Aline Charabaty, MD, FACG, AGAF

Professor of Medicine, Director #IBD Center @UMBaltimore/ Creator @MondayNightIBD/ Co-Founder @ScrubsNHeels #WomenInGI #DEI #WLI Opinions 🚫Not medical advice

[Aline Charabaty, MD, FACG, AGAF @DCharabaty]

We laughed, cried & celebrated
Empowerment is recognizing our own value, elevating each other & creating space to be vulnerable in our failures & successes

TY @AmerGastroAssn for your commitment to⏩ health & gender equity in GI

Grateful to share this w ppl I admire & love

[American Gastroenterological Association (AGA) @AmerGastroAssn]

Congratulations, @DCharabaty, @IBDAPN, and @IssakaMD! We are proud to recognize each of you and how you've championed gender and health equity.

[Aline Charabaty, MD, FACG, AGAF @DCharabaty]

@anoushkaduaMD @UCIrvineHealth CONGRATS !!! The field of GI is lucky to have you as one of our own !! The future is bright 🌟🌟🌟🌟🌟

[Marcel Yibirin, MD, MPH @MarcelYibirin]

1- 🧠 Intro to #IBD #Back2Basics
➖Epidemiology and definition of UC and CD
➖Symptoms
➖Endoscopic findings & scoring
➖Diagnostic work-up
➖Phenotype classification
➖Basics of biologics & small molecules

[Marcel Yibirin, MD, MPH @MarcelYibirin]

2- 🔑 IBD=Chronic inflammatory diseases of the GI tract
👥 Can affect all ages
📈 Peak incidence: 20–39 years
📈 Second incidence peak: age >50
⚡ Characterized by flares of:
💩 GI symptoms
🌡️ ± systemic manifestations
🦴 ± extraintestinal manifestations (EIMs)

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ 3- Suspecting #IBD ❓
🔰 Symptoms: abd pain, diarrhea, hematochezia, urgency/tenesmus, wt loss, perianal dz, EIM
🩸 Labs: CBC, CMP, iron, B12, Vit D, CRP
💩 Stool: Cx, O&P, C. diff, calprotectin/lactoferrin
🔭 Colonoscopy = key test
🧲 Imaging if an abscess or SBO is suspected

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ 4- Diagnosis
Colonoscopy + TI intubation = 🥇standard
👍 Benefits:
🔑 Defines extent + severity
🔑 Rules out other GI dx
🔑 Allows bx
👎 Limitations:
⚠️ Invasive (prep + sedation)
⬇️ pt acceptance
⚠️ Small bowel assessment limited (TI)
⚠️May miss isolated small bowel CD

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ 4a UC 🧠
📍 Hallmark sx: rectal bleeding 🩸
🔥 Superficial inflammation (mucosa + submucosa)
🔦 Starts in the rectum (exception👇)
➡️ Continuous proximal spread
📌 Extent:
• Proctitis = rectum only
• Pancolitis = extends beyond splenic flexure
📊 Endoscopic scores👇

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ @AdamFayeMD @dunleavy_katie @kehutchins77 @KatieFalloonMD @NayantaraCoelho @AmJGastro @DrJordanAxelrad @DaniyalRaza92 @IBD_Houston 4-b UC in endoscopy
📢 UC + PSC → relative rectal sparing
📢 Cecal patch = periappendiceal inflammation with distal UC (not Crohn’s skip lesions)
📢 Backwash ileitis in severe pancolitis ≠ Crohn’s ileocolitis

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ @AdamFayeMD @dunleavy_katie @kehutchins77 @KatieFalloonMD @NayantaraCoelho @AmJGastro @DrJordanAxelrad @DaniyalRaza92 @IBD_Houston @CathyLuMD @AroojMianMD @DCharabaty @IBDMD @DrSamirAShah1 @Samir_Grover @IBDimmunology @dr_fcalderaibd 5- C-scope in Crohn’s disease 🧠
🗝️ Patchy inflammation 🔥 anywhere in GI tract
🗝️ Most common: ileocolonic disease
🗝️ Ulcers: aphthous → deep, linear, serpiginous
💎 #B2BPearl: Rectal involvement can occur in CD; anorectal ulcers → ↑ perianal disease risk

