinician Award in Academic Practice from the American Gastroenterological Association.
“I want to make our center the last stop for patients needing complex IBD care and treatment for IBD surgical complications,” he says. “I think we are well on the way to doing that.”
Contact Columbia’s IBD Center at https://columbiasurgery.org/colorectal/inflammatory-bowel-disease-center-columbia or (212) 305-9664.