{"id":217,"date":"2026-01-24T16:58:29","date_gmt":"2026-01-24T07:58:29","guid":{"rendered":"https:\/\/www.med.osaka-u.ac.jp\/pub\/gh\/wp\/?page_id=217"},"modified":"2026-02-25T23:30:44","modified_gmt":"2026-02-25T14:30:44","slug":"disease-ibd","status":"publish","type":"page","link":"https:\/\/www.med.osaka-u.ac.jp\/pub\/gh\/en\/patient\/disease\/disease-ibd\/","title":{"rendered":"IBD"},"content":{"rendered":"


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About Inflammatory Bowel Disease<\/h2>\n<\/p><\/div>\n
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\n Inflammatory Bowel Disease (IBD) is a general term for diseases that cause chronic inflammation of the intestinal tract, primarily represented by ulcerative colitis and Crohn's disease. Although the causes of IBD are not fully understood, it is believed that genetic factors, immune abnormalities, intestinal microflora, and environmental factors are intricately involved.<\/p>\n

In addition to the latest evidence-based drug therapy, endoscopic therapy, and nutritional therapy, the Department provides a comprehensive medical care system in collaboration with related departments and local medical institutions. We aim to improve long-term quality of life (QOL) by providing optimal treatment for each patient according to his or her individual condition.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n

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Main Target Diseases<\/h2>\n<\/p><\/div>\n
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\n ulcerative colitis
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\n The Department of Ulcerative Colitis provides drug therapy for mild to severe ulcerative colitis based on the latest national and international evidence, combining various treatment options such as 5-ASA agents, steroids, immunomodulators, biologic agents, and JAK inhibitors appropriately according to the disease status.
\n In difficult-to-treat cases, we actively consider participation in clinical trials and clinical studies, and propose treatment strategies aimed at maintaining higher remission. In severe cases, we work closely with the Department of Surgery to provide comprehensive treatment, including surgical treatment at the appropriate time.<\/p>\n<\/p><\/div>\n

\"ibd\"
\n Figure 1: Active lesion of ulcerative colitis. Ulcers and lichen white adhesions are seen on the rough mucosa.<\/p>\n

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\n Crohn's disease
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\n For Crohn's disease, we provide personalized treatment combining nutritional therapy, immunomodulators, biologic agents, and JAK inhibitors after detailed evaluation of the site, extent, and activity of intestinal lesions.
\n For small intestinal lesions, we can perform a precise diagnosis using a double-balloon small bowel endoscope, and we actively perform endoscopic balloon dilatation (EBD) for stenosis. For complex lesions with fistulas or abscesses, we provide multidisciplinary treatment in collaboration with the Department of Surgery and the Department of Radiology.<\/p>\n<\/p><\/div>\n

\"ibd\"
\n Figure 2. active lesion of Crohn's disease. Longitudinal ulcer (left) and paving stone image (right) are seen.<\/p>\n

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\n intestinal Behcet's syndrome
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\n For intestinal Beh\u00e7et's disease, we carefully evaluate the depth and activity of lesions by endoscopy and imaging, and treat with 5-ASA agents, steroids, immunomodulators, and biological agents. In refractory cases, we collaborate with the Department of Immunology to determine the optimal treatment plan from the perspective of the disease as a systemic disease. In cases where serious complications such as perforation or massive bleeding are suspected, we promptly cooperate with the Department of Surgery and give top priority to safety.<\/p>\n<\/p><\/div>\n

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\n Other Inflammatory Bowel Diseases
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\n We provide specialized diagnosis and treatment for inflammatory bowel diseases other than IBD, such as eosinophilic enteritis, ischemic enteritis, drug-induced enteritis, and infectious enteritis. When necessary, we collaborate with the Department of Immunology, the Department of Infectious Diseases, and the Department of Surgery to provide comprehensive care in accordance with the disease background.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n

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Special features of our department's treatment of inflammatory bowel disease<\/h2>\n<\/p><\/div>\n
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Professional and systematic diagnosis<\/h3>\n

\n In the diagnosis of inflammatory bowel disease, the Department combines endoscopy, capsule endoscopy, double-balloon small bowel endoscopy, and CT to precisely evaluate the extent, depth, and activity of lesions. We also utilize stool calprotectin and blood biomarkers (especially LRG: leucine-rich \u03b12-glycoprotein) for non-invasive and objective disease assessment. This enables us to determine treatment efficacy and predict relapse with high accuracy.<\/p>\n<\/p><\/div>\n

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Treatment strategies based on Treat to Target (T2T)<\/h3>\n

\n In IBD treatment, \"Treat to Target (T2T)\" is emphasized, in which the treatment goal is not only symptomatic improvement but also achievement of objective indices including mucosal healing (mucosal healing). In our department, endoscopic findings, biomarkers such as calprotectin and LRG are regularly evaluated, and treatment intensity is appropriately adjusted to achieve the treatment goal. This allows us to practice systematic treatment aimed at preventing long-term relapse, steroid-free remission, and improving quality of life.\n <\/p>\n<\/p><\/div>\n

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Promotion of personalized medicine<\/h3>\n

\n Since the pathophysiology of inflammatory bowel disease varies greatly from patient to patient, the Department promotes more precise and personalized medicine through gene panel testing and evaluation of treatment response. IBD specialists play a central role in selecting and switching biologic agents and adjusting the intensity of treatment, and formulate optimal treatment plans based on the patient's life background and wishes.\n <\/p>\n<\/p><\/div>\n

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Multidisciplinary treatment for refractory cases<\/h3>\n

\n For refractory IBD, we provide comprehensive treatment in collaboration with surgery, radiology, nutrition support team, immunology, infectious diseases, and psychiatry. Especially for Crohn's disease stenosis, fistulas, and abscesses, the optimal treatment strategy combining endoscopic, drug, and surgical treatment is discussed at regular conferences between the Department of Medicine and the Department of Surgery.\n <\/p>\n<\/p><\/div>\n

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Close collaboration with affiliated hospitals and treatment policy review system<\/h3>\n

\n The Department has established a system that allows for seamless diagnosis, treatment, and long-term follow-up in close collaboration with affiliated and core hospitals in the region. Our specialists share information on the treatment plan for referred patients as necessary, in an effort to provide high-quality IBD care throughout the region. For patients who are difficult to treat or have complex pathologies, we hold IBD board meetings on an irregular basis to exchange opinions on treatment strategies. This allows us to formulate optimal treatment strategies based on the latest findings and multifaceted perspectives, and to provide the most appropriate medical care for each individual patient.<\/p>\n

We are also working on fecal microbiota transplantation (FMT) for refractory cases that do not respond well to conventional treatment, although it is still in the research stage. FMT has the potential to become a new treatment option through improvement of the intestinal microbiota and is a field that is expected to develop in the future.\n <\/p>\n<\/p><\/div>\n

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Nutritional Therapy and Lifestyle Support<\/h3>\n

\n Nutritional management is important in IBD, and the Department, in cooperation with the Nutrition Support Team, provides nutritional therapy including enteral nutrition and home central venous nutrition (HPN). We also provide support for the psychological burden associated with long-term disease, in collaboration with specialists as needed, with an emphasis on the patient's quality of life (QOL).\n <\/p>\n<\/p><\/div>\n<\/section>\n

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Results of medical treatment (number of examinations and treatments)<\/h2>\n
\n Go to the Medical Results page
\n <\/a>\n <\/div>\n<\/section><\/div>\n

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