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ @AdamFayeMD @dunleavy_katie @kehutchins77 @KatieFalloonMD @NayantaraCoelho @AmJGastro @DrJordanAxelrad @DaniyalRaza92 @IBD_Houston @CathyLuMD @AroojMianMD @DCharabaty @IBDMD @DrSamirAShah1 @Samir_Grover @IBDimmunology @dr_fcalderaibd 5a- Endoscopic scoring CD: SES-CD (slide👇)
🔤 Montreal classification in CD
🔤 A = Age at diagnosis
📍 L = Location in GI tract
⚙️ B = Disease behavior

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ @AdamFayeMD @dunleavy_katie @kehutchins77 @KatieFalloonMD @NayantaraCoelho @AmJGastro @DrJordanAxelrad @DaniyalRaza92 @IBD_Houston @CathyLuMD @AroojMianMD @DCharabaty @IBDMD @DrSamirAShah1 @Samir_Grover @IBDimmunology @dr_fcalderaibd @vipuljairath @ahmed_alqady_md @AasmaShaukatMD @MazenAlmasry4 @HishamWehbeMD @jalpa_devi @AshwinMDIBD @rebelliousgut @waqqasafif 6 Imaging dx
ECCO: newly dx/⬆️suspicion CD 🔜 EGD+small bowel assessment
🔍 Imaging complements but ❌replace scope
✅ Preferred:
🧲 MRE or 🔊 IUS > CTE
➡️ helps ⬇️radiation exposure ☢️
🚨 CT saved for acute sx/complications
📹 VCE if imaging inconclusive & neg for stricture🎯

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ @AdamFayeMD @dunleavy_katie @kehutchins77 @KatieFalloonMD @NayantaraCoelho @AmJGastro @DrJordanAxelrad @DaniyalRaza92 @IBD_Houston @CathyLuMD @AroojMianMD @DCharabaty @IBDMD @DrSamirAShah1 @Samir_Grover @IBDimmunology @dr_fcalderaibd @vipuljairath @ahmed_alqady_md @AasmaShaukatMD @MazenAlmasry4 @HishamWehbeMD @jalpa_devi @AshwinMDIBD @rebelliousgut @waqqasafif @ifrahfatima @EBGIdoc @GI_JeffMD @BenClickMD @fudmanMD @ibdseb @KevinWatsonJrMD @KendallBeckMD @_miquelmarques @FezaRemziMD 7 🧠 IBD therapies basics
📌 Mild–Mod UC: 💊 mesalamine, budesonide
📌 Mod–Severe UC/CD: 🚀 advanced therapies (AT)
⚙️ AT =
🧬 Biologics (proteins → 💉 SQ/IV)
💊 Small molecules (oral 🟠 pills)
🔑 Different MOA by class 🎯

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ @AdamFayeMD @dunleavy_katie @kehutchins77 @KatieFalloonMD @NayantaraCoelho @AmJGastro @DrJordanAxelrad @DaniyalRaza92 @IBD_Houston @CathyLuMD @AroojMianMD @DCharabaty @IBDMD @DrSamirAShah1 @Samir_Grover @IBDimmunology @dr_fcalderaibd @vipuljairath @ahmed_alqady_md @AasmaShaukatMD @MazenAlmasry4 @HishamWehbeMD @jalpa_devi @AshwinMDIBD @rebelliousgut @waqqasafif @ifrahfatima @EBGIdoc @GI_JeffMD @BenClickMD @fudmanMD @ibdseb @KevinWatsonJrMD @KendallBeckMD @_miquelmarques @FezaRemziMD @grepmeded @HenryHW_Liu @zsgottlieb @Sahara88uk 8- Choice of therapy depends on ⬇️
🔹 IBD severity, activity & phenotype
⚖️ MOA balance: safety vs efficacy
🦴 Presence of EIMs / associated immune diseases
🚫 Patient-specific contraindications (by MOA)
🤰 Pregnancy plans
➕ and more ⬇️⬇️

[Marcel Yibirin, MD, MPH @MarcelYibirin]

