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Inflammatory bowel disease pregnancy

Sangmin Lee, Amy Metcalfe, Maitreyi Raman, Yvette Leung, Fariba Aghajafari, Nicole Letourneau, Remo Panaccione, Gilaad G Kaplan, Cynthia H Seow
Background and Aims: Vitamin D insufficiency is prevalent in individuals with inflammatory bowel disease, as well as in pregnant women; however, the prevalence of vitamin D insufficiency in pregnant women with IBD is unknown. This study assessed the prevalence of vitamin D insufficiency in pregnant women with IBD and the adequacy of recommended supplementation. Methods: A cross-sectional study was conducted in pregnant women with inflammatory bowel disease (Crohn's disease=61, ulcerative colitis=41) and without inflammatory bowel disease (n=574)...
March 13, 2018: Journal of Crohn's & Colitis
Jildou Hoekstra, Aafke H C van Roon, Frank C Bekkering, Antonie J P van Tilburg, Rachel L West
INTRODUCTION: The aim of this study was to evaluate information provided on pregnancy, personal decision making, disease course, and outcome of pregnancy from a patient's perspective in a population of patients with inflammatory bowel disease (IBD) attending two general hospitals. PATIENTS AND METHODS: A questionnaire was sent to all female patients with IBD in two general hospitals in the Netherlands. The questionnaire comprised four sections: (i) demographic data and medication use (ii) details on previous pregnancies and reasons for not becoming pregnant, (iii) outcome of pregnancies before IBD diagnosis, and (iv) outcome of pregnancies after IBD diagnosis...
March 14, 2018: European Journal of Gastroenterology & Hepatology
Lesley J Scott
Intravenous ferric carboxymaltose (Ferinject® ; Injectafer® ) is a colloidal solution of nanoparticles which consist of a polynuclear iron (III)-(oxyhydr)oxide core stabilized by carboxymaltose and may be given as a single high-dose, 15-min infusion. This article reviews the clinical use of ferric carboxymaltose in various patient populations with iron deficiency (ID) [± anaemia] and briefly summarizes its pharmacological properties. Based on extensive experience in the clinical trial and real-world settings, ferric carboxymaltose is an effective and generally well tolerated treatment for rapidly replenishing iron stores and correcting anaemia in patients with ID (± anaemia) of various aetiologies, including patients with chronic heart failure (CHF), chronic kidney disease, inflammatory bowel disease or perioperative anaemia, and women with ID during pregnancy, postpartum or associated with heavy uterine bleeding...
March 2018: Drugs
Wolfgang Miehsler, Clemens Dejaco, Hans-Peter Gröchenig, Harry Fuchssteiner, Christoph Högenauer, Lili Kazemi-Shirazi, Harald Maier, Andreas Mayer, Alexander Moschen, Walter Reinisch, Wolfgang Petritsch, Reingard Platzer, Pius Steiner, Herbert Tilg, Harald Vogelsang, Heimo Wenzl, Gottfried Novacek
Anti-TNFα-antibodies have revolutionized the therapy of inflammatory bowel diseases and other immune-mediated inflammatory diseases. Due to the increasing application of these substances, the Working Group of Inflammatory Bowel Diseases of the Austrian Association of Gastroenterology and Hepatology intended to update their consensus report on the safe use of Infliximab (published in 2010) and to enlarge its scope to cover all anti-TNFα-antibodies. The present consensus report summarizes the current evidence on the safe use of anti-TNFα-antibodies and covers the following topics: general risk of infection, bacterial infections (i...
