Crohn’s and colitis patients now have convenient, comprehensive multidisciplinary care

People suffering from persistent diarrhea, abdominal pain, anemia, weight loss and malnutrition can now get the most convenient care and latest treatments available in North Texas, all under one roof at UT Southwestern Medical Center.

Inflammatory bowel diseases (IBD) are conditions in which the walls of the small and large intestines become chronically inflamed. The two primary forms of IBD are Crohn’s disease, which can affect any part of the digestive system, and ulcerative colitis, which affects the large intestine and rectum. Both can raise the risk for cancer.

The new Crohn’s and Colitis Program at UT Southwestern is one of the first comprehensive programs in the state. Adult and pediatric patients receive team care from doctors who specialize in gastroenterology, colorectal surgery, obstetrics and gynecology, hematology and imaging. Dr. Daniel Podolsky, UT Southwestern president and an international authority on physiologic mechanisms and treatment of IBD, is part of the program.

“Having this comprehensive care here in Dallas will give thousands of IBD patients direct and immediate access to a wide range of specialists under one roof, without having to travel from doctor to doctor and deal with various patient care systems,” said Dr. Prabhakar Swaroop, assistant professor of internal medicine and director of the program.

The program also includes a patient support group and 24-hour emergency access to a gastroenterologist. Imaging and laboratory results, medications, appointments and e-mail correspondence can be accessed anytime through the online resource MyChart.

Crohn’s and Colitis Program patients have access to the latest diagnostic and treatment equipment and procedures. Through participation in clinical trials, patients have the promise of getting new treatment years in advance of the general public.

“For patients with this debilitating condition, we have a whole spectrum of testing and treatments that other facilities may not have, and certainly not under one roof,” Dr. Swaroop said. “Crohn’s and colitis suffers now have hope of leading full lives not disrupted by uncontrolled IBD symptoms.”

UT Southwestern Medical Center will be participating in the Take Steps for Crohn’s and Colitis event on Sunday, May 23, 2010. The walk is sponsored by the Crohn’s and Colitis Foundation of America. For more information or to register to walk with the UT Southwestern team, please contact Rose Dewald at 214-645-3070.

When skull-base tumors are located in close proximity to such sensitive areas as the brain and eyes, they are particularly dangerous due to possible brain injury, vision risk or hearing loss.

At UT Southwestern Medical Center, neurosurgeons, head and neck surgeons, and radiologists routinely care for these cases in a multidisciplinary team as part of the Comprehensive Skull Base Program. A multidisciplinary team collaborates to confirm and diagnose such tumors, explain clearly to the patient what is happening, and, most importantly, offer the best options for treating the conditions.

“We consider it crucial to carefully coordinate care and treatment,” said Dr. Sam Barnett, assistant professor of neurological surgery who co-directs the program with Dr. Pete Batra, associate professor of otolaryngology.

At a weekly conference, doctors discuss face-to-face the nuances of each patient’s needs – the best approach, the potential pitfalls and the latest research.

The Comprehensive Skull Base Program covers more than two dozen types of skull-base-related conditions, including sinus tumors, glomus tumors, meningioma, neurofibromatosis, pituitary neoplasms, sarcoma, squamous cell carcinoma and acoustic neuroma.

The assembled expertise includes a range of hard-to-find specialties: otorhinolaryngology (head and neck surgery), neurosurgery, neuro-ophthalmology, neurologic oncology, radiation oncology, interventional radiology and pathology. The medical center is home to one of the world’s premier neurological surgery centers with a state-of-the-art intensive care unit. Care also is coordinated with the Harold C. Simmons Comprehensive Cancer Center.

“Minimally invasive techniques have revolutionized the field of skull-base surgery,” Dr. Batra said. “Many formerly inoperable tumors can now be reached using a telescope through the person’s nasal passages without the need for facial incisions. In addition, surgery can be performed with minimal brain movement, thus minimizing complications and preserving normal neurologic and facial function.”

In addition, the medical center offers ancillary services such as audiology, occupational and speech therapy, balance testing and facial nerve rehabilitation.

