Treatments and Services
Inflammatory Bowel Disease Center
What is inflammatory bowel disease?
Inflammatory bowel disease (IBD) is a group of related conditions that can require complex treatment. It includes Crohn's disease and ulcerative colitis. Doctors believe IBD happens because of a problem between a child's genetic makeup, their immune system and their microbiome.
To diagnose and treat IBD, it's important to understand and address this complex relationship. This is why our IBD Center combines care from experts in digestive health, immune health, nutrition, surgery and psychology.
What is the Inflammatory Bowel Disease Center?
The IBD Center at Seattle Children's brings a team of specialists together in one place to give your child and family the most complete care.
We treat the whole child. Members of the IBD Center team have special training not only in their field, but also in the unique needs of children. We understand how IBD affects children differently from adults, and we know what it's like for families to live with IBD.
The team also conducts research to learn more about the causes of IBD, find better treatments and improve the quality of life for children with IBD. We're part of ImproveCareNow, a group of more than 55 centers working together to study and refine IBD care for children across the country and internationally.
We provide second opinions for IBD diagnosis and current treatment plans for children with:
- Crohn’s disease
- Ulcerative colitis
- Indeterminate IBD
For patients visiting from outside Washington state, we are able to provide our opinion as a consultation resource for your local primary pediatric and gastroenterology providers. Patients and families have found this experience to be helpful. In this role, we partner with but do not replace your primary providers.
We offer the following services:
- Consultations: 1 or 2 per year
- Recommendations for you and your child’s primary care and gastroenterology providers to consider (such as laboratory and imaging diagnostic tests, medications and procedures)
- Specialized procedures (including various advanced endoscopy services) as requested by your child’s primary care provider or gastroenterologist
- Communication with your child’s primary care provider and gastroenterologist
We are unable to provide the following services:
- Routine follow-up visits
- Medication management
- Ordering tests, receiving or reviewing test results
- Phone, email or fax communication directly with you and your family for routine IBD care
As a consultation resource for patients outside Washington state, we do not replace your child's primary care provider or gastroenterologist.
How will the IBD Center meet my needs?
The center provides rapid access to many IBD experts:
- You can usually get an appointment with an IBD specialist within 5 to 7 days.
- We can schedule your visit so your child sees many members of the healthcare team in one place on the same day.
Your child's team will design a short-term plan to get your child feeling better and a long-term plan to keep them better. You and your child are active partners in making treatment choices.
We offer IBD infusion services in Seattle, Bellevue and Federal Way.
What treatments and services does the IBD Center offer?
- We try to treat children without using corticosteroids. These medicines can cause long-lasting side effects if they’re used again and again.
- Seattle Children’s offers advanced treatments, such as the medicines natalizumab, ustekinzumab and vedolizumab.
- In 2017, 86% of our patients had prednisone-free remission.
- These medicines are given through infusion. We offer infusion services at 3 convenient locations: Seattle, Bellevue and Federal Way.
- One of the early signs of remission is how much medicine is still in your child’s body after a certain amount of time. We will check your child’s medicine levels early so we can individualize the dose, and increase the likelihood of your child getting – and staying – in remission.
- Dr. Namita Singh has lead research on the usefulness of early therapeutic monitoring to improve patient outcomes.
- Seattle Children’s is the only IBD Center in our region to use ultrasound monitoring to check patients’ response to treatment.
- Ultrasound is less invasive than endoscopy, and does not require advance preparation like endoscopy.
- Using ultrasound to monitor your child’s intestinal health means we can adjust your child’s care plan more frequently, and personalize their treatment in real time.
- Clinical studies show that certain nutritional therapies (formulas or diets) may reduce IBD inflammation and promote healing of the lining of the bowel (the intestinal mucosa).
- We offer exclusive enteral nutrition (EEN) and support the Specific Carbohydrate Diet (SCD). We can help you and your child decide whether nutritional therapy is right for them and how to do it.
- Children with IBD need special focus on nutrition to support their growing bodies, such as making sure they get the nutrients to build strong bones. We assess and address your child's unique needs.
- Dr. David Suskind's research focuses on SCD. Learn more about SCD.
The surgery that some children need for IBD is highly technical. Our surgeons do more of these operations for children than any other surgeons in the region, including Oregon, Washington, Alaska, Montana and Idaho. Greater experience leads to better results.
If your child has severe Crohn’s disease (or a severe Crohn’s disease–like condition) that started before age 5, immunologists at Seattle Children’s can test for genetic changes and immune deficiencies that might be the cause.
Through the IBD Center, your child has access to a range of expert team members, such as a psychologist, dietitian and social worker, to help meet their needs.
Our physician-researchers lead clinical trials to study new treatment approaches. We invite children and their families to participate in our clinical trials. This gives patients access to some of the latest treatments and therapies.
What to Expect
To learn more about what to expect at your IBD Center appointments, read our Inflammatory Bowel Disease Center Clinic Visit Roadmap (PDF).
Things to do before your appointment
- Get records and test results. Ask your child's primary gastroenterology provider for testing results related to your child's condition, including biopsies and X-rays. Have your provider fax them to us at 206-985-3121.
- Know your child’s medicines. Bring a list of medicines your child is on now as well as the doses. Please include special diets, supplements, etc.
- Plan to arrive 15 minutes early to get your photo name badge and check in for your appointment.
- Bring a list of questions.
Your visit will last 30-60 minutes and will include:
- A complete history of your child’s illness and family history of illness
- A physical exam
- A review of your child’s current treatment plan
- Teachings about specific therapies
- A list of care recommendations to discuss with the provider who referred you. If your provider has questions, we are happy to talk with them.
- A visit with a psychologist or social worker, if needed
What happens after our second-opinion visit?
- We will give you a detailed summary of our IBD consultation.
- We will send your child’s referring provider a copy of our IBD consultation and recommendations.
- If you have further questions about your child’s care and treatment, please ask your referring provider.
Members of the IBD Center team have special training and experience working with children who have IBD and their families. The team includes:
- Ghassan T. Wahbeh, MD, IBD Center director
- David L. Suskind, MD, co-chair of the nutrition committee; physician leader of ImproveCareNow
- Matthew Giefer, MD
- Dale Lee, MD
- Mary K. Len, MD
- Namita Singh, MD
Advanced registered nurse practitioner
- Kimberly Braly, RDN
- Nila Gregory, MPH, RDN, CNSC, IBCLC
- Rachelle Foreman, RN
- Sarah Mbonde, RN
- Teresa Wachs, RN
The team also has a medical assistant. Based on your child’s needs, the team will involve other healthcare providers, such as immunologists and radiologists with special expertise in IBD, child life specialists and social workers.
We partner closely with the Crohn’s and Colitis Foundation of America (CCFA). Seattle Children’s Dr. Ghassan Wahbeh and nurse Teresa Wachs are the medical directors of the CCFA’s Camp Oasis in Washington, where more than 90 kids with IBD gather for a week each year.