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Sophie Balzora, MD

Clinical Associate Professor of Medicine in the Division of Gastroenterology and Hepatology at the NYU Grossman School of Medicine

Q: I have Crohn’s disease and was recently diagnosed with Immune thrombocytopenia purpura (ITP). How common is it in Crohn’s patients? What are some concerns I should discuss with my doctor.

A: ITP in inflammatory bowel disease (IBD) is considered rare, with less than twenty cases reported in the medical literature. It is a type of “extraintestinal manifestation” of IBD, or a condition that patients with IBD may have that is unrelated to the gut, but is directly related to having the disease (ex include joint aches, eye or skin conditions, and blood disorders like ITP to name a few). Concerns to discuss with your doctor would be if any medications used to treat ITP interact with medications used to treat Crohn’s disease, or could exacerbate symptoms or cause worsening inflammation. hide answer

Q: I have ulcerative colitis and I want to get breast augmentation (probably a lift with implants). I have been in remission for years and in good shape. I take Apriso (mesalamine) to stay in remission. Is it safe to get cosmetic surgery? I am concerned about a possible flare up.

A: If your symptoms are well-controlled, and your colon looks healthy on colonoscopy, you are in what we would characterize as “deep remission”, which is the goal we strive towards in our patients with IBD. For an elective surgery unrelated to the bowel, this is the ideal position in which to be. A potential flare-up is always a concern, especially when the body is subjected to stress, but some flare-ups are ultimately not in anyone’s control. However, positioning the surgery at a time when you are in deep remission is the wisest choice, and one you should discuss with your gastroenterologist before going ahead with the surgery. hide answer

Q: I am 33 years old and had a colonoscopy recently because I had blood in my stool. The doctor says I have ulcerative colitis but then I found out he took biopsies. I am wondering the purpose of the biopsies are since he knows what is wrong with me.

A: A diagnosis of inflammatory bowel disease (IBD) requires many types of testing – taking a detailed history about a patient’s symptoms, family history, and tobacco history/exposure, for example, is one crucial part. Other important information to gather includes bloodwork and stool testing, colonoscopy findings and biopsy samples, and sometimes imaging tests (cat scan or MRI for example), and sometimes even additional testing still. Taking biopsies during the colonoscopy is standard when a diagnosis of ulcerative colitis is suspected. hide answer

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