Corey A. Siegel, is the Director of the Inflammatory Bowel Disease (IBD) Center at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and an Assistant Professor of Medicine at Dartmouth Medical School. Dr. Siegel received his medical degree from Tufts University School of Medicine in Boston, Massachusetts in 1998. He completed his residency in internal medicine at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. Dr. Siegel served as chief medical resident at Dartmouth from 2001-2002, where he also completed a fellowship in gastroenterology. From 2004-2005, he completed a fellowship in Inflammatory Bowel Disease at Massachusetts General Hospital in Boston, Massachusetts. In 2009 he received a Master's Degree from the Dartmouth-Institute of Health Care and Clinical Practice in the Evaluative Clinical Sciences. Dr. Siegel. along with his friends and colleagues founded the BRIDGe group in 2006. He lives in Hanover, NH with his wife and two boys.

Inflammatory Bowel Disease Center

The Dartmouth-Hitchcock Inflammatory Bowel Disease Center is dedicated to the comprehensive care of patients with Crohn's disease and ulcerative colitis. Our group includes four adult gastroenterologists, a pediatric gastroenterologist, two surgeons, a dedicated nursing staff with an IBD nurse practitioner and wound ostomy continence nurses, and research study coordinators. Our group has become an efficient team to help in every aspect of patient care, support and research.

In addition to extensive experience using both standard and cutting-edge therapies, we have active research protocols for both Crohn's disease and ulcerative colitis, allowing patients access to exciting new options for treatment. Our renewed partnership with the Crohn's and Colitis Foundation of America will provide multiple opportunities for support and educational programs for our patients.

Director: Corey A. Siegel, MD
Phone: (603) 650-6734
Fax: (603) 650-5225

Medical Team
Steve P. Bensen, MD
L. Campbell Levy
Susan T. Edwards, MD (pediatrics)
Gary M. Levine, MD
Corey A. Siegel, MD
Connie Dragnev, APRN, MSN

 Evaluating a Shared Decision Making Program for Crohn's Disease

Specific Aim: Study the impact of the Crohn's Disease Shared Decision Making Program on patients' treatment choice, persistence with chosen therapy, decision quality, cost of care, and outcomes

Hypothesis: The Crohn's Disease Shared Decision Making Program will help patients understand which treatments are right for them and will lead to a higher acceptance of appropriate therapy, improved persistence with chosen therapy, lower costs and improved clinical outcomes. To accomplish this aim, Investigators will perform a randomized controlled trial to:

Determine how the shared decision making program influences patients' choice of therapy
Evaluate how the shared decision making program affects persistence with chosen therapy
Determine how the shared decision making program affects decision quality
Determine how the shared decision making program influences cost of care and clinical outcomes

Expected Outcome and Impact: Investigators expect that this program will influence patients' choice of therapy, persistence with their preferred therapy, and lead to improved clinical outcomes. Investigators believe that this product can be successfully operationalized in the clinic to establish a new paradigm of how providers can communicate personalized treatment options to patients across a broad range of diseases.

Estimated Enrollment: 300
Study Start Date: March 2014
Estimated Primary Completion Date: July 2017 (Final data collection date for primary outcome measure)

 Hyperbaric Oxygen for Ulcerative Colitis

The investigators aim to prospectively study the feasibility and clinical impact of hyperbaric oxygen therapy in acute hospitalized moderate to severe ulcerative colitis flares as an adjunct to standard medical treatment. Specifically, we will investigate the impact of hyperbaric oxygen therapy on clinical response/remission and serum and mucosal inflammatory markers. The investigators expect that hyperbaric oxygen therapy will improve patient responsiveness to steroids and avoid progression to second line therapy during hospitalization.

Estimated Enrollment: 77
Study Start Date: August 2013
Estimated Study Completion Date: July 2016
Estimated Primary Completion Date: July 2015 (Final data collection date for primary outcome measure)

 Study to Determine Risk Factors for Post-operative Infection in Inflammatory Bowel Disease (PUCCINI)

Understanding of how best to treat inflammatory bowel disease (IBD) has evolved over the last ten years. Evidence now suggests that the most effective therapy early in the course of Crohn's disease (CD) and ulcerative colitis (UC) involves the use of immune suppressing medications such as the anti-Tumor Necrosis Factor (anti-TNF) agents infliximab, adalimumab, and certolizumab. However, many CD and UC patients still ultimately require surgery despite the use of these medications. Side effects of the anti-TNF agents include increased risk of infections due to their effect on the immune system. Little is known about how use of these medications near the time of surgery may affect patients' risks of infection or other post-operative complications. The only available studies on this topic have given conflicting results. These studies have been limited by the fact that they have been small in size and retrospective. Retrospective studies primarily involve chart review as the method of identifying potential risk factors for infections and other complications after they have already occurred. This method limits both the type and quality of information/data that can be collected. The conflicting results have led to variance in practice patterns with regards to management of anti-TNF agents, the timing of surgery, and even the types of surgery.

By enrolling patients at the time of their surgery, collecting extensive information may be possible than previously studied on potential risk factors for both infectious and non-infectious complications following surgery. Risk factors to be studied will include individual patient characteristics, disease characteristics, surgical methods, novel characteristics of CT scans and MRIs and extensive medication exposures. The primary objective is to determine if exposure to anti-TNF agents prior to surgery increases the risk of infection post-operatively. And evaluate exposure to anti-TNF agents by both patient history of use and measurement of anti-TNF drug levels at the time of surgery. Monitoring of drug levels at the time of surgery has never been utilized in this way to evaluate the risk of anti-TNF agents in IBD. However, this has been done to assess the risk of other medications in different diseases.

If anti-TNF agents are found to pose a risk for infectious or non-infectious outcomes in IBD patients undergoing surgery, change maybe needed in the way these medications are used around the time of surgery. Additionally, by collecting comprehensive information on other potential risk factors besides medication use patients at greatest risk for bad outcomes can be identified and take protective measures when possible. The aims of this study address the CCFA challenge to better define the risks of medical and surgical therapies to improve the quality of care of IBD patients undergoing surgery.

Estimated Enrollment: 1000
Study Start Date: February 2014
Estimated Study Completion Date: January 2017
Estimated Primary Completion Date: January 2017 (Final data collection date for primary outcome measure)