We are pleased to introduce one of four colorectal surgeons at UW Medicine, Erin Lange, MD, who practices at Northwest Hospital & Medical Center and is part of the UW Medicine Colorectal Surgery team.
Dr. Lange’s clinical interest in diverticulitis was sparked during her surgery residency, where she focused some of her research on how the diagnosis is made and symptoms patients with diverticulitis experience. “What drew me is how much we don’t know about it given how common it is—when to do surgery, who benefits, and how to manage people who don’t get surgery,” she says.
Dr. Lange is enrolling patients in the DEBUT study at Northwest Hospital in North Seattle. “As a community-based hospital, we see a lot of patients in the outpatient arena, and I personally see a lot of patients with chronic symptoms of diverticular disease where decision-making is more nuanced,” she says. “Sometimes it takes a while to come to a diagnosis, and the decision to have surgery is harder because I’m not sure if they are going to continue to have symptoms or not. And sometimes the question is not if they need surgery, but what surgery they need and when the timing will be best.”
Dr. Lange has connections with community primary care providers who refer patients with low grade diverticulitis to her in order to see if surgery could be part of their treatment plan. Her team is working on getting higher participation in the study by making sure they identify all patients with diverticulitis before they come to the clinic.
"Most research in this area previously focused on the inpatient population, where decision-making can be less complicated because the patients are more sick and therefore require more invasive care such as immediate surgery," Dr. Lange says. "Decision-making in the primary care setting can be hard because there are significant lifestyle implications over whether or not to do surgery and what it means to patients to be sick multiple times a year. Understanding the impact on patients’ lives is important for treatment decisions, and that metric isn’t often included in past studies.”
Because the disease has a wide spectrum of presentations, there may not be one answer about how to best treat it, Dr. Lange says. “Some people are more afraid of surgery then they are of the symptoms, and some want to book tomorrow. There’s room for us to treat everyone on that spectrum, but how can we help people better make that decision? What is going to give the biggest bang for your buck in terms of lifestyle, and what are the tradeoffs?” she says. “The DEBUT study will not only inform decision-making around the disease, but it will also teach us how to study diseases like this more effectively in the future.”