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 … inflammatory bowel disease. 

While millions of other Americans are watching pro football, the Johns Hopkins gastroenterologist and IBD specialist hosts “Monday Night IBD,” a Twitter discussion dedicated to improving care for people who live with inflammatory bowel disease.

Since May 2019, Charabaty, who directs the IBD Center at Johns Hopkins Medicine’s Sibley Memorial Hospital in Washington, D.C., has used the social media platform to moderate a weekly discussion among clinicians who care for patients with IBD. They cover difficult cases and topics that affect their patients, from coordination of care to new treatment options — all as they relate to the family of conditions known as IBD.

The Twitter handle Charabaty established for the discussions, @MondayNightIBD, has more than 7,300 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 unanswered clinical questions and gray areas in the management of patients with IBD,” says Charabaty, who has treated IBD patients in the Washington, D.C., area for almost 20 years.

The field of gastroenterology has taken notice of the regular social media event. 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 Monday Night IBD. And three academic journals dedicated to gastroenterology have published articles recently recommending the ongoing discussion as a reliable source of information and education.

Charabaty says Monday Night IBD evolved from a clinical question she posed on Twitter on a Monday in early 2019. Several physicians around the world engaged in a lively impromptu exchange in response to her tweet. 

“After we finished discussing this clinical management case, someone said ‘We should do this more often,’” Charabaty recalls. “So I set up a Twitter handle for Monday Night IBD, and started scheduling weekly Monday discussions. In just a few weeks, it really took off.”

Each week, Charabaty picks a topic for discussion and invites an expert to moderate the conversation around the practical management of clinical situations encountered in IBD practice. Week after week, hundreds of clinicians participate in Monday Night IBD discussions, with multidisciplinary input from gastroenterologists, surgeons, nutritionists, psychologists and other specialists, resulting in more than 700,000 Twitter users following at least part of the conversation. 

A recent session asked participants how they would manage a patient admitted with acute severe ulcerative colitis who had stopped responding to IBD medication.

A discussion followed, exploring the potential benefits and limitations of accelerated dosing of a different immunosuppressive drug, as well as the indications and the data behind alternate medical therapies and the timing of surgery. 

The poll numbers rose to more than 250, as participants voted on the next best course of action, and gastroenterologists, ostomy nurses, pathologists and colorectal surgeons from around the world shared published peer-reviewed data and expert opinions, engaging in a friendly but rigorous discussion of the case. 

Early sessions were aimed mainly at gastroenterologists. But as the series gained popularity, Charabaty wanted to expand the discussion to include other clinicians who treat IBD patients, such as rheumatologists, psychologists, pelvic floor therapists and nurses, as well as to GI trainees and patients. She established three more weekly Twitter conversations related to the Monday discussions: Saturdays focus on reviewing the basics of a topic in IBD ahead of the more complex discussion on Monday. Wednesdays are co-led by a patient advocate and focus on patients’ experiences with the disease. 

“And on Fridays, we put together a PowerPoint slide that summarizes key teaching and management points of what we discussed during the week,” says Charabaty. 

Participants in the week’s discussions can earn free continuing medical education credits, courtesy of educational grants Charabaty received to support the effort. 

“That’s been very popular,” she says. “We all need CMEs, and this has been a practical way to get them during the pandemic, when conferences and other professional meetings have been on hold.”

Charabaty says most participants are in North America, but that clinicians and patients from Europe, Asia and South America are frequent moderators and attendees. 

While Monday Night IBD has added some hours to her workdays, Charabaty says the series is worth the time and effort. 

“I’m always surprised by how well it is received and by the high quality of engagement,” she says. “It’s been like a second job, but mostly a wonderful and enriching opportunity to educate colleagues and get educated. I’m really enjoying it.”