Training in Inflammatory Bowel Diseases

Trainees will gain experience in the broad range of clinical manifestations of IBD. They will be familiar with features that are specific to pediatric patients, such as delays in growth and pubertal development, will be able to identify the broad range of extra intestinal manifestations of IBD (rheumatologic involvement including arthritis, arthralgia and ankylosing spondylitis; mucocutaneous signs such as pyoderma gangrenosum and erythema nodosum; urinary tract abnormalities including calculi, fistulae, and ureteral compression; hepatobiliary involvement with autoimmune hepatitis, primary sclerosing cholangitis and gallstones; vascular and thrombotic complications, including deep vein thrombosis and vasculitis; ophthalmologic involvement with episcleritis, glaucoma, and cataracts; metabolic bone disease; and pancreatitis).

At the end of training period the Trainees will be able to:

• Diagnose and manage IBD using various diagnostic tests including stool examination for pathogens, alpha-1- antitrypsin, blood tests for specific autoantibodies and for monitoring disease activity
• Recognize the histological, radiological, and endoscopic features of inflammatory bowel disease
• Indicate various diagnostic techniques used in diagnosis and management of inflammatory bowel disease
• Interpret the endoscopic, histological, imaging and laboratory results
• Develop a collaborative relationship with radiologists which is essential for the careful management of inflammatory bowel disease
• Treat acutely ill patients in hospitals as well as ambulatory patients
• Perform a competent nutritional assessment of patients with inflammatory bowel disease
• Develop a plan for nutritional intervention including total parenteral nutrition and enteral feeding techniques
• Select pharmacologic therapies appropriate for the type, location, and severity of disease
• Acquire knowledge about the dose range, efficacy, toxicity, and appropriate monitoring of drugs used to treat
• Understand the risk of cancer in IBD, the role of endoscopy in surveillance, and the significance of dysplasia
• Recommend surgery and understand the indications, timing, and range of surgical therapeutic options available for the patient with inflammatory bowel disease
• Be aware of the expected results, prognosis, risk of relapse, potential complications of surgical approaches
• Understand the psychosocial impact of IBD and recognize that eating disorders may develop in these patients
• Educate patients and families and should be aware of the educational materials that aid in this process