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https://www.readbyqxmd.com/read/29788269/smoking-and-the-risk-of-pouchitis-in-ulcerative-colitis-patients-with-ileal-pouch-anal-anastomosis
#1
Venkata Subhash Gorrepati, August Stuart, Susan Deiling, Walter Koltun, Andrew Tinsley, Emmanuelle D Williams, Matthew D Coates
Background: Ulcerative colitis (UC) patients who undergo proctocolectomy with ileal pouch-anal anastomosis (IPAA) may develop pouchitis, a poorly understood inflammatory condition. There is controversy over whether tobacco use can protect against pouchitis. We undertook this investigation to further evaluate whether smoking reduces the risk of developing pouchitis and to determine whether other previously associated clinical factors change the risk for pouchitis. Methods: We performed a retrospective analysis using a consented inflammatory bowel disease (IBD) natural history registry between the years 1995-2015 from a single tertiary care referral center...
May 17, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29787362/j-pouch-imaging-findings-surgical-variations-natural-history-and-common-complications
#2
Joshua D Reber, John M Barlow, Amy L Lightner, Shannon P Sheedy, David H Bruining, Christine O Menias, Joel G Fletcher
Ileal pouch-anal anastomosis, or J pouch, surgery has become the procedure of choice for treatment of medically refractory ulcerative colitis and familial adenomatous polyposis. Overall, this operation is associated with a low rate of postoperative morbidity and good long-term function. However, when complications develop, there is a heavy reliance on imaging to facilitate an accurate diagnosis. Reported postoperative complication rates range from 5% to 35%. Complications generally can be categorized as structural, inflammatory, or neoplastic conditions...
May 25, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29780596/value-of-routine-stool-testing-for-pathogenic-bacteria-in-the-evaluation-of-symptomatic-patients-with-ileal-pouches
#3
Amandeep Singh, Jean Ashburn, Gursimran Kochhar, Rocio Lopez, Tracy L Hull, Bo Shen
Background: In symptomatic patients with an ileal pouch, stool studies are often sent to diagnose enteric pathogens. Aim of this study is to find the value of routine stool studies in the evaluation of symptomatic patients and the clinical implications of such pathogens in patients with ileal pouches. Methods: Consecutive ileal pouch-anal anastomosis (IPAA) patients who had stool tests out of a 2283-case registry from 2002 to 2015 were included in the study. Patients with positive stool cultures were compared with controls (symptomatic without positive stool culture) in a 1:4 ratio...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29757363/targeting-endothelial-ligands-icam-1-alicaforsen-madcam-1
#4
Walter Reinisch, Kenneth Hung, Mina Hassan-Zahraee, Fabio Cataldi
The specific blockade of the endothelial ligands intercellular adhesion molecule-1 (ICAM-1) and mucosal addressin cell adhesion molecule (MAdCAM) involved in leukocyte recruitment to the site of inflammation as therapeutic targets in inflammatory bowel disease (IBD) has been recognized from their overexpression in the inflamed mucosa and their successful intervention in preclinical animal models. Interventions to target ICAM-1 in human IBD are confined to the ICAM-1 anti-sense oligonucleotide alicaforsen. Whereas results with parenteral formulations of alicaforsen in Crohn's disease were largely negative, efficacy signals derived from studies with an enema formulation in ulcerative and pouchitis are promising and having lead to a FDA Fast-Track designation for the latter...
May 11, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29720865/use-of-vedolizumab-in-a-patient-with-chronic-and-refractory-pouchitis
#5
Eleni Orfanoudaki, Kalliopi Foteinogiannopoulou, Ioannis E Koutroubakis
No abstract text is available yet for this article.
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29719998/biologics-and-immunomodulators-for-treating-crohn-s-disease-developing-after-surgery-for-an-initial-diagnosis-of-ulcerative-colitis-a-review-of-current-literature
#6
Abhijeet Yadav, Joshua Foromera, Kenneth R Falchuk, Joseph D Feuerstein
Crohn's Disease (CD) or CD-like (CDL) conditions of the pouch are rare long-term inflammatory complications of patients who were initially diagnosed with ulcerative colitis (UC) who undergo total proctocolectomy with ileo-anal anastomosis (IPAA). There are no societal guidelines nor a consensus on their treatment, resulting in significant challenges for clinicians for their diagnosis and management. It is important to differentiate them from other more common pouch-related complications like pouchitis, cuffitis, irritable pouch syndrome, surgery associated stricture, and fistula...
