Inflammatory bowel disease

 

Crohn's disease and ulcerative colitis are the two main forms of inflammatory bowel disease (IBD). Crohn's disease causes inflammation to develop in various parts of the gut, usually the small bowel, colon and anal region. Ulcerative colitis (UC) is a disease of the rectum and the colon (otherwise known as the large intestine).

The Exeter IBD team looks after approximately 3,500 patients. We have a wide range of backgrounds, skills and experience but we all share one common goal: to make sure you receive safe, consistent, high quality, personalised care.

More on what we do

Crohn's disease and ulcerative colitis affect more than 300,000 people in the UK. However, they are thought of as hidden diseases, largely because of the stigma attached.  

In both conditions, parts of the digestive system become swollen, inflamed and ulcerated. There are differences between Crohn's and ulcerative colitis, mainly in the areas of the gut affected and the depth of inflammation.

At present, there is no known cure, however the symptoms can be treated. Medicine and sometimes surgery can give long periods of relief from the symptoms, which include abdominal pain, diarrhoea, weight loss and tiredness.

Symptoms will vary in severity from one person to another and can follow an unpredictable course with periods of remission (when you are symptom free) and periods of flare (when you have symptoms). 

We aim to increase your understanding of your diagnosis and provide the care and support you need to manage your disease and its symptoms. Your needs can change with different stages of the illness. We are here to make sure you get the clinical support you need.

If you are admitted to hospital, specialist nurses will visit you on the ward. We can help to explain treatments, medications and test results. We offer support and reassurance and help to keep you informed of your care plans.

After diagnosis and initial treatment you might need regular hospital follow up or shared care with your GP. 

Gastroenterology Day Unit:
Our day unit is run by the IBD nurse specialists. We administer intravenous treatments, such as infliximab, vedolizumab and iron infusions, as well as new therapies as part of clinical trials. The unit is open Monday to Friday, 9am to 5pm.

Research:
We have an active research department. All of our patients are invited to take part in both local and national research studies. Your consultant or specialist nurse will discuss this with you. Please let your doctor or nurse know if you are interested in taking part in research. They will give you information on any studies that might be suitable for you. We have a dedicated team of research nurses who provide an individual service to patients who to take part.

IBD team meetings: 
The IBD team holds weekly team meetings to discuss patients’ progress. This helps to ensure that you receive the best care from all members of the IBD team.

Treatments

Treatments can vary but can include a range of medicines and other options, such as:

Aminosalicylates (5ASA)

  • Mesalazine
  • Sulphasalazine
  • Olsalazine
  • Balsalazide

Immunomodulating therapies

  • Azathioprine and mercaptopurine
  • Methotrexate
  • Tacrolimus
  • Tofacitinib

Biologics

  • Infliximab
  • Adalimumab
  • Golimumab
  • Vedolizumab
  • Ustekinumab

Dietary therapies

  • Modulen
  • Modulife

Our team

Gastroenterologists (doctors with specialist training and experience in the investigation and management of symptoms and diseases of the gastrointestinal tract). You will be allocated a named consultant gastroenterologist. They will be responsible for your overall care and be kept up to date with your progress, but you will not necessarily see them at each appointment. The consultants are supported by a team of doctors undergoing higher specialist training and research (registrars and fellows). If needed, after you have seen the registrar or fellow, one of the consultants may also review you.

IBD nurse specialists
IBD nurse specialists are senior nurses with specialist training in IBD. They offer support, advice information and treatment recommendations for patients with IBD. They support and care for patients in the outpatient clinic, infusion unit and on the ward. They deliver the IBD Helpline and are often the best point of contact with the team for any advice you might need.

Research nurses
We are actively involved in research and run clinical trials of new therapies for patients with IBD. We welcome patient participation where appropriate. If you would like further information please contact the IBD specialist nurses who will put you in contact with the research nursing team.

IBD surgeons
Patients with IBD sometimes require surgery. We work closely with our specialist surgeons to ensure appropriate timing of surgery.

Dietitians
If you have Crohn's disease you might be referred to our dietitian to discuss specific dietary therapy. You might also benefit from more general dietary advice if you have lost weight or need help managing difficult symptoms.

