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Siriraj Inflammatory Bowel Disease Center of Excellence (SiIBD)

Associate Professor Julajak Limsrivilai, M.D.

Lecturer Thanaboon Chaemsupaphan, M.D.

Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University

The Siriraj Inflammatory Bowel Disease Center of Excellence (SiIBD), under the Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, is a specialized center providing comprehensive care for patients with chronic inflammatory bowel disease. The center focuses on precise diagnosis, advanced therapeutics, and long-term monitoring to optimally elevate patients’ quality of life.

Inflammatory Bowel Disease (IBD) is a group of conditions characterized by chronic inflammation of the gastrointestinal tract, driven by immune system dysregulation combined with genetic susceptibility, environmental factors, and gut microbiome dysbiosis. The two most common subtypes are Ulcerative Colitis (UC) and Crohn’s disease. The incidence of these diseases has been continuously increasing in the Asia-Pacific region, including Thailand. IBD is currently an incurable condition; patients often suffer from abdominal pain, chronic diarrhea, or hematochezia (rectal bleeding).

Expertise in the Management of Inflammatory Bowel Disease
The SiIBD provides comprehensive patient care, encompassing systematic symptom assessment, diagnosis, treatment, and follow-up. Principal presenting symptoms of this disease include abdominal pain, chronic diarrhea, hematochezia, weight loss, and fatigue. Patients receive a thorough clinical evaluation to establish an accurate diagnosis and tailor an individualized, optimal therapeutic strategy.

Diagnosis and Disease Monitoring with Advanced Technologies
The SiIBD prioritizes precise diagnosis and meticulous disease monitoring. Currently, gastroenterologists subspecializing in IBD conduct outpatient clinics two days a week. Furthermore, daily consultations are available during official working hours for new patients and those experiencing disease flares. The diagnosis and therapeutic monitoring utilize state-of-the-art tools and technologies, which include:

  • Gastrointestinal Endoscopy: This includes colonoscopy, direct visualization of the small intestine via small bowel enteroscopy, and video capsule endoscopy—recognized as advanced endoscopic techniques—to evaluate the characteristics and severity of mucosal inflammation, as well as to obtain targeted biopsies for histological diagnosis.
  • Blood Tests: Utilized to assess systemic inflammation, monitor complications, and evaluate treatment outcomes. This encompasses therapeutic drug monitoring (TDM), significantly enhancing treatment precision and accuracy.
  • Fecal Calprotectin Testing: Employed as a reliable biomarker for intestinal inflammation, this allows for highly accurate therapeutic monitoring and helps reduce the need for repeated endoscopic procedures.
  • Intestinal Ultrasound (IUS): The SiIBD is the first and only center in Thailand equipped with physicians formally trained in utilizing ultrasound to assess bowel inflammation. This modality is highly convenient, accurate, non-invasive, and safe, and can be performed without the need for prior fasting. This examination can assess crucial disease characteristics, such as increased bowel wall thickness and augmented vascular flow within the bowel wall. Such capabilities empower physicians to better monitor therapeutic responsiveness and reduce the necessity for repeated endoscopic assessments.

Personalized Medicine and Multidisciplinary Care
The SiIBD provides comprehensive treatments employing modern medical protocols that strictly adhere to international standards. Currently, therapeutic options for IBD have advanced remarkably. Transitioning from reliance on conventional agents and traditional immunosuppressants, there is now an extensive armamentarium of biologic agents featuring diverse mechanisms of action. The intricacies involved in drug selection, efficacy evaluation, and the rigorous monitoring of adverse events dictate that IBD management must be strictly overseen by highly experienced specialists.

The medical team at the SiIBD brings over a decade of dedicated clinical experience in IBD management, having treated a cohort of over 700 patients. The team demonstrates profound expertise in navigating highly complex cases, designing treatment regimens that meticulously account for long-term efficacy, safety profiles, patient comorbidities, and the sustained quality of life. Moreover, the center possesses the advanced capability to perform therapeutic drug monitoring (measuring serum drug levels) and assess anti-drug antibody formation. These proficiencies facilitate precise treatment optimization, maximize the probability of achieving sustained disease control, minimize the risk of secondary loss of response, and prevent unnecessary medication switching or surgical interventions.

Additionally, recognizing the multisystemic nature of IBD, the SiIBD operates within a highly integrated multidisciplinary framework. The team comprises IBD-specialized gastroenterologists, surgeons, rheumatologists, psychiatrists, IBD specialist nurses, clinical dietitians, clinical pharmacists, and other relevant allied health professionals. This infrastructure guarantees that patients receive holistic and comprehensive care—spanning from precise diagnosis and targeted therapy to longitudinal follow-up and the prevention of complications—ultimately culminating in optimal long-term clinical outcomes.

Striving Towards an International Reference Center
Beyond providing exemplary patient care, the SiIBD plays a pivotal role in advancing clinical research, pioneering knowledge development, and forging robust academic collaborations with leading institutions both domestically and internationally. These initiatives are directed at elevating Thailand’s standard of IBD care to seamlessly align with international benchmarks. The center’s faculty act as integral members of prominent global academic networks, including the Asian Pacific Association of Gastroenterology (APAGE). They consistently contribute to the dissemination of impactful research, the organization of premier academic congresses, and the continuous evolution of IBD clinical practice guidelines. Furthermore, the center operates as a distinguished observation site and advanced training hub for physicians, nurses, and allied medical personnel—from within the nation and abroad—who possess a specialized interest in inflammatory bowel disease. This collaborative effort continuously fortifies a robust network of experts and critically elevates the regional quality of patient care.

Siriraj Inflammatory Bowel Disease Center of Excellence (SiIBD)
6th floor, Navamindrabopitr 84th Anniversary Building, Siriraj Hospital โรงพยาบาลศิริราช
Telephone: +662-419-8435, +6697-230-7606

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