March 2018: Zeitschrift Für Gastroenterologie
Pauline Danion, Anthony Buisson, Xavier Roblin, Nicolas Mathieu, Anne-Laure Charlois, Joshua N Borgerding, Nicolas Williet, Emilie Del Tedesco, Bernard Flourié, Stéphane Nancey, Gilles Boschetti
Background: It has been demonstrated in many chronic conditions, including inflammatory bowel disease (IBD), that better patient knowledge about pathology and treatment improves the course and management of disease. The aim of this study was to develop an updated self-questionnaire to assess patients' level of knowledge of IBD. Methods: The IBD-INFO included 3 parts: an original part (Q1) and 2 parts from the translation of the preexisting questionnaires Crohn's and Colitis Knowledge score (CCKNOW) (Q2) and Crohn's and Colitis Pregnancy Knowledge score (CCPKNOW) (Q3)...
March 1, 2018: Inflammatory Bowel Diseases
Heidi Kammerlander, Jan Nielsen, Jens Kjeldsen, Torben Knudsen, Kim Oren Gradel, Sonia Friedman, Bente Mertz Nørgård
Background: Fecal calprotectin (FC) is a biomarker used for assessing disease activity among IBD patients. Sparse knowledge exists as to whether FC correlates with clinical disease activity during pregnancy. Our aim was to assess FC and selected biomarkers in women with moderate-severe IBD and correlate them with clinical disease activity scores in pregnant women. Methods: We identified a nationwide cohort of 219 singleton pregnancies in women with moderate-severe disease (all treated with anti-tumor recrosis factor-α [anti-TNF-α] therapy during pregnancy), and we reviewed the medical records to extract clinical details and information on biomarkers...
February 28, 2018: Inflammatory Bowel Diseases
Angela S Gupta, Julia R Nunley, Michael J Feldman, Alex G Ortega-Loayza
Pyoderma gangrenosum (PG) is a rare, neutrophil-predominant dermatosis that usually presents as a papule or pustule and progresses into a painful ulcer. Clinical and histopathological features are nonspecific, making PG a challenging condition to diagnose. Lesions may occur anywhere on the body; however, the lower extremity is the most common location. Solitary lesions in atypical locations such as the scalp are uncommon, making this clinical variant especially difficult to recognize and diagnose. Although the clinical features and subsequent management of scalp PG might be different from other anatomic sites, the typical presentation and treatment of scalp PG is still unclear...
February 2018: Wounds: a Compendium of Clinical Research and Practice
Nirupama Bonthala, Sunanda Kane
PURPOSE OF REVIEW: Inflammatory bowel disease affects approximately 800,000 women in the USA with the peak incidence between ages 15 to 40. Thus for many females, IBD can impact nearly every stage of their life from menarche to pregnancy, menopause, and beyond. This paper will review the most recent updates on the topics of sexual health, cervical cancer screening, menstruation, fertility, contraception, and menopause. RECENT FINDINGS: Menarche can be delayed in females especially those who are underweight, malnourished, or with active inflammatory bowel disease...
February 26, 2018: Current Treatment Options in Gastroenterology
M Chaparro, A Verreth, T Lobaton, E Gravito-Soares, M Julsgaard, E Savarino, F Magro, I Avni Biron, P Lopez-Serrano, M J Casanova, M Gompertz, S Vitor, M Arroyo, D Pugliese, Y Zabana, R Vicente, M Aguas, A Bar-Gil Shitrit, A Gutierrez, G A Doherty, L Fernandez-Salazar, J Martínez Cadilla, J M Huguet, A O'Toole, E Stasi, N Manceñido Marcos, A Villoria, K Karmiris, J F Rahier, C Rodriguez, M Diz-Lois Palomares, G Fiorino, J M Benitez, M Principi, T Naftali, C Taxonera, G Mantzaris, L Sebkova, B Iade, D Lissner, I Ferrer Bradley, A Lopez-San Roman, I Marin-Jimenez, O Merino, M Sierra, M Van Domselaar, F Caprioli, I Guerra, P Peixe, M Piqueras, I Rodriguez-Lago, Y Ber, K van Hoeve, P Torres, M Gravito-Soares, D Rudbeck-Resdal, O Bartolo, A Peixoto, G Martin, A Armuzzi, A Garre, M G Donday, F J Martín de Carpi, J P Gisbert
OBJECTIVES: The long-term safety of exposure to anti-tumor necrosis factor (anti-TNFα) drugs during pregnancy has received little attention. We aimed to compare the relative risk of severe infections in children of mothers with inflammatory bowel disease (IBD) who were exposed to anti-TNFα drugs in utero with that of children who were not exposed to the drugs. METHODS: Retrospective multicenter cohort study. Exposed cohort: children from mothers with IBD receiving anti-TNFα medication (with or without thiopurines) at any time during pregnancy or during the 3 months before conception...
