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Jared Lander, Elizabeth Richardson, Adam Kaufman
No abstract text is available yet for this article.
March 2018: American Journal of Gastroenterology
Ali Rezaie, Phillip Gu, Gilaad G Kaplan, Mark Pimentel, Ahmed K Al-Darmaki
Background: Inflammatory bowel disease (IBD) patients often continue to experience nonspecific gastrointestinal symptoms despite quiescent disease. Unlike non-IBD patients, IBD patients with dyssynergic defecation (DD) may present with various symptoms such as diarrhea, fecal incontinence, constipation, and rectal discomfort. Despite its importance and treatability, DD in IBD patients is not well recognized in practice. We conducted a systematic review and meta-analysis on the prevalence, diagnosis, and management of DD in IBD patients with ongoing defecatory symptoms...
February 24, 2018: Inflammatory Bowel Diseases
Aonghus Lavelle
The hypothesis of altered bacterial communities contributing to the development of pouchitis began a scientific quest to link host mucosal factors, microbial metabolism and spatial structure of the colonic microbiome in ulcerative colitis, reaching its apotheosis with the integration of advanced spatial sampling with laser capture microdissection, mucin array profiling, molecular microbiology and next-generation sequencing technologies. This article, part of a festschrift, summarises the contributions of the O'Connell lab to the field of host-microbial interactions in inflammatory bowel disease...
March 9, 2018: Irish Journal of Medical Science
M L Sunde, A Negård, T Øresland, N Bakka, J T Geitung, A E Færden
PURPOSE: Variability in functional outcome after ileal pouch-anal anastomosis (IPAA) is to a large extent unexplained. The aim of this study was to use MRI to evaluate the morphology, emptying pattern and other pathology that may explain differences in functional outcome between well-functioning and poorly functioning pouch patients. A secondary aim was to establish a reference of normal MRI findings in pelvic pouch patients. METHODS: From a previous study, the best and worst functioning patients undergoing IPAA surgery between 2000 and 2013 had been identified and examined with manovolumetric tests (N = 47)...
March 9, 2018: International Journal of Colorectal Disease
Lei Lian, Emmanuel Obusez, Erick M Remer, Manoj Monga, Bo Shen
Background: Enlarged prostate is often noticed in patients with ileal pouch-anal anastomosis (IPAA) in our clinical practice. The aims were to identify the factors associated with enlarged prostate and to investigate its clinical implications. Methods: IPAA patients with available prostate imaging after IPAA were included. Prostate length and width were measured in the axial plane and height in coronal plane. Prostate volume was calculated with the formula (length × width × height) × π/6...
February 2018: Gastroenterology Research
Xian Hua Gao, Hanumant Chouhan, Gang Lei Liu, Nan Lan, Erick Remer, Luca Stocchi, Jean Ashburn, Tracy L Hull, Bo Shen
Background: There are no published studies on the impact of peripouch fat on pouch outcomes in inflammatory bowel disease (IBD) patients. Methods: Patients with pelvic MRI-DIXON scans from our prospectively maintained Pouch Database between 2002 and 2016 were evaluated. Peripouch fat area was measured on MRI-DIXON-F images at the middle height level of the pouch (area M) and the highest level of the pouch (area H). Results: Of all 1863 patients in the database, 197 eligible patients were included in this study...
March 1, 2018: Inflammatory Bowel Diseases
Hajar Khazraei, Alimohammad Bananzadeh, Seyed Vahid Hosseini
Background: Ulcerative colitis (UC) is an idiopathic inflammatory disorder. Currently, the final treatment is colectomy. The aim of this study was to investigate the outcomes of proctocolectomy in patients that used a high dose of prednisolone. Materials and Methods: Seventy-five patients presenting for surgical management of histopathologically proven UC. All patients were offered total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA). Patients were divided into two groups: low dose of steroids (Group A) and high dose of steroid (Group B) consumers...
2018: Advanced Biomedical Research
M A Samaan
No abstract text is available yet for this article.
March 2018: Alimentary Pharmacology & Therapeutics
Nielce Maria Paiva, Lívia Bitencourt Pascoal, Leandro Minatel Vidal Negreiros, Mariana Portovedo, Andressa Coope, Maria de Lourdes Setsuko Ayrizono, Claudio Saddy Rodrigues Coy, Marciane Milanski, Raquel Franco Leal
Total retocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgery of choice for patients with ulcerative colitis (UC) that are refractory to clinical treatment. Pouchitis is one of the most common complications after this procedure. Defects in autophagy have been reported in inflammatory bowel diseases. However, there are no studies on the IP. Therefore, we studied markers for autophagy in the IP mucosa of UC and FAP patients comparing them to controls with a normal distal ileum. Sixteen patients with IP in "J" shape, asymptomatic and with endoscopically normal IP were evaluated...
February 8, 2018: Scientific Reports
Vivek Pandrangi, Daniel Mandel, Norman Gellada, Dionisio Mieses, Cindy Kallman, Karen Zaghiyan, Phillip Fleshner
Chronic pouchitis (CP) after ileal pouch-anal anastomosis is a significant clinical problem. Adipose tissues produce antiinflammatory cytokines and chemokines. We evaluated the association between abdominal visceral fat area (VFA) and CP. Patients with a preoperative CT evaluation were included. The diagnosis of CP was confirmed in all cases by endoscopy with afferent ileal limb intubation. Patients were allocated into groups of high VFA and low VFA. The study cohort of 52 patients had a median body mass index of 22 (range, 14-32)...