“Follow-up is equally important,” said Dr. Peter Roland, chairman of otolaryngology. “So having the entire continuum of care on-site is a real plus, with professionals who know one another and work regularly together.”

UT Southwestern surgeons have achieved several firsts in single-incision surgery, including the nation’s first single-incision kidney removal, North Texas’ first single-incision gallbladder surgery and the first single-incision hysterectomy in Durango, Mexico. UT Southwestern surgeons also have performed single-incision colectomies and appendectomies.

“We have a track record of innovation here,” says Dr. Daniel Scott, associate professor of surgery and director of the Center for Minimally Invasive Surgery at UT Southwestern

In 2008, UT Southwestern surgeons performed the first single-incision Lap-Band weight-loss surgery in Texas. Rather than the traditional five small incisions used for traditional laparoscopic gastric banding surgery, surgeons used a single 8-centimeter incision, reducing future scarring and accelerating healing.

“There’s a current revolution in minimally invasive surgery: Can we make laparoscopic surgery better by decreasing the number of incisions?” says Dr. Scott. “The theory behind this, not yet proven, is that fewer scars are better cosmetically and for pain control. The pain may be less because you alleviate additional cuts, and therefore the recovery may be hastened.”

The trend has taken two paths. With SILS, or single-incision laparoscopic surgery, surgeons make one incision instead of several through the abdominal wall. NOTES, or natural orifice transluminal endoscopic surgery, involves instrumentation access through an existing orifice such as the mouth, colon or vagina.

UT Southwestern surgeons are part of a national group evaluating the feasibility and safety of single-incision surgeries and have a joint academic venture with surgeons in Shanghai, China, to develop the techniques.

UT Southwestern’s Center for Minimally Invasive Surgery is accredited by the American College of Surgeons as a regional education center, one of only 46 worldwide, one of three in Texas and the only one in Dallas. In addition, UT Southwestern’s bariatric surgery program is part of the American College of Surgeons' Bariatric Surgery Center Network Accreditation Program.

UT Southwestern Medical Center is nationally ranked in more specialty-care areas than any other health care provider in North Texas in U.S. News & World Report’s America’s Best Hospitals 2009-10.

The UT Southwestern specialties and their respective ranks on the list include: urology at 15; neurology and neurosurgery at 20; kidney disorders at 23; and gynecology at 33.

“These specialty rankings affirm the excellence UT Southwestern is building upon in our strategic initiative,” said Dr. Daniel K. Podolsky, president of UT Southwestern. “We are dedicated to enhancing quality, safety and innovation in patient care, reinforced by superb clinical and basic research and our commitment to training the next generation of dedicated physicians and scientists.”

The America’s Best Hospitals guide identifies 174 out of about 4,800 medical centers nationwide that excelled in one or more of 16 specialties. The rankings in 12 of the 16 specialties weigh four elements equally: reputation, death rate, patient safety and a set of care-related factors such as nursing and patient services. In these 12 specialties, medical institutions have to pass through several criteria to be ranked in the Best Hospitals guide.

To make the list, a facility must be a teaching hospital; have at least 200 beds; or have at least 100 beds plus four of eight important medical technologies.

To be ranked in a particular specialty, a hospital must have either a specified volume in certain procedures and conditions over three years, or must have been nominated in the magazine’s yearly specialist survey.

In addition to UT Southwestern, Parkland Memorial Hospital – which is staffed by UT Southwestern physicians – ranked 11th in gynecology. UT Southwestern physicians also provide the majority of specialists for Children’s Medical Center Dallas, recently named one of the top 10 children’s hospitals nationwide in a separate analysis by U.S. News & World Report.

At UT Southwestern, our physicians and researchers are world-renowned for their knowledge and expertise. Every day, they push the frontiers of medicine to bring you the latest advancements in patient care. Cancer. Heart disease. Neurosurgery. Urology. Common ailments to complex diseases. We’re the only academic medical center in North Texas and one of the country’s leading research facilities. At UT Southwestern, we’re not just keeping pace with medicine; we’re delivering the future of medicine, today.