Aline Charabaty, MD, FACG, AGAF
@DCharabaty
Care & Advocate for #GI #IBD pts Assoc Prof @hopkinsGIHep /Creator @MondayNightIBD/ Co-Founder @ScrubsNHeels #WomenInGI #DEI #WLI Opinions 🚫Not medical advice
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http://www.facebook.com/DrAlineCharabaty/ 24-04-2018 01:00:27
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Charlie Lees
I write about inflammatory bowel disease providing inspiration, education and deep community. I am Professor of Gastroenterology and UKRIFLF. I also run a lot.
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@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. 🦠Microbiome, brain-gut axis, diet, IBS, IBD, motility, #MedEd🇬🇷
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The American College of Gastroenterology has 18,000 members dedicated to advancing GI & improving patient care. @AmJGastro @ACG_CTG @ACGCRJ @ACG_EBGI
American Gastroenterological Association (AGA)
Our mission is to empower clinicians and researchers to improve digestive health. Also follow @AGA_Gastro @AGA_CGH @AGA_CMGH @AGA_TIGE @AGA_GHAdvances @AGA_GIHN
I’m so excited and happy that my best friend Enrique de-Madaria received my_UEG Research Prize 🏆🔥 !!
Kike! Well deserved!! Keep shining and inspiring all of us! #GITwitter
Join 🌟 faculty for ACG #IBD School & Eastern Régional PostGrad Course!
📌June 6-8, Washington DC
📲Register by May 7 for best rates gi.org
Sara Horst MD, MPH, FACG Arun Swaminath MD & Isabel Roitman NP Atoosa Rabiee & Reezwana C, MD, FACG Simon Hong Jordan Axelrad, MD, MPH David Choi, PharmD & al!
Let’s talk #Crohns Perianal #Fistula !
🧵 #Back2Basics Dheera Grover: #CPF Classification, Dx & initial Rx👇🏽
🗳️ #IBDPolls 👇🏽
🗓️May 6 convo Phillip Fleshner MD What’s after a Seton?
🆓 #CME 👉🏽bit.ly/MNIBD24-25
Support by edu grants Takeda JanssenUS
📌Where r you in your🩺
#PreB2B #IBDPoll1️⃣
🆓 #CME 👉🏽 bit.ly/PerianalDisPre
How often do #PerianalFistula #CPF complications affect patients with #Crohns disease?
#MondayNightIBD 4/Welcome #GITwitter #IBDTwitter to another 🔥 #MondayNightIBD #Back2Basics !
Let’s talk #Perianal Fistula in #Crohns #CPF
☑️ Incidence
☑️ Classification
☑️ Diagnosis
☑️ Initial therapy
#MondayNightIBD 5/ #CPF #Incidence & #Prevalence
➡️Can be isolated (w/o luminal dis)
➡️Initial presentation in 10-17%
➡️Affects 30-40% of CD pts
➡️Prevalence varies by CD location, rectal disease=risk factor
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan 6/ #CPF #Classification
💠Simple: Does not cross the sphincter complex, 1⃣ external opening
💠Complex: Inter/Trans/supra/intra sphincteric, > 1⃣ opening +/- Abscess/stricture/ Rectovaginal fistula
#B2BPearl : #CPF Often complex!
Complex fistula assoc w⬇️remission &⬆️recurrence
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC 7/New Consensus #CPF Classification
💠Stratification according to CPF severity & outcome
💠Goals is to guide decision making in trials & practice
💠Take into account: Fistula anatomy+ presence of luminal dis + symptoms burden/QO
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre 8/ #MondayNightIBD #CPF #Diagnosis
🟡History and PE (perianal pain, discharge, fever)
🟡Imaging (MRI > CT) or rectal EUS
🟡➕ EUA (diagnostic+therapeutic for drainage +/- seton)
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS 9/ #MondayNightIBD
🎯 #CPF Management
👉Control infection
👉Treat rectal🔥/stricture
👉Heal fistula
(✅Definition of response & remission👇)
👉Prevent recurrence
👉Improve quality of life
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️⚧️👩🏼⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet Sun-Ho Lee MD PhD 10/ #MondayNightIBD Complex #CPF Initial Management
1⃣ EUA: Abscess drainage+Seton
2⃣ Abx: Cipro>Flagyl. Prolonged course w biologics: ⬇️drainage,⬆️CPF response
3⃣ IFX typically 1st choice +/-AZA
💎 #B2BPearl No fistulotomy in complex CPF !
💎Optimize strategy to ⬆️response👇
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️⚧️👩🏼⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet 11/ In Summary : #Crohns #Perianal #Fistula
🔺Challenging complications, affecting up to 40% of pts
🔺Often complex & require MultiD care
🔺Combo medical+ surgical Rx
✅Proposed #CPF Management👇 Journal of the Canadian Assn of Gastroenterology doi.org/10.1093/jcag/g…
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️⚧️👩🏼⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet Journal of the Canadian Assn of Gastroenterology 12/ #MondayNightIBD
#PostConvo #IBDPoll 1️⃣
🆓 #CME 👉🏼bit.ly/PerianalDisPost
How often do #PerianalFistula #CPF affect patients with #Crohns disease?
#MondayNightIBD Jean-Frederic Colombel Oriana M. Damas, MD Erin Forster MD MPH Morgan Sendzischew Shane, MD Jennifer Seminerio @Dr. Samir A Shah SandraQuezadaMD Parambir Dulai Cristina Flores M.D. PhD Yi Yuan Tan Noa Krugliak Cleveland, MD Jeff Ko, MD Asad ur Rahman, MD, FACP Alexa Weingarden MD PhD Taku Kobayashi Dr. Mohamed Alboraie MD. FRCP Rishika Chugh Maria T. Abreu Beth-Ann Norton, MS, RN, ANP-BC Severine Vermeire Jordan Axelrad, MD, MPH “Get Screened” King-Mullins, MD Dorna Jafari, MD, FACS, FASCRS David Liska Thomas Read Sean Langenfeld Dhaval Patel Mark Soliman, MD, FACS, FASCRS jeremielefevre Mario Trejo-Avila Robin Phillips FRU, St Mark's Richard Brady Kat Baker 💙 (née Gash) Bassem Matta M.D. Dr.Ajab khan Fasiha Kanwal Reena Chokshi, MD Jeremy Glissen Brown MD, MSc Ali Soroush, MD, MS Dr Brian Bressler Laura Targownik 🏳️⚧️👩🏼⚕️ Eric Benchimol Vipul Jairath MBChB DPhil Gil Kaplan MD MPH Bram Verstockt Parul Tandon Seth Shaffer Laurent Peyrin-Biroulet Journal of the Canadian Assn of Gastroenterology 13/ #MondayNightIBD
#PostConvo #IBDPoll 2️⃣
🆓 #CME 👉🏼bit.ly/PerianalDisPost
57 y/o w recent diagnosis of #Crohns ileum + rectum presents with perianal fistula + abscess . What treatment(s) will optimize chance of fistula healing?
It was such an honor to address trainees at the Scrubs & Heels Summit 2024 alongside the ⭐️ Shaina Sekhri, MD !
I was truly impressed by all the amazing, accomplished women in GI!
Thank you , Dr. Aline Charabaty, MD, FACG, AGAF and Dr. Anita Afzali MD, MPH, MHCM, FACG, AGAF for this incredible opportunity!
#WomenInGI #EmpowerHer