@BarbaraOlendzki @AKohli_MD @joshsteinbergMD @JasonHouMD @EdwardLoftsu2 @BattatMD4IBD @JosephHabibi_MD @AimenKhanMD @BassiMehak @GutMD_ @AdamFayeMD @dunleavy_katie @kehutchins77 @KatieFalloonMD @NayantaraCoelho @AmJGastro @DrJordanAxelrad @DaniyalRaza92 @IBD_Houston @CathyLuMD @AroojMianMD @DCharabaty @IBDMD @DrSamirAShah1 @Samir_Grover @IBDimmunology @dr_fcalderaibd @vipuljairath @ahmed_alqady_md @AasmaShaukatMD @MazenAlmasry4 @HishamWehbeMD @jalpa_devi @AshwinMDIBD @rebelliousgut @waqqasafif @ifrahfatima @EBGIdoc @GI_JeffMD @BenClickMD @fudmanMD @ibdseb @KevinWatsonJrMD @KendallBeckMD @_miquelmarques @FezaRemziMD @grepmeded @HenryHW_Liu @zsgottlieb @Sahara88uk 9/ Summary
📌 Assess UC vs CD, extent, endo scoring, phenotype
🔍 labs 🩸 + stool 💩 + colonoscopy (severity, extent, biopsies🔭 +SB imaging
💊 Mod–severe IBD requires advanced therapies (biologics or small molecules)
⚖️ Choice of Rx = severity+phenotype +MOA +EIM + 🧑‍🤝‍🧑 specifics

[#MondayNightIBD @MondayNightIBD]

Congrats #GIFellows on a new year !This June29 #Back2Basics @MarcelYibirin is focused on you

📲DM us for #IBD topics you want to learn more about!

CME👉🏼 https://t.co/sd42H9vTGV

🗳️IBDPolls👇🏽

Support by educ grants @AbbVie @JNJInnovMed @TakedaPharma

📌Where are you in your🩺

[#MondayNightIBD @MondayNightIBD]

#PreB2B #IBDPoll1️⃣

Patients with #UlcerativeColitis always have inflammation that involves the #rectum & can extend more proximally;

🤔with the #exception of 👇🏽 where there can be relative rectal sparing

[#MondayNightIBD @MondayNightIBD]

#PreB2B #IBDPoll2️⃣

😉this one is a tough one

22y/ with new dx of #Crohns disease .

🔦Colonoscopy: patchy inflammation right colon + ileum.
📸MRE : no evidence of stricture or fistula

The #Montreal classification (Age. Location. Behavior) for this patient is

[Dawn Sears, MD, FACG @GutGirlMD]

It is easy to get lost in the sea of requirements, but having the right mentor in your corner changes everything.

I am opening up my schedule to give you the exact, one-on-one preparation that turns a stressful application into a successful match.

https://t.co/vEwtrqxrHr

[Aline Charabaty, MD, FACG, AGAF @DCharabaty]

@ibdseb @IbdHull @gilkaplan @NickPowellLab @Alboraie @yzabanaa @philtozer1 @anjan_dhar6 @drvishal82 @DrAilsaHart @ShahidaDin1 @ibd_pal @JuliaoFabi7818 @CholestasisDoc @AlaaEl_Hussuna @Bealoquebea @UKGastroDr @IBDimmunology @EdwardLoftus2 @P_DeepakIBDMD @Jonathansegal85 @KaazanPatricia @fgomollon @PhilSmithIsBack Congrats on putting together this 🌟 meeting !

[Seb @ibdseb]

3️⃣ weeks only to go for the FREE Global IBD Meeting in Hull hosted by @IbdHull
Leading speakers including @gilkaplan @NickPowellLab @Alboraie @yzabanaa @philtozer1 @anjan_dhar6 @drvishal82 @DrAilsaHart @ShahidaDin1 @ibd_pal @JuliaoFabi7818 @CholestasisDoc @AlaaEl_Hussuna and many others

❇️Free to register : https://t.co/YuI96yIG9c
❇️In Person at @connexinlive Hull or Live stream Globally

[Tauseef Ali MD, FACG AGAF FACP @ibdtweets]

Building a new clinical service line is really about building a shared vision, earning trust, and creating lasting value for patients.

I was honored to join Dr. @AdvaniRashmiMD and Dr. @DVinsard at the recent @ScrubsNHeels Leadership Summit to discuss the principles behind successfully launching new gastroenterology service lines across academic, government, and private healthcare settings.

🌱My key message was simple: Passion starts the journey, but alignment of vision and true co governance between physicians and healthcare leaders is what sustains success. When clinical teams and administrative leadership work together with shared goals, organizations can build programs that improve access, quality, innovation, and the patient experience.

Thank you to @gastroendonews for highlighting this important discussion. The future of healthcare will be shaped by leaders who build partnerships, not silos

@AmCollegeGastro @DCharabaty
@IBD_Afzali

https://t.co/UmB4o4qgwU