May 19 is World Inflammatory Bowel Disease (IBD) Day. Each year, World IBD Day unites people worldwide to support the diagnosis of and care for patients and families living with inflammatory bowel disease. At the University of Kentucky College of Medicine, the division of gastroenterology and hepatology is honored to provide comprehensive care for patients living with Crohn disease and Ulcerative Colitis.
The IBD care team includes gastroenterologists and surgeons with deep expertise in the care of inflammatory bowel disease, advanced practice providers dedicated to the care of IBD, nurses, pharmacists, and dietitians. They are all focused on helping patients achieve remission and live full lives that are not defined by a diagnosis.
UK is a member of IBD QORUS, a multicenter collaborative initiative to improve health outcomes and care delivery for patients with IBD. Courtney Perry, DO, assistant professor, was awarded the QORUS Pfizer Health Equity award to focus on IBD health care delivery in Appalachia.
“We are committed to research that will improve patient care, and which may someday lead to a cure,” says Deborah Flomenhoft, MD, professor of internal medicine and director of endoscopy. Dr. Flomenhoft leads multiple sponsored clinical trials, which expand treatment options for patients in the division’s IBD clinic and throughout Kentucky. These efforts are supported by clinical coordinators who are among the best in their field.
The GI faculty and fellows are committed to ongoing research both at the bench and at the bedside. Terrence Barrett, MD, professor of internal medicine, has been recognized with continuous extramural funding. His team has recently developed a potential therapeutic agent targeting mitochondria as a means of accelerating mucosal repair and controlling the microbiome, in preclinical investigation.
The IBD team is here to support both patients living with IBD and colleagues who care for patients in their communities.
Below is an associated review of IBD in 2026, provided by Terrence Barrett, MD, a recognized global leader in IBD research, and inaugural Crohn and Colitis fellow.
The evolution of IBD care: the promise of better patient lives in an evolving therapeutic landscape
As we look back on the care of patients with inflammatory bowel disease (IBD) in the United States and across the globe, several trends emerge. In 2026, 3.1 million US adults are living with IBD (Xu F et al. MMWR Morb Mortal Wkly Rep 2018;67:190–195). The incidence of IBD in early industrializing regions is also increasing rapidly. Although the reasons for this are incompletely understood, evidence suggests environmental factors associated with Westernization of society—e.g. increased smoking, Western diet, and improved hygiene—may contribute by altering mucosal immune responses to the intestinal microbiome in genetically susceptible individuals (Hracs, L et al. Nature volume 642, pages458–466 (2025). Whereas some researchers propose that sanitation lowers tolerogenic organisms (helminths), more recent studies indicate that the increasing incidence of IBD is more likely related to the increased consumption of ultra-processed foods, refined sugars, saturated fats and food additives (like emulsifiers) which damage the gut lining and alter the microbiome (Catalon-Serra, I et al. United European Gastroenterol J . 2025 Jul 9;13(8):1410–1417).
The evolution of IBD treatment over the past 30 years exemplifies the successful application of newly emerging biopharmaceutical technologies. Treatment has been transformed from broad, symptom-focused medications (steroids, nonspecific immunosuppressives) to highly targeted disease-modifying biologic and oral therapies aimed at deep endoscopic and mucosal healing (Hafez M et al. World J Methodol. 2025 Dec 20;15(4):10764). The biological revolution began in 1998 with anti-tumor necrosis factor (TNF), the first targeted therapies aimed at treating Crohn’s and ulcerative colitis. What followed were agents that block intestinal recruitment of activated lymphocytes (vedolizumab) as well as anti-IL-12-23 mAb (ustekinumab) that target cytokine that drive inflammation.
More recently (2015-2026) patients have benefited from oral JAK inhibitors (tofacitinib, upadacitinib), S1P receptor modulators (ozanimod, etrasimod) and newer generation anti-IL-23s (risankizumab, guselkumab and mirikizumab). Availability of these newer therapies empowers clinicians with multiple opportunities to help IBD patients achieve remission and live full lives. Newer therapies are well tolerated and associated with less immunogenicity, promising more durable treatment.
The role of the surgeon on the IBD team has evolved in parallel to the expansion of medical therapy. The use of newer therapies has significantly delayed — and in many cases reduced — the need for emergent bowel resections and colectomies. But we have also learned that surgery is an important part of good IBD care, helping patients achieve durable remission and excellent quality of life. Involving a surgeon at an early stage of the disease is now considered good clinical practice and is part of most quality-control parameters (Bemelman WA et al Journal of Crohn's and Colitis, Volume 12, Issue 8, August 2018, Pages 1005–1007). Overall, the expansion of approaches to IBD therapy has increased cost (Burisch J et al. Clin Gastroent and Hep. Volume 23, Issue 3, February 2025, pages 386-395) while dramatically reducing surgical rates (by 25 to 50%, Hogden A et al. BMJ Open Gastroenterol. 2025 Jun 19;12(1)), cancer risk (Stidham RW. Clin Colon Rectal Surg, 2018 May;31(3):168-178), and disability (Mateos AMC et al. J Clin Med. 2025 Feb 25;14(5):1536.
Crohn’s disease and ulcerative colitis are ever-growing, debilitating diseases of our modern society that can be difficult to recognize. Yet, our ability to treat these diseases and help patients achieve remission and return to health is growing.