Dr. Farraye received his medical doctorate from Albert Einstein College of Medicine in New York. He completed an internal medicine residency and gastroenterology fellowship at the Beth Israel Hospital in Boston. Dr. Farraye received a Masters Degree in Epidemiology from the Harvard School of Public Health.

Dr. Farraye's clinical interests are in the care of patients with inflammatory bowel disease and the management of colon polyps and colorectal cancer. He is currently investigating C. difficile infection in IBD patients, the management and diagnosis of dysplasia and cancer in patients with IBD; pouchitis after ileal pouch anal anastomosis; vaccinations in patients with IBD; and the role of serrated polyps as an alternative pathway to the development of colorectal cancer.

A frequent speaker and invited lecturer on topics on the diagnosis and management of inflammatory bowel disease, Dr. Farraye has authored or co-authored over 350 original scientific manuscripts, chapters, reviews, and abstracts. He is the series editor for the text Curbside Consultations in Gastroenterology and co-wrote the text, Curbside Consultation in Inflammatory Bowel Disease and Gastrointestinal Emergencies. His newest books for patients are Questions and Answers about Ulcerative Colitis, Questions and Answers about Crohn’s Disease and Ulcerative Colitis for Dummies.

Dr. Farraye is a Fellow of the American College of Physicians, American Society of Gastrointestinal Endoscopy, American Gastroenterological Association and the American College of Gastroenterology. He has served on numerous committees and currently is a member of the ACG Board of Trustees and the Chapter Medical Advisory Committee for the New England CCFA where he was past chairman. The New England CCFA named Dr. Farraye Humanitarian of the Year in 2003. In 2009, the ACG awarded Dr. Farraye the William Carey Award for service to the college. Dr. Farraye was recognized as “Top Doctor” in Gastroenterology by Boston Magazine and U.S. News and World Report in 2010, 2011, 2012 and 2013.

Mayo Clinic
Inflammatory Bowel Disease Clinic

The Inflammatory Bowel Disease Clinic is devoted to the diagnosis and treatment of the inflammatory bowel diseases, including ulcerative colitis, Crohn's disease and pouchitis. This clinic also provides diagnosis and treatment for patients with microscopic colitis, lymphocytic colitis and collagenous colitis. Services provided include advanced medical diagnosis and care by gastroenterologists whose practices are focused on inflammatory bowel disease (IBD); surgical consultation and treatment by colon and rectal surgeons who are very experienced in operating on patients who have ulcerative colitis and Crohn's disease; and ulcerative colitis and Crohn's disease care by specialized gastrointestinal radiologists and pathologists with a high level of expertise. In addition to routine clinical care for patients with ulcerative colitis and Crohn's disease, the Inflammatory Bowel Disease Clinic is actively involved in research and can provide investigational drug therapy with a variety of drugs for patients who do not respond to standard medical therapy.

 Host Immune Response to Clostridium Difficile Infection in Inflammatory Bowel Disease Patients

The inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn's disease (CD) are chronic conditions affecting approximately 1.4 million Americans. The burden of Clostridium difficile infection (CDI), a frequent cause of infectious diarrhea is mediated by toxins A and B and is increasing faster in IBD patients, than the general population. Clinically, CDI in patients with IBD leads to a range of clinical syndromes from symptomless carriage, to severe life threatening colitis, colectomy and death.

This pilot study will look at the relationship between IBD and this variable host immune response. Clostridium difficile colonization (asymptomatic carrier state) is lower in the IBD population than in the general population. In the general population, high antitoxin titers have been linked with colonization and low antitoxin titers with recurrent disease. The investigators hypothesize that patients with IBD will have a lower Clostridium difficile colonization and will have lower antibody titers than the control group. Additionally those with lower titers will have an increased risk of developing CDI.

In Aim 1 the investigators will determine Clostridium colonization in IBD subjects by stool study (including CD, UC and UC patients after IPAA) compared to non-IBD subjects (controls). In Aim 2 the investigators will compare antitoxin titers in these IBD subjects compared to controls. In Aim 3 the investigators will follow these subjects for 12 months and calculate the incidence of CDI in patients with IBD compared to controls and associations with anti-toxin titers.

Estimated Enrollment: 400
Study Start Date: October 2011
Estimated Study Completion Date: October 2016
Estimated Primary Completion Date: October 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)

 Ileal Pouch-Anal Anastomosis Registry (IPAA)

Little is known about the factors that predispose patients to complications after an ileal pouch-anal anastomosis procedure (IPAA). Our goal is to establish a registry that prospectively captures pre- and post-surgical data from participants. Retrospective studies concerning IPAA outcomes and will be conducted using these data.

Estimated Enrollment: 1500
Study Start Date: November 2009
Estimated Study Completion Date: December 2050
Estimated Primary Completion Date: December 2050 (Final data collection date for primary outcome measure)