May 2, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29713128/diversion-colitis-and-pouchitis-a-mini-review
#7
REVIEW
Kentaro Tominaga, Kenya Kamimura, Kazuya Takahashi, Junji Yokoyama, Satoshi Yamagiwa, Shuji Terai
Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion...
April 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29697797/efficacy-and-safety-of-endoscopic-balloon-dilatation-of-ileoanal-pouch-strictures
#8
Mathurin Fumery, Niraj S Patel, Brigid S Boland, Parambir S Dulai, Siddharth Singh, William J Sandborn
Background and aims: Colectomy with ileoanal pouch is the standard of care for most patients with ulcerative colitis (UC) who require surgery. However, 5%-38% of patients with ileoanal pouch develop pouch strictures that can severely impact the functional results. We retrospectively evaluated the efficacy and safety of endoscopic balloon dilation of ileoanal pouch strictures in patients with inflammatory bowel disease (IBD). Methods: All consecutive patients with IBD that underwent endoscopic balloon dilatation of a pouch stricture at our institution between January 1, 2011, and April 31, 2016, were included...
April 25, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29688474/increase-in-processing-factors-is-involved-in-skewed-microrna-expression-in-patients-with-ulcerative-colitis-who-develop-small-intestine-inflammation-after-pouch-surgery
#9
Hadas Sherman Horev, Keren M Rabinowitz, Hofit Elad, Revital Barkan, Shay Ben-Shachar, Metsada Pasmanik Chor, Iris Dotan
Background: A large-scale increase in microRNA (miRNA) expression was observed in patients with ulcerative colitis who underwent pouch surgery and developed inflammation of the pouch (pouchitis). In this study, we assessed miRNA expression in these patients and investigated how regulation of its expression changes in the setting of pouchitis. Methods: Autologous samples that included mucosal biopsies, peripheral blood cells, and plasma were collected from the patients...
April 23, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29688472/management-of-pouchitis-and-other-common-complications-of-the-pouch
#10
Robin L Dalal, Bo Shen, David A Schwartz
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the preferred surgical treatment for refractory or complicated ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Pouchitis is the most common complication of this procedure and can occur in about 50% of patients. Treatment of pouchitis depends on the phenotype of disease. Pouchitis can be classified as acute, chronic/refractory, or secondary pouchitis, which includes pouchitis occurring due to Crohn's disease (CD)...
April 23, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29664798/pouch-volvulus-in-patients-having-undergone-restorative-proctocolectomy-for-ulcerative-colitis-a-case-series
#11
Rachel M Landisch, Paul M Knechtges, Mary F Otterson, Kirk A Ludwig, Timothy J Ridolfi
BACKGROUND: Restorative proctocolectomy with IPAA improves quality of life in patients with medically refractory ulcerative colitis. Although bowel obstruction is common, pouch volvulus is rare and described only in case reports. Diagnosis can be challenging, resulting in delayed care and heightened morbidity. OBJECTIVE: The purpose of this study was to delineate the symptoms and successful management strategies used in patients with IPAA volvulus that result in pouch salvage...
April 16, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29660321/reliability-among-central-readers-in-the-evaluation-of-endoscopic-disease-activity-in-pouchitis
#12
Mark A Samaan, Bo Shen, Mahmoud H Mosli, Guangyong Zou, William J Sandborn, Lisa M Shackelton, Sigrid Nelson, Larry Stitt, Stuart Bloom, Darrell S Pardi, Paolo Gionchetti, James Lindsay, Simon Travis, Ailsa Hart, Mark S Silverberg, Brian G Feagan, Geert R D'Haens, Vipul Jairath
BACKGROUND & AIMS: Pouchitis is a common adverse event after proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis. Evaluation of pouchitis disease activity and response to treatment requires use of validated indices. We assessed the reliability of items evaluating endoscopic pouchitis disease activity. METHODS: Twelve panelists used a modified RAND appropriateness methodology to rate the appropriateness of items evaluating endoscopic pouchitis disease activity derived from a systematic review, and also identified additional potential endoscopic items based on expert opinion...