February 20, 2018: American Journal of Gastroenterology
Tenzin Choden, Rohan Mandaliya, Aline Charabaty, Mark C Mattar
Inflammatory bowel disease has a high prevalence in women of childbearing age and can have a significant impact on pregnancy, from conceiving to carrying the pregnancy. Active disease during pregnancy is known to have negative effects on pregnancy outcomes; therefore, careful monitoring during this period is an important but challenging aspect of care and is crucial as it affects important management decisions. Recent data seems to suggest that endoscopy is a relatively safe procedure during all trimesters of pregnancy...
February 6, 2018: World Journal of Gastrointestinal Pharmacology and Therapeutics
Michael Mendall, Maria Christina Harpsøe, Devinder Kumar, Mikael Andersson, Tine Jess
BACKGROUND: Crohn's disease (CD) has traditionally been associated with weight loss and low BMI, yet paradoxically obesity has recently been suggested as a risk factor for CD, but not for ulcerative colitis (UC). We therefore hypothesized that the relation between BMI and CD is U shaped. AIM: To conduct a large population-based prospective cohort study of BMI and later risk of IBD, taking age at IBD diagnosis into account. METHODS: A cohort of 74,512 women from the Danish National Birth Cohort, with BMI measured pre-pregnancy and 18 months after delivery, was followed for 1,022,250 person-years for development of IBD, according to the Danish National Patient Register...
2018: PloS One
Vineet S Rolston, Laleh Boroujerdi, Millie D Long, Dermot P B McGovern, Wenli Chen, Christopher F Martin, Robert S Sandler, John D Carmichael, Marla Dubinsky, Gil Y Melmed
Background: Many women with inflammatory bowel disease (IBD) report changes in symptoms in association with hormonal changes during menses, pregnancy, and hormonal contraceptive use, suggesting a hormonal influence on disease activity. We aimed to identify and characterize IBD symptom fluctuations in women during times of hormonal variation. Methods: From June 2012 through September 2012, women enrolled in Crohn's and Colitis Foundation of America Partners , an online Internet cohort of patients with IBD, were invited to participate in this study...
January 18, 2018: Inflammatory Bowel Diseases
Fernando Bermejo, Mariam Aguas, María Chaparro, Eugeni Domènech, Ana Echarri, Esther Garcia-Planella, Iván Guerra, Javier P Gisbert, Antonio López-Sanromán
Thiopurines (azathioprine and mercaptopurine) are widely used in patients with inflammatory bowel disease. In this paper, we review the main indications for their use, as well as practical aspects on efficacy, safety and method of administration. They are mainly used to maintain remission in steroid-dependent disease or with ciclosporin to control a severe ulcerative colitis flare-up, as well as to prevent postoperative Crohn's disease recurrence, and also in combination therapy with biologics. About 30-40% of patients will not respond to treatment and 10-20% will not tolerate it due to adverse effects...
January 18, 2018: Gastroenterología y Hepatología
Mariangela Allocca, Daniela Gilardi, Gionata Fiorino, Federica Furfaro, Laurent Peyrin-Biroulet, Silvio Danese
There has been considerable literature on sexual issues in women with inflammatory bowel disease (IBD), but relatively little attention has been paid to these aspects in men. To review the available literature and to provide the best management of sexual and reproductive issues in male patients with IBD. The scientific literature on sexual and reproductive issues in men with IBD was reviewed. Several factors, including surgical and medication treatments, disease activity, lifestyle, and psychological factors, may play a role in the development of infertility and sexual dysfunction and may negatively impact pregnancy outcomes...
