Principal Investigator: Emanuelle Bellaguarda, MD; Co-Principal Investigator: Stephen B. Hanauer, MD Inflammatory bowel disease (IBD) often affects people in their reproductive years, with little known about the impact of anti-inflammatory and immunosuppressive therapies on reproductive health. Men with IBD and their partners often request information on the effect of medication on male fertility. Fears and doubts significantly affect family planning as well as impact adherence to drug treatment and disease control. Fertility concerns emphasize the need to investigate the safety of drug treatment in these patients. Investigating the impact of two novel IBD treatments on sperm quality and genetic structure in male patients, Dr. Bellaguarda hopes to improve future patient care by ultimately enhancing patient counseling. Her team at Northwestern Memorial Hospital has joined forces with Aarhus University Hospital in Denmark to take advantage of the expert knowledge in the different centers within reproduction, medical treatment in IBD, and drug...
Principal Investigator: Shilajit D. Kundu, MD One million-plus Americans have IBD, accounting for more than two million ambulatory and emergency room visits annually. This health care utilization can lead to annual medical expenditures ranging from $5,000 to $8,000 per patient. Reducing unnecessary medical costs in this patient group is paramount. Take for example, PSA tests. While PSA screening can reduce prostate cancer deaths, false-positive elevations commonly occur, especially for patients with IBD. The Kundu research group recently found that men 65 and older with IBD, who underwent prostate cancer screening at Northwestern Memorial Hospital, had higher PSA values than non-IBD controls. In addition, men with IBD had a significantly higher risk of prostate cancer. However, whether the elevation in PSA is due to IBD-related inflammation versus a true reflection of an increased risk of prostate cancer remains unclear. Study findings may optimize how men with IBD are screened for prostate cancer by better assessing their risk while at the same time reducing needless medical...
Principal Investigator: Madeline McGuire Bertha, MD, MS Medical marijuana use has grown among patients attempting to tamp down the debilitating effects of Inflammatory Bowel Disease (IBD). However, no one knows if cannabis improves intestinal inflammation—critical to treating IBD. In fact, marijuana could be simply masking symptoms and delaying necessary medical treatment. To determine if that’s the case, Northwestern Medicine researchers led by internal medicine resident Madeline McGuire Bertha, MD, MS, will compare patients in symptomatic remission (feeling well/ without symptoms) who use marijuana to those in symptomatic remission who do not use it. The researchers suspect that while patients using cannabis feel fine, they actually may have a higher level of dangerous, underlying inflammatory activity than their perceived “lack of intestinal distress” might imply. Supported by a grant from the Digestive Health Foundation, the investigators will use blood and fecal tests to assess levels of intestinal inflammation in the two groups. In particular, they will focus on measuring a blood marker of inflammation, C-Reactive Protein, and a stool marker, fecal calprotectin. If the study hypothesis holds true, the IBD patients using marijuana as a proposed alternative or complementary therapy will be found to have significantly higher levels of these inflammatory markers compared to non-cannabis users who experience no symptoms. Findings of this study will help to advance the limited data assessing the therapeutic efficacy of cannabis on objective markers of intestinal inflammation in patients with IBD. These research efforts could have important clinical and societal implications as medical marijuana becomes more widespread. New knowledge in this area could help both ordering physicians and patients to make more informed...
Principal Investigator: Anne Grosen, MD Immunosuppressive drugs have made living with inflammatory bowel disease (IBD) easier. But these powerful medications have their drawbacks, especially when it comes to potentially affecting future fertility. Complicating matters, IBD often strikes people during their key reproductive years. Patients’ fertility fears may dissuade them from taking effective medication that could help them to better manage their disease. Methotrexate (MTX) is a commonly prescribed drug treatment for IBD. Linked to birth defects, though, it is not recommended for pregnant women. How the drug affects a man’s ability to start a family remains a mystery. Funded by a Digestive Health Foundation grant, Northwestern Medicine researchers led by visiting scholar Anne Grosen, MD, from Aarhus University Hospital in Denmark, plan to shed light on the effects of this potent drug by examining several markers of male fertility, including sperm quality and reproductive hormones. Dr. Grosen’s research team, which includes GI and fertility and reproductive medicine specialists, will focus on adult males (ages 18 to 45) who have been diagnosed with Crohn’s disease or ulcerative colitis. Seen by the IBD team at Northwestern Medicine, these individuals are either planning to start MTX treatment or are currently taking the drug for their disease. A healthy control group will participate in a separate study in Denmark and be used for comparative purposes. By analyzing MTX metabolites and other biomarkers in blood and semen samples, the investigators hope to determine if MTX makes a clinically relevant impact on male fertility. Study findings of this trans-Atlantic collaboration have the potential to improve future patient care by allaying concerns about drug safety...
Principal investigator: Itishree Trivedi, MD Graduating from high school. Going away to college. Getting that first job. For many, these milestones mark the transition from childhood to adulthood, with parents and their children diligently preparing for them as they arise. Yet a young adult patient’s move from beloved pediatrician or family doctor to an unfamiliar adult care specialist is often abrupt. Learning to be in charge of your own health can be challenging, especially for those with chronic illnesses. Inflammatory bowel disease (IBD), often identified as ulcerative colitis or Crohn’s disease, affects 1.4 million Americans. About 30 percent of IBD patients are diagnosed with the disease before age 18. The journey from adolescent to adult can be bumpy for anyone, but IBD comes with its own set of hurdles. Typically inhibiting physical growth and often causing social and developmental stresses, the disease can lead to missed doctors’ appointments, increased use of emergency rooms, and higher healthcare costs. “Transition programs” to prepare youth for adult care have been used for patients with conditions such as Type 1 diabetes mellitus and organ transplantation. Requiring “buy-in” from healthcare practitioners to be successful, these programs help young adults bridge the transition gap. They’ve been shown to prevent the worsening of disease and reduce hospitalizations. Supported by a grant from the Digestive Health Foundation, a young clinical investigator in Northwestern Medicine’s Division of Gastroenterology and Hepatology now intends to do the same for young adults with IBD. Adapting the GotTransition toolbox (developed by the Center for Health Care Transition Improvement), Itishree Trivedi, MD, plans to develop the first such program specifically geared toward improving...