October 1, 2017: American Surgeon
Jonathan P Segal, Simon D McLaughlin, Omar D Faiz, Susan K Clark, Ailsa L Hart
BACKGROUND: Restorative proctocolectomy is the procedure of choice in patients with ulcerative colitis refractory to medical therapy. Prepouch ileitis is characterized by mucosal inflammation immediately proximal to the pouch. Prepouch ileitis is uncommon, and long-term follow-up data are lacking. OBJECTIVE: The aim of this study is to report the long-term outcomes of prepouch ileitis. DESIGN: We followed up a cohort of patients with prepouch ileitis that was originally described in 2009...
January 23, 2018: Diseases of the Colon and Rectum
Mathilde Huguet, Bruno Pereira, Marion Goutte, Félix Goutorbe, Anne Dubois, Gilles Bommelaer, Anthony Buisson
Background: Inflammatory complications including chronic refractory pouchitis and Crohn's disease (CD)-like complications of the pouch are common complications after ileal pouch-anal anastomosis (IPAA) following colectomy for ulcerative colitis (UC). We performed a systematic review and meta-analysis to evaluate the efficacy of anti-TNF therapy in distinguishing patients with chronic refractory pouchitis from those with CD-like complications of the pouch. Methods: We performed a systematic literature search to identify articles and abstracts reporting anti-TNF agents efficacy in treating inflammatory complications of the pouch after IPAA for UC...
January 18, 2018: Inflammatory Bowel Diseases
Joseph F Pierre, Reinhard Hinterleitner, Romain Bouziat, Nathan A Hubert, Vanessa Leone, Jun Miyoshi, Bana Jabri, Eugene B Chang
Inflammatory bowel diseases (IBD) are caused by the convergence of microbial, environmental, and genetic factors. Diet significantly alters these interactions by affecting both the host and microbiome. Using a mucosal inflammatory model that resembles the human condition of ileal pouchitis, we investigated the effects of Control (CONT) or Antioxidant (AOX) diet, containing pharmacologically relevant levels of 4 micronutrients, on disease risk in wild-type and IL-10-/- animals following surgical self-filling (SF) ileal blind loop placement...
December 10, 2017: Journal of Nutritional Biochemistry
Uri Netz, Norman J Galbraith, Stephen O'Brien, Jane Carter, Stephen Manek, Robert E Petras, Susan Galandiuk
BACKGROUND: The advisability of performing ileal pouch-anal anastomosis for patients with indeterminate colitis is debated. Indeterminate colitis is found in up to 15% of inflammatory bowel disease colectomy specimens. We determined long-term outcomes in patients diagnosed with indeterminate colitis undergoing ileal pouch-anal anastomosis. METHODS: Fifty-six patients were included with a mean follow-up of 14 ± 7 years. Long-term behavior was defined based on surgeon assessment as "Crohn disease-like" in patients who subsequently developed clear signs of Crohn disease and as "non-Crohn disease-like...
January 8, 2018: Surgery
Anders Mark-Christensen, Søren Brandsborg, Søren Laurberg
PURPOSE: The aim of this study was to explore the effects of primary fecal diversion on the risk of pouch dysfunction. METHODS: Patients operated with an ileal pouch-anal anastomosis in Denmark in 2000-2010 were identified and validated bowel function questionnaires retrieved from a cross-sectional study. Multivariate logistic regression analysis was performed to determine the effect of primary fecal diversion on pouch dysfunction. A diagnostic or procedural code for intraabdominal abscesses and fistulas, occurring within 1 year after pouch creation, and anastomotic leakage or extremely early-onset pouchitis within 30 days of surgery defined a pelvic complication...
February 2018: International Journal of Colorectal Disease
Alexander T Hawkins, Jun W Um, Amosy E M'Koma
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed for fulminant colitis (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of the proximal ileum, which may influence the essential physiological function of gut-associated lymphoid tissues. Circulating plasma immunoglobulin G (p-IgG) deficiency is observed in patients with fulminant UC...
2017: Clinical Medicine Insights. Gastroenterology
J P Segal, S Oke, G L Hold, S K Clark, O D Faiz, A L Hart
BACKGROUND: The resident gut microbiota is essential for physiological processes; the disturbance of its balance is linked to intestinal inflammation. The ileoanal pouch is a model for the study of intestinal inflammation, as inflammation of the pouch is common and mostly develops within 12 months following ileostomy closure. This allows the longitudinal study of the microbiota, giving insight into the microbiota changes during transition from a normal to an inflamed pouch. AIM: To explore the literature on the microbiota of the ileoanal pouch in health and disease...
February 2018: Alimentary Pharmacology & Therapeutics
Bincy P Abraham, Eamonn M M Quigley
Evidence indicates that the gut microbiota and/or interactions between the microbiota and the host immune system are involved in the pathogenesis of inflammatory bowel disease (IBD). Strategies that target the microbiota have emerged as potential therapies and, of these, probiotics have gained the greatest attention. Data derived from animal models of IBD have revealed the potential of several bacterial strains to modify the natural history of IBD. However, thought there is some evidence for efficacy in ulcerative colitis and in pouchitis, in particular, there has been little indication that probiotics exert any benefit in Crohn disease...
December 2017: Gastroenterology Clinics of North America
Dani O Gonzalez, Benedict C Nwomeh
Total colectomy with ileal pouch-anal anastomosis (IPAA) is considered the standard procedure for the surgical management of ulcerative colitis. Despite the widespread utility of the procedure, as many as 75% of patients who undergo IPAA, experience at least 1 complication. This review highlights difficult intraoperative scenarios and complications of pouch surgery in children, including intraoperative, postoperative, and functional complications. Intraoperative scenarios include insufficient mesenteric length and positive leak tests...
December 2017: Seminars in Pediatric Surgery
M Coletta, M Paroni, F Caprioli
No abstract text is available yet for this article.
December 4, 2017: Journal of Crohn's & Colitis
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