The Curbsiders Internal Medicine Podcast #502 Inflammatory Bowel Disease with Dr. Aline Charabaty
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Oct 20, 2025 Dr. Aline Charabaty, a leading gastroenterologist and clinical director at the IBD Center at Johns Hopkins, shares her expertise on inflammatory bowel disease (IBD). She discusses the importance of early diagnosis, differentiating IBD from other GI symptoms, and the latest imaging modalities. Treatment options range from anti-TNFs to dietary strategies for better management. Dr. Charabaty emphasizes preventive health, including vaccinations and screening for nutrient deficiencies, while noting the rising incidence of IBD and the need for a multidisciplinary approach.
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Endoscopic Healing Beats Symptom‑Only Goals
- Endoscopic healing predicts lower relapse, complications, and cancer risk beyond symptomatic remission.
- Clinical remission can coexist with persistent mucosal inflammation, so objective assessment matters.
Counsel On Practical, Culturally Adapted Diet Changes
- Recommend whole-food, less‑processed diets: lean proteins, tolerated vegetables, healthy fats, and minimize ultra‑processed foods and added sugars.
- During flares favor easily digestible foods and avoid dairy if lactose intolerance is suspected.
Prioritize Vaccination Before Immunosuppression
- Ensure age‑appropriate non-live vaccines before or during immunosuppression: pneumococcal, annual influenza, HPV, recombinant zoster, and COVID.
- Avoid live vaccines while on biologics or immunosuppressants.