🌟Ever found yourself doubting about IBD new drugs doses? or forgetting Thiopurine metabolism details?

I've been there too

So I thought it could help having 'IBD Cheat Sheets' and that is what I did:

ibd-eii.com/ibdcheatsheet

I hope it helps as much as it helps me
1/2
#IBD

🔥Endoscopic classification systems for selected upper gastrointestinal pathology

AMA ACG Cleveland Clinic Katarzyna Monika Pawlak Dalbir Sandhu, MD, FACG, FASGE Steven Bollipo Andrés Rodríguez Parra, MD Roberto Simons-Linares, MD Prabhleen Chahal MD,FASGE,FACG Mohammad Bilal, MD Aline Charabaty, MD, FACG, AGAF Rashid Lui 雷諾信 Sunil Amin, MD, FASGE, FRCPC

#MondayNightIBD Phillip Fleshner MD Waseem Ahmed Sean Langenfeld Steven Carter Nicolas Avellaneda Jasper Stijns Amar S. Naik, MD Stefan Holubar MD MS Dominik Bettenworth Dr Celestino Gutiérrez González MD 🇪🇸🍏🇻🇪 Julio Mayol #IBDAlgorithm #MondayNightIBD

🎯Crohn's Perianal Fistula (CPF) Aline Charabaty, MD, FACG, AGAF

w/ guest Phillip Fleshner MD

🧩Check the AGA (2003) and expert consensus classifications (2020)
🧩Initial management strategies
🧩Landmark trials for CPF

🎯PostConvo polls🗳️👇
(Answers in Algorithm😉)

#IBDHorizons24 Bincy Abraham, MD, MS
How would you answer this Q?

Which is FALSE:
A) Most dysplastic lesions are endo visible
B) Screening for SB cancer is indicated annually with ileal #Crohns
C) Dz duration, extent, & activity are a/w dysplasia risk
D) PSC a/w⬆️dysplasia risk

I don’t know how he has time to do this but cheering on my friend & forever conference roommate Joseph Sleiman, MD 👇🏼
#DDW2024

Let’s talk #Crohns Perianal #Fistula !

🧵 #Back2Basics Dheera Grover: #CPF Classification, Dx & initial Rx👇🏽
🗳️ #IBDPolls 👇🏽

🗓️May 6 convo Phillip Fleshner MD What’s after a Seton?

🆓 #CME 👉🏽bit.ly/MNIBD24-25

Support by edu grants Takeda JanssenUS
📌Where r you in your🩺

#PreB2B #IBDPoll1️⃣

🆓 #CME 👉🏽 bit.ly/PerianalDisPre

How often do #PerianalFistula #CPF complications affect patients with #Crohns disease?

#PreB2B #IBDPoll2️⃣

🆓 #CME 👉🏽 bit.ly/PerianalDisPre

57 y/o recent dx #Crohns ileum + rectum presents w perianal fistula + abscess . What treatment(s) will optimize the chance of #CPF #Fistula healing?

#MondayNightIBD 4/Welcome #GITwitter #IBDTwitter to another 🔥 #MondayNightIBD #Back2Basics !

Let’s talk #Perianal Fistula in #Crohns #CPF

☑️ Incidence
☑️ Classification
☑️ Diagnosis
☑️ Initial therapy

#MondayNightIBD 5/ #CPF #Incidence & #Prevalence
➡️Can be isolated (w/o luminal dis)
➡️Initial presentation in 10-17%
➡️Affects 30-40% of CD pts
➡️Prevalence varies by CD location, rectal disease=risk factor

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan 6/ #CPF #Classification
💠Simple: Does not cross the sphincter complex, 1⃣ external opening
💠Complex: Inter/Trans/supra/intra sphincteric, > 1⃣ opening +/- Abscess/stricture/ Rectovaginal fistula

#B2BPearl : #CPF Often complex!
Complex fistula assoc w⬇️remission &⬆️recurrence

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC 7/New Consensus #CPF Classification
💠Stratification according to CPF severity & outcome
💠Goals is to guide decision making in trials & practice
💠Take into account: Fistula anatomy+ presence of luminal dis + symptoms burden/QO

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre 8/ #MondayNightIBD #CPF #Diagnosis

🟡History and PE (perianal pain, discharge, fever)
🟡Imaging (MRI > CT) or rectal EUS
🟡➕ EUA (diagnostic+therapeutic for drainage +/- seton)

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS 9/ #MondayNightIBD
🎯 #CPF Management

👉Control infection
👉Treat rectal🔥/stricture
👉Heal fistula
(✅Definition of response & remission👇)
👉Prevent recurrence
👉Improve quality of life

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️‍⚧️👩🏼‍⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet Sun-Ho Lee MD PhD 10/ #MondayNightIBD Complex #CPF Initial Management
1⃣ EUA: Abscess drainage+Seton

2⃣ Abx: Cipro>Flagyl. Prolonged course w biologics: ⬇️drainage,⬆️CPF response

3⃣ IFX typically 1st choice +/-AZA

💎 #B2BPearl No fistulotomy in complex CPF !
💎Optimize strategy to ⬆️response👇

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️‍⚧️👩🏼‍⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet 11/ In Summary : #Crohns #Perianal #Fistula
🔺Challenging complications, affecting up to 40% of pts
🔺Often complex & require MultiD care
🔺Combo medical+ surgical Rx

✅Proposed #CPF Management👇 Journal of the Canadian Assn of Gastroenterology doi.org/10.1093/jcag/g…

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️‍⚧️👩🏼‍⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet Journal of the Canadian Assn of Gastroenterology 12/ #MondayNightIBD
#PostConvo #IBDPoll 1️⃣
🆓 #CME 👉🏼bit.ly/PerianalDisPost

How often do #PerianalFistula #CPF affect patients with #Crohns disease?

#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️‍⚧️👩🏼‍⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet Journal of the Canadian Assn of Gastroenterology 13/ #MondayNightIBD
#PostConvo #IBDPoll 2️⃣
🆓 #CME 👉🏼bit.ly/PerianalDisPost

57 y/o w recent diagnosis of #Crohns ileum + rectum presents with perianal fistula + abscess . What treatment(s) will optimize chance of fistula healing?

If planning postop meds, which one do you choose?

If following FCP, what cutoff do you use?