Treating gut-wrenching conditions

Dr. Nimisha Parekh intended to follow her grandfather’s footsteps and become an ophthalmologist. She liked the idea of having long-term relationships with patients. But after a few years in medical school at Tulane University in New Orleans, it was the digestive system that caught her eye.

“I was interested in all the new things happening in the diagnosis and treatment of digestive diseases, and I really liked doing procedures. Being a gastroenterologist would mean I could provide care for chronic diseases, allowing me to develop long-term relationships with patients, and I could also perform endoscopies and colonoscopies.”

After completing her residency in internal medicine at Tulane, Parekh went on to the University of Texas-Southwestern for a fellowship in gastroenterology and hepatology, and then to the University of Chicago for advanced training in inflammatory bowel disease (IBD), making her a rare subspecialist in the condition. As director of UCI Health’s Inflammatory Bowel Disease Program in the H.H. Chao Comprehensive Digestive Disease Center, Parekh works with a multidisciplinary team to provide a seamless, humane approach to treating patients with IBD and related conditions that can result.

About 1.4 million Americans suffer from IBD—either ulcerative colitis or Crohn’s disease—which involves chronic inflammation of the intestines.  IBD symptoms include diarrhea, blood in the stool, stomach pain, bowel urgency, fever and weight loss. The disease is caused by the body’s immune system going into overdrive and damaging the intestinal tract lining. Without effective treatment, the symptoms can rule a patient’s life, keeping the person isolated, indoors and reluctant to socialize, form relationships, travel or take on new challenges.

Parekh is still fascinated by her field and by the advances have made it possible not only to treat the medical condition but also to improve the quality of patients’ lives. “In the last 10 years, we’ve gained a better understanding of the disease. We have advanced treatments with new drugs and minimally invasive surgical techniques that give patients hope. Many young people and even teenagers get these diseases. Today we see them living long, happy and productive lives. My younger patients can go on to college, start careers, get married and have families.”

Newer medications and comprehensive treatment, including nutritional and emotional support, can help people with IBD manage their disease. When medication is not effective, surgery is an option. Parekh works closely with UC Irvine colorectal surgeons, who are trained in minimally invasive and robot-assisted surgical techniques. Other members of the team include radiologists, pathologists, dietitians and social workers.

UC Irvine is the only comprehensive center in Orange County for people with complex cases of inflammatory bowel disease. The IBD program is unique in addressing the emotional, psychological and social effects of the disease along with physical aspects. Education programs and a monthly support group are open to the public.

There is no cure for IBD, but with proper treatment and follow-up, people can lead normal, pain-free lives. UC Irvine physicians and researchers are continually investigating new treatment therapies, and Parekh is currently conducting a Phase 2 clinical trial using an experimental stem cell treatment for Crohn’s disease patients.

Parekh believes that as the science and treatment of IBD evolves, Crohn's patients and caregivers need to be aware of advances that can improve quality of life. When she arrived at UC Irvine five years ago to head up the IBD program, she established an annual family education conference for patients, their families and medical center staff.

“The more patients know about their condition,” she says, “the better prepared they will be to handle its challenges.”