April 13, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29659775/ustekinumab-rescue-therapy-in-a-patient-with-chronic-refractory-pouchitis
#13
Jack Peter, Jonas Zeitz, Andreas Stallmach
No abstract text is available yet for this article.
April 5, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29649668/laparoscopic-vs-open-restorative-proctocolectomy-with-ipaa-for-ulcerative-colitis-impact-of-surgical-technique-on-creating-a-well-functioning-pouch
#14
Michela Mineccia, Francesca Cravero, Paolo Massucco, Luca Portigliotti, Franco Bertolino, Marco Daperno, Alessandro Ferrero
BACKGROUND: Patients with ulcerative colitis are often young, and proctocolectomy with restorative ileo-pouch anal anastomosis is a crucial act that can improve or worsen the quality of the rest of their lives. The literature is scant on long-term functional outcomes after laparoscopy. The purpose of this study was to investigate results in terms of pouch function after standardized total laparoscopic technique compared with open intervention. MATERIALS AND METHODS: This was a retrospective comparative study...
April 9, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29630002/modified-pfannenstiel-open-approach-as-an-alternative-to-laparoscopic-total-proctocolectomy-and-ipaa-comparison-of-short-and-long-term-outcomes-and-quality-of-life
#15
Leonardo C Duraes, Destiny A Schroeder, David W Dietz
BACKGROUND: A laparoscopic approach to total proctocolectomy with IPAA has been suggested to have better short-term outcomes and cosmesis, whereas open surgery by midline incision may result in shorter operative times. We hypothesized that a modified Pfannenstiel open approach would combine the advantages of both techniques. OBJECTIVE: The purpose of this study was to compare outcomes of open total proctocolectomy with IPAA using a modified Pfannenstiel incision versus those following the laparoscopic approach...
May 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29588846/long-term-follow-up-of-the-use-of-maintenance-antibiotic-therapy-for-chronic-antibiotic-dependent-pouchitis
#16
Jonathan P Segal, Stephanie X Poo, Simon D McLaughlin, Omar D Faiz, Susan K Clark, Ailsa L Hart
Objective: Restorative proctolectomy is considered the procedure of choice in patients with ulcerative colitis who have failed medical therapy. Chronic pouchitis occurs in 10%-15% of patients, which often require long-term antibiotics to alleviate symptoms. Safety and efficacy of long-term maintenance antibiotics for chronic pouchitis has yet to be established. We aimed to assess the long-term safety and efficacy of maintenance antibiotic therapy for chronic pouchitis. Design: This was an observational study...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29588334/how-do-you-treat-this-diversion-ileitis-and-pouchitis
#17
Kentaro Tominaga, Atsunori Tsuchiya, Junji Yokoyama, Shuji Terai
No abstract text is available yet for this article.
March 27, 2018: Gut
https://www.readbyqxmd.com/read/29577558/a-systematic-review-and-meta-analysis-comparing-adverse-events-and-functional-outcomes-of-different-pouch-designs-after-restorative-proctocolectomy
#18
REVIEW
Constantinos Simillis, Thalia Afxentiou, Gianluca Pellino, Christos Kontovounisios, Shahnawaz Rasheed, Omar Faiz, Paris P Tekkis
AIM: There is no consensus as to which ileoanal pouch design provides better outcomes after restorative proctocolectomy. This study compares different pouch designs. METHOD: A systematic review of the literature was performed. A random effects meta-analytical model was used to compare adverse events and functional outcome. RESULTS: Thirty comparative studies comparing J, W, S and K pouch designs were included. No significant differences were identified between the different pouch designs with regards to anastomotic dehiscence, anastomotic stricture, pelvic sepsis, wound infection, pouch fistula, pouch ischaemia, perioperative haemorrhage, small bowel obstruction, pouchitis and sexual dysfunction...
March 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29535436/another-resin-for-pouchitis-chronic-pouchitis-with-erosion-secondary-to-sodium-polystyrene-sulfonate-crystals
#19
Jared Lander, Elizabeth Richardson, Adam Kaufman
No abstract text is available yet for this article.
March 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29529194/dyssynergic-defecation-in-inflammatory-bowel-disease-a-systematic-review-and-meta-analysis
#20
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...
April 23, 2018: Inflammatory Bowel Diseases
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