January 18, 2018: European Journal of Gastroenterology & Hepatology
Anne K Örtqvist, Cecilia Lundholm, Jonas Halfvarson, Jonas F Ludvigsson, Catarina Almqvist
OBJECTIVE: Earlier studies on antibiotics exposure and development of IBD (Crohn's disease (CD) and ulcerative colitis (UC)) may have been biased by familial factors and gastroenteritis. We aimed to estimate the association between antibiotics during pregnancy or infantile age and very early onset (VEO) IBD. DESIGN: In this cohort study of 827 239 children born in Sweden between 2006 and 2013, we examined the link between exposure to systemic antibiotics and VEO-IBD (diagnosis <6 years of age), using Cox proportional hazard regression models...
January 10, 2018: Gut
Begoña Gonzalez-Suarez, Shreyashee Sengupta, Alan C Moss
AIM: To investigate the effect of disease activity or thiopurine use on low birth weight and small for gestational age in women with inflammatory bowel disease (IBD). METHODS: Selection criteria included all relevant articles on the effect of disease activity or thiopurine use on the risk of low birth weight (LBW) or small for gestational age (SGA) among pregnant women with IBD. Sixty-nine abstracts were identified, 35 papers were full text reviewed and, only 14 of them met inclusion criteria...
December 7, 2017: World Journal of Gastroenterology: WJG
Yael Lichtman, Eyal Sheiner, Tamar Wainstock, Idit Segal, Daniella Landau, Asnat Walfisch
PROBLEM: Recurrent pregnancy loss (RPL) potentially involves an abnormal maternal inflammatory response. We investigated whether children of mothers with a history of RPL are at an increased risk for childhood gastrointestinal (GI) morbidity, with a specific focus on inflammatory bowel diseases (IBD). METHOD OF STUDY: A population-based cohort analysis comparing the risk for long-term GI morbidity in children born to mothers with and without a history of RPL. Gastrointestinal (GI) morbidity included hospitalizations involving a pre-defined set of ICD-9 codes...
December 15, 2017: American Journal of Reproductive Immunology: AJRI
Jens Walldorf, Susanne Brunne, Fleur S Gittinger, Patrick Michl
OBJECTIVE: Inflammatory bowel disease (IBD) frequently affects women when family planning and pregnancy (FPP) are important issues. This survey aimed to identify patients with an increased need for medical counselling. PATIENTS AND METHODS: An internet-based questionnaire was offered to women with IBD. Characteristics in terms of FPP were analysed with respect to sociodemographic and disease-related factors. RESULTS: Childlessness was frequently reported (64...
March 2018: European Journal of Gastroenterology & Hepatology
Cecilia Ximenez, Javier Torres
Dysbiosis of the gut microbiota has been associated with increasing numbers of diseases, including obesity, diabetes, inflammatory bowel disease, asthma, allergy, cancer and even neurologic or behavioral disorders. The other side of the coin is that a healthy microbiota leads to a healthy human development, to a mature and well trained immune system and to an efficient metabolic machinery. What we have learned in adults is in the end the result of a good start, a programmed, healthy development of the microbiota that must occur in the early years of life, probably even starting during the fetal stage...
November 30, 2017: Archives of Medical Research
Edward Lichten
The important role of microfilaria (worms) in human and animal disease remains an area of key disagreement between the naturopathic and allopathic physicians. While microfilaria infections are rampart in undeveloped countries, they rarely rise to identification as a cause of disease in Western countries. New research studies in the diagnosis and treatment of SIBO (Small Intestinal Bacterial Overgrowth) and (IBD) Inflammatory Bowel Diseases of ulcerative colitis, Crohn's Disease and microcytic colitis may make both sides equally correct...
November 2017: Medical Hypotheses
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