Colorectal Surgery Clinic Helps Young Patients Transition to Adult Care

Cleveland Clinic has established a Pediatric & Adult Colorectal Surgery Clinic to help transition young patients with colorectal disorders to adult care.

“Our goal is to provide a multidisciplinary approach for lifelong diseases in order to ensure patients receive the best care from diagnosis to adulthood,” says pediatric general surgeon Anthony DeRoss, MD, who runs the clinic with colorectal surgeon Jeremy Lipman, MD.

Surgical care a key component

A large percentage of patients with inflammatory bowel disease need surgery, and Crohn’s patients require more than one surgery in their lifetime. “When these diseases are present in childhood, the patient will eventually need an adult surgeon. That’s why both adult and pediatric surgeons are involved,” Dr. DeRoss explains.

“We like to get to know our patients before they need surgery. Surgery is better tolerated and the experience is better, if it is scheduled electively, and the patient is not meeting us for the first time in an emergent situation,” he adds.

Managing expectations

Patients are generally referred to the clinic by a pediatric gastroenterologist when the patient is nearing the limits of medical management and will need surgery in the near future. But Dr. Lipman feels that an earlier introduction can be invaluable in helping patients prepare for their future.

“We would like to help patients make an informed decision about biologic therapy and surgery before they have failed every medical therapy. This way, they understand the course of their disease, know what to expect and are not frightened by the treatment options,” he says.

The approach seems to work. “We haven’t had a single patient get upset about an IV or heparin shot. In fact, we have been impressed at how well-adjusted our patients are, even though some get a stoma,” he says.

Preparing for the future

The transitional clinic fills an important role for college-age patients, who are often lost after aging out of pediatric care. Drs. DeRoss and Lipman do not let this happen.

“When these kids leave home, they are tempted to stop taking their medications. They need to understand why this can’t happen,” says Dr. Lipman. “We are there for them when they need us. They understand our goal is to make them feel better.”

Who and when to refer a patient

Children, teens and young adults up to age 21:

• With a diagnosed colorectal disease such as IBD, Crohn’s disease, constipation, rectal prolapse or a hereditary condition such as familial polyposis
• Rectal bleeding not caused by a constipation-related anal fissure
• Subtle signs of inflammatory bowel disease, such as unexplained weight loss, fatigue, abdominal pain, bloody stool, diarrhea.
• History of colorectal cancer at a young age

Making an appointment

Call the triage nurse at 216.444.8555. Appointments are coordinated with pediatric/adult gastroenterology, pediatric surgery, adult colorectal surgery, nutrition, psychology and the hereditary cancer registry, if needed. All tests will be ordered in advance of the first visit to optimize the appointment.