UC Irvine center unites digestive disease experts

The UC Irvine H.H. Chao Comprehensive Digestive Disease Center (CDDC) is one of the few facilities in the nation — and the only one in Orange County — that provides a full spectrum of care specifically for patients with digestive diseases. A multidisciplinary team of specialists led by gastroenterologist Dr. Kenneth Chang delivers leading-edge treatment for a broad range of GI conditions, including liver disease, pancreatic disease, gastroesophageal reflux disease (GERD), Barrett’s esophagus, acid reflux, inflammatory bowel disease, colorectal disorders and associated cancers and pre-cancerous conditions.

Founded in 2003 by Chang, the CDDC sees about 20,000 patients a year; more than 50 percent of them are people with cancer or precancer of the digestive system. Bucking the traditional academic hospital structure of separate departments for medicine and surgery, the CDDC is designed to be more patient-friendly by placing all specialists who treat digestive diseases under one roof. Gastroenterologists, hepatologists, GI surgeons, colon and rectal surgeons, oncologists, radiologists, pathologists, dietitians, nurses, social workers and case managers all come together to treat these patients.

“We wanted to provide the ultimate ‘one-stop shop’ centered on the patient,” explains Chang, medical director of the CDDC. “Our motto is, ‘We're in this together,’ which means that when a patient comes to us with a digestive health issue, every possible specialist is available to provide individualized care without the patient having the hassle of going from one place to another. In this kind of environment, physicians are better able to coordinate treatment options and everyone's on the same page.”

From the point where food enters the body to where it exits, the gastrointestinal (GI) system is a 20-foot long complex tract of digestive organs that turns food into fuel for the body. It includes the esophagus, stomach, liver, bile duct, gall bladder, pancreas, small intestine, large intestine (colon), rectum and anus. When something goes wrong with one of these vital organs, it can be embarrassing, painful and even life threatening. 

With about one in four Americans affected by a digestive disorder, advances in research and technology have greatly improved patients’ outcomes and quality of life. UC Irvine physicians are leading the charge by using minimally invasive endoscopic, laparoscopic and robot-assisted surgical techniques, pioneering interventional endoscopy procedures and studying new medications through clinical trials.

The CDDC has highly trained colorectal surgeons, all skilled in minimally invasive surgical techniques that preserve bowel function. Colorectal cancer or inflammatory bowel disease patients who need a colon resection also occasionally need an ostomy, colostomy or ileostomy, which is most commonly a temporary measure but sometimes can be permanent. A sort of bypass, an ostomy involves the surgeon creating an opening from the colon or small intestine (ileum) through the abdominal wall, avoiding the diseased portion of the intestines and allowing waste to pass into a bag outside the body.

“Nationwide, upwards of 25 to 50 percent of patients treated for rectal cancer end up with a permanent colostomy. At UC Irvine, only 5 percent of patients end up with a permanent bag,” explains Dr. Michael Stamos, a colon and rectal surgeon and chair of the Department of Surgery and a member of the CDDC team. Stamos heads an accredited UC Irvine program to train colorectal surgeons. “There is a shortage of colorectal surgeons in the country, so to have nationally recognized surgeons of this caliber is a real advantage for UC Irvine patients.” 

The CDDC is also home to leaders in interventional endoscopy. With endoscopy, doctors use thin, flexible tubes equipped with miniature cameras and other devices inserted through natural orifices to diagnose and treat disorders ranging from gastroesophageal reflux disease to certain cancers. Chang is nationally known for his expertise in new techniques with endoscopic ultrasound (EUS) to diagnose, biopsy and treat these conditions. He pioneered the endoscopic ultrasound-guided, fine-needle aspiration technique, a superior, cost-effective and less invasive alternative to surgical biopsy. Now used worldwide, it spares patients from difficult and painful exploratory surgeries.

CDDC doctors have championed several nonsurgical methods to treat GI cancer. Photodynamic therapy is a procedure that combines a light-sensitive drug with laser energy to destroy cancer cells in targeted areas of the esophagus. Radiofrequency ablation uses an electric current to treat Barrett’s esophagus, a precancerous condition that can result from long-term acid reflux. 

CDDC doctors, working at Orange County’s only university hospital, also are actively studying new drug therapies. Chang conducts research involving gene therapy for pancreatic cancer. Dr. Namisha Parekh, director of UC Irvine’s Inflammatory Bowel Disease Program, is investigating an experimental stem cell treatment for patients with Crohn’s disease. Dr. David Imagawa, a surgeon specializing in liver and pancreatic diseases, is using a patient’s own insulin-producing islet cells to combat diabetes after surgical removal of the pancreas. 

“We’ve seen much progress in diagnosing and treating digestive diseases,” says Chang. “But there’s more to be done, so we’ll keep at it.”

For more information or to make an appointment with a CDDC specialist, please contact us at 888-717-GIMD (888-717-4463).