There’s no theme music or flashy graphics. There are no announcers or sideline reporters. And there’s no stadium full of fans.
But it’s Monday night and Aline Charabaty is ready for some … discussion of inflammatory bowel disease.
While millions of other Americans watch pro football, the Johns Hopkins gastroenterologist and inflammatory bowel disease (IBD) specialist hosts Monday Night IBD, a Twitter discussion dedicated to improving care for people who live with the disease.
Since May 2019, Charabaty, who directs the Meyerhoff Inflammatory Bowel Disease Center at Washington, D.C.’s Sibley Memorial Hospital, has used the social media platform to moderate a weekly discussion among gastroenterologists, surgeons, psychologists, nutritionists and other clinicians who care for IBD patients. They cover difficult cases and topics that affect their patients, such as coordination of care and new treatment options — all as they relate to the family of conditions known as IBDs.
The Twitter handle Charabaty established for the discussions, @MondayNightIBD, has nearly 7,200 followers and regularly draws comments from many of the world’s leading IBD physicians and researchers.
“No matter how experienced we are, there are always questions and gray areas,” says Charabaty, who has treated patients with IBD in the Washington area for almost 20 years.
The field of gastroenterology has noticed Monday Night IBD. At the 2019 American College of Gastroenterology Annual Meeting in San Antonio, medical journal publisher Healio presented Charabaty one of its “Disruptive Innovator Awards” for founding the online discussion. And three academic journals dedicated to gastroenterology have published articles recently recommending Monday Night IBD as a reliable source of information and education.
Sometimes confused with irritable bowel syndrome (IBS) because of its similar acronym, IBDs are a group of autoimmune disorders that cause inflammation of the gastrointestinal tract. Crohn’s disease and ulcerative colitis are the most common, but others such as Behçet’s disease and microscopic colitis also fall into the IBD category. The Centers for Disease Control and Prevention estimates that 3 million U.S. adults have been diagnosed with IBD, with a sharp increase over the past 20 years. The condition can be difficult to treat, and each case is a unique challenge for clinicians.
In addition to enduring often debilitating symptoms, people with IBD are at greater risk for colon cancer, as well as cardiovascular, kidney, respiratory and liver disease. Cases vary in severity and in response to treatment. Since the disease is not curable, physicians work with patients to keep the disease under control and avoid flare-ups.
Charabaty says Monday Night IBD evolved from a question she posed on Twitter in early 2019. Several physicians around the world engaged in a lively impromptu exchange in response to her tweet.
“After we finished discussing the question, someone said ‘we should do this more often,’” Charabaty recalls. “So I got a special Twitter handle for Monday Night IBD and we started right away. In just a few weeks, it really took off.”
The series has been popular since its inception. Beginning with a discussion of cases in which patients develop ulcerative colitis late in their lives, Monday Night IBD was off and running with 49 participants from 40 countries. The inaugural discussion consisted of 111 tweets and 233,000 views.
Word spread quickly. The following week’s topic, IBD and pregnancy, garnered 245 tweets from 77 people, yielding 552,000 views.
Each week since then, Charabaty has picked a topic for discussion and invited an expert to answer questions or discuss de-identified cases. Recent topics have included diet and nutrition, non-GI symptoms of IBD and functional GI disorders. Week after week, hundreds of people participate in some or all of the agenda. Recent sessions have been seen by more than 700,000 Twitter users.
As moderator, Charabaty will pose a question to followers, accompanied by a multiple-choice Twitter poll. Recently, she shared a case of a 25-year-old patient with IBD concerned about risk of colon cancer. Charabaty asked Twitter followers what might prompt them to begin colorectal cancer screening for such a patient?
The poll numbers rise as participants vote on what might lead a physician to begin surveillance for cancer right away. Gastroenterologists, pathologists and rheumatologists from around the world engage in a friendly but rigorous and challenging discussion of the case.
Early sessions were aimed mainly at gastroenterologists. But as the series gained popularity, Charabaty wanted to expand the discussion to other medical fields that treat people with IBD, as well as to GI trainees and patients. She established three more weekly Twitter conversations related to the Monday discussions: Saturdays are discussions for students, fellows and residents of the basics on the week’s topic. Wednesdays are for patients with IBD to share their experiences.
“And on Fridays, we put together a PowerPoint slide that summarizes what we discussed,” says Charabaty.
Participants in the week’s discussions can earn free continuing medical education (CME) credits, courtesy of several grants Charabaty has received to support the effort.
“That’s been very popular,” she says. “We all need CMEs, and this has been a way to get them during the pandemic, when conferences and other professional meetings have been on hold.”
