Gastroenterology Advances


Advances in Gastroenterology and GI Surgery

Dr. Bo Shen: Leading the Way in IBD and Pouch Disorders

image of Dr. Bo Shen

Dr. Bo Shen

Bo Shen, MD, a renowned gastroenterologist recognized as the preeminent expert in pouch disorders and pouchitis, as well as interventional IBD worldwide, was named Section Head and Medical Director for the Inflammatory Bowel Disease Center and Vice Chair for Innovation in Medicine and Surgery at NewYork-Presbyterian/Columbia University Irving Medical Center. Dr. Shen comes to Columbia from the Cleveland Clinic, where he founded a pouchitis clinic and an interventional IBD unit, the first and the largest of its kind in the United States. He is a leader in using endoscopy to manage complications of IBD and IBD-related surgery, ranging from bowel blockage to surgical suture-line leaks.

image of Dr. P. Ravi Kiran

Dr. P. Ravi Kiran

“We are delighted that Dr. Shen has accepted the position as the new medical director of the IBD Center, a program that takes on the most complex cases of IBD,” says P. Ravi Kiran, MD, Chief of the Division of Colorectal Surgery at NewYork-Presbyterian/Columbia and Director of the Center for Innovation and Outcomes Research in the Department of Surgery at Columbia University Vagelos College of Physicians and Surgeons. “Dr. Shen is a recognized pioneer in the field of interventional approaches for treating IBD and ileal pouch disorders. We are excited that he will build on the medical, endoscopic, and surgical interventional expertise now available at NewYork-Presbyterian and Columbia.”

“Dr. Shen is a recognized pioneer in the field of interventional approaches for treating IBD and ileal pouch disorders. We are excited that Dr. Shen will build on the medical, endoscopic, and surgical interventional expertise now available at NewYork-Presbyterian and Columbia.”

— Dr. P. Ravi Kiran

In his new role, Dr. Shen will work to develop and expand the adult IBD Center at NewYork-Presbyterian and Columbia while closely collaborating with the pediatric IBD program, providing patients from birth to adulthood with a full spectrum of care. Dr. Shen has world-renowned expertise in interventional IBD that allows the minimally invasive endoscopic management of conditions that would otherwise only be amenable to surgery. Access to his endoscopic interventions will now be more easily available to patients in New York as well as across the world.

Pursuing Novel Approaches to Managing Pouchitis

Dr. Shen is known internationally as the preeminent expert in pouchitis, the most common complication among patients with ulcerative colitis who have undergone restorative proctocolectomy with ileal pouch-anal anastomosis, and other ileal pouch disorders, as well as endoscopic management of IBD and IBD surgery-associated complications. “Pouchitis is actually a spectrum of some 30 to 40 disorders that vary in etiology, pathogenesis, phenotype, and clinical course,” says Dr. Shen. “Although initial acute episodes typically respond to antibiotic therapy, patients can become dependent on antibiotics or develop refractory disease.”

Many factors contribute to the course of refractory pouchitis, such as the use of nonsteroidal anti-inflammatory drugs, infection with Clostridium difficile, pouch ischemia, or concurrent immune-mediated disorders. Identification of these secondary factors can help direct therapy.

While the pouch procedure has been shown to improve patients’ quality of life significantly and to reduce the risk for colitis-associated neoplasia, at the same time, complications from the pouch surgery can result, ranging from procedure-associated leaks, strictures, sinuses, or fistulae, to pouchitis, cuffitis, and de novo Crohn’s disease (CD)-like conditions of the pouch and irritable pouch syndrome.

“The management of chronic antibiotic-refractory pouchitis has been challenging and, in fact, chronic pouchitis is one of the most common causes for pouch failure, defined as permanent diversion, pouch excision, or complete pouch revision,” notes Dr. Shen. “The mechanical complications that affect people, such as pouch strictures, surgical leaks, and pouch prolapse, can be managed with endoscopic therapy. We have also applied the endoscopic approaches to other forms of disease, including Crohn’s disease.”