IBD specialist pharmacist
Our pharmacists are happy to provide advice about any medicine that you might be taking. They are also involved in monitoring of treatments to maximise the benefit and minimise the risks to you. Our pharmacist may contact you to discuss blood test results and treatment doses.

Clinical psychologist
We know that the gut and the brain are connected in many important ways. The way we feel, think and behave can affect our gut, and our gut can affect the way that we feel, think and behave. It is clear that we need to work with the mind and the body to fully understand what is happening.

We know that living with a health condition can have a big impact on a person’s mood and quality of life. It is very usual to feel low, frustrated or anxious about the impact of symptoms, especially when they get in the way of what is important to us. Current struggles or past experiences can be more difficult to cope with when we are living with a health condition. Ways of coping that were helpful in the past can become less helpful.

Psychologists working in health care try to understand interactions between people’s bodies, minds, experiences, strengths and struggles. They use this understanding to think with a person about changes they might want to make

Patient panel
The patient panel meets four times a year to discuss the service provision for IBD patients. The patient panel are a group of patients with IBD who highlight the perspective of patients. They provide feedback and suggestions to improve the IBD services within the hospital and work towards enabling improvements to happen. New members are very welcome or if you simply have any ideas to put forward they would love to hear from you. The IBD nurses will be happy to pass on your contact details or you can email IBDpatientspanel@gmail.com

Consultants

  • Dr Tariq Ahmad, IBD Lead
  • Dr Nick Kennedy
  • Dr James Goodhand
  • Dr Shyam Prasad
  • Dr Chris Calvert
  • Dr Ovi Roy
  • Dr Tawfique Daneshmend
  • Dr Tarek Shirazi

IBD Specialist Nurses

  • Vida Cairnes, Lead IBD Nurse
  • Sarah Hawkins
  • Michelle Clarke
  • Clare Redstone
  • Nina Winter
  • Halina Windak

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Endoscopy: Level 2, Area N

Okement Ward: Level 2, Area F

Clinics: Level 1, Area D

Gastroenterology Day Unit: temporarily relocated to the Nuffield Hospital, Wonford Road, Exeter, EX2 4UG

Contact us

  • RD&E Switch Board: 01392 411611
  • IBD Helpline: 01392 402728
  • Gastroenterology Day Unit: 01392 404638
  • Research Nurses: 01392 408937 and 01392 408940
  • Okement Ward: 01392 402800
  • Endoscopy Appointment: 01392 406429
  • Medical Bookings Team: 01392 406925

For symptom concerns and medicine enquiries we have a dedicated telephone and email helpline.

  • Telephone helpline: 01392 402728, open Monday to Friday, 9am-5pm, excluding bank holidays (unless otherwise stated on answer machine message)
  • Email helpline: rde-tr.IBDhelpline@nhs.net

We will provide you with rapid access to our specialist service; if you are unwell with symptoms of active IBD, have queries regarding your medications or any other IBD-related concerns. We can arrange investigation of your symptoms, review your medications and, if necessary, arrange urgent hospital review. There is an answer phone service available which we encourage you to use if your call is not answered. We aim to return your call within 24 hours, Monday to Friday. If your call is urgent and you are unable to speak with the IBD team directly, please contact your GP or out-of-hours service. If, in the rare event the helpline is closed, a message will clearly state the date and time it will re-open.

For outpatient appointment queries please contact the Medical Bookings Team on 01392 406925.

Patient leaflets and documents

Community services

We also carry out endoscopy procedures in the day case unit at Tiverton Community Hospital

Children and young people

We work closely with paediatrics to provide a smooth transition for older children into the adult care environment.

Clinics

Consultant and specialist IBD nurse clinics are held every day. This means that both specialists are on hand for advice and discussion about treatment options.

We hold a number of joint clinics with other members of the IBD team, including surgeons, paediatricians, pharmacist, research and dietetics.

We offer a combination of face to face, telephone and video consultations

It is recommended that patients with IBD have an annual review. This can be done by your GP or by a member of the IBD hospital team. This might include assessment of disease activity, medication monitoring, assessing the need for any colonoscopy/endoscopy procedures, smoking cessation advice and vaccinations.

Follow up and review may be more frequent, depending on the activity of your disease or the treatments you are having.

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