Dr. Shen will also call on the expertise of Columbia’s colorectal surgical team to manage patients who encounter mechanical complications, including Dr. Kiran, who has particular expertise in pouch revision surgery.

“Creating the pouch is one of the most difficult procedures in GI surgery. Patients should seek a high volume center, such as Columbia’s, for our expertise in this field. Mechanical or structural complications of ileal pouch surgery, such as pouch strictures, presacral sinus, and prolapse are common, which had traditionally been treated with surgical re-intervention. Before going to the reconstruction, however, we may try an endoscopic therapy first. We always save surgical intervention or revision surgery as a last step for which our Columbia surgical team has great expertise.”

— Dr. Bo Shen

A Focus on Medical Management of IBD

image of Dr. Garrett Lawlor

Dr. Garrett Lawlor

“At the IBD Center, we do everything we can to help the patient heal in the least invasive way possible,” says Garrett Lawlor, MD, Associate Director. “This requires a multilevel approach and close cooperation between medical therapy, interventional therapy, and surgical therapy. In the Pouch Center, we provide all three facets right beside each other. Alongside standard approved medical therapies, we have over 20 clinical trials of therapies that can be used in difficult cases. For every facet of inflammatory bowel disease, whether we are discussing Crohn’s disease or ulcerative colitis, we have a clinical trial tailored for that type of disease. This gives us the unique advantage over other centers in helping patients get back to the life they deserve.”

“For every facet of inflammatory bowel disease, whether we’re talking about Crohn’s or colitis, we have a clinical trial tailored for that type of disease.”

— Dr. Garrett Lawlor

“Since 2014 alone we have had three major drugs newly approved by the FDA for use in IBD, targeting new pathways and providing new solutions,” continues Dr. Lawlor. “These drugs have given us a much greater choice in providing the best, safest, and most convenient treatment for a patient; and by extension, avoid future complications of the disease. It is very reassuring to see so many new options becoming available for us and our patients.”

About Dr. Shen

At the Cleveland Clinic, Dr. Shen also held appointments in the department of gastroenterology and hepatology and was a professor of medicine of Lerner College of Medicine of Case Western Reserve University, and the Ed and Joey Story Endowed Chair at the Cleveland Clinic. Dr. Shen founded the special interest group in interventional IBD in the American Society for Gastrointestinal Endoscopy and the Global Interventional IBD Group.

As a Principal Investigator, Dr. Shen’s research has been funded by grants from the National Institutes of Health, American Gastroenterological Association, American College of Gastroenterology, American Society for Gastrointestinal Endoscopy, American Society of Colon and Rectal Surgeons, Broad Foundation, Crohn’s and Colitis Foundation, and philanthropic organizations. Dr. Shen is pursuing multiple basic science, translational, and clinical projects in IBD and ileal pouch disorders, ranging from disease characterization and classification to innovative medical and endoscopic management of the diseases. He has lectured extensively throughout the U.S. and abroad and has published more than 500 peer-reviewed articles and edited three reference books in IBD, interventional IBD, and ileal pouch disorders.

Dr. Shen earned his medical degree from Nantong Medical College in Jiangsu, China. He completed an internship and residency in internal medicine at Nantong Medical College Hospital in China, and a residency in internal medicine at University of Illinois at Urbana-Champaign in Illinois. Dr. Shen also completed a fellowship in gastroenterology at the Cleveland Clinic. He holds a certification for Internal Medicine and Gastroenterology by the American Board of Internal Medicine.

“I am excited to lead the expansion of such a comprehensive center that offers multidisciplinary care for IBD patients at all stages of life,” says Dr. Shen, who took on his new role in December 2019. “The IBD Center has a stellar group of expert gastroenterologists, colorectal surgeons, GI pathologists, GI radiologists, nutritionists, clinical psychologists, and specialized staff who treat patients with the most complex IBD and gastrointestinal issues. I see innovation coming from many sides, from the bench side in the form of translational research, to the surgical and medical treatment of patients, to delving more into theories of disease.”

For more information

Dr. Garrett Lawlor