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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/28644565/long-term-risk-of-infection-in-patients-with-crohn-s-disease-on-anti-tnf-treatment-a-prospective-single-center-cohort-study-in-china
#1
Yue Li, Hui Jun Shu, Hong Lu, Hong Yang, Ji Li, Bei Tan, Jiaming Qian
BACKGROUND: Anti-TNF agents have demonstrated to greatly improve management strategies for inflammatory bowel disease (IBD). Clinical trials and registry studies in Western countries have shown that infections and malignancy are the most concerned complications of anti-TNF treatment. However, data derived from clinical practice in China are limited. The aim of this study is to explore the long-term infection risk of infliximab (IFX) in treating patients with Crohn's disease (CD) from a tertiary IBD center in China...
June 23, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28643285/skin-manifestations-of-inflammatory-bowel-disease
#2
REVIEW
Thomas Greuter, Alexander Navarini, Stephan R Vavricka
Inflammatory bowel disease (IBD) with its two main subtypes Crohn's disease and ulcerative colitis is not restricted to the gastrointestinal tract. Indeed, so-called extraintestinal manifestations (EIMs) are frequent and considerably affect morbidity and mortality. The prevalence of EIMs ranges from 6 to 47%. In up to one quarter of the patients, EIMs can present even before an IBD diagnosis is established. The pathophysiology of EIMs remains elusive, although data from clinical trials demonstrating anti-tumor necrosis factor (TNF) efficacy suggest a common pathogenic link between intestinal and extraintestinal disease activity...
June 23, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28642198/treatment-of-intestinal-fibrosis-in-experimental-inflammatory-bowel-disease-by-the-pleiotropic-actions-of-a-local-rho-kinase-inhibitor
#3
Tom Holvoet, Sarah Devriese, Karolien Castermans, Sandro Boland, Dirk Leysen, Yves-Paul Vandewynckel, Lindsey Devisscher, Lien Van den Bossche, Sophie Van Welden, Melissa Dullaers, Roosmarijn E Vandenbroucke, Riet De Rycke, Karel Geboes, Arnaud Bourin, Olivier Defert, Pieter Hindryckx, Martine De Vos, Debby Laukens
BACKGROUND: Intestinal fibrosis resulting in (sub)obstruction is a common complication of Crohn's disease (CD). Rho kinases (ROCKs) play multiple roles in TGFβ1-induced myofibroblast activation that could be therapeutic targets. Because systemic ROCK inhibition causes cardiovascular side-effects, we evaluated the effects of a locally acting ROCK inhibitor (AMA0825) on intestinal fibrosis. METHODS: Fibrosis was assessed in mouse models using dextran sulfate sodium and adoptive T cell transfer...
June 19, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28634703/isoperistaltic-versus-antiperistaltic-side-to-side-anastomosis-after-right-laparoscopic-hemicolectomy-for-cancer-isovanti-trial-study-protocol-for-a-randomised-clinical-trial
#4
N Ibañez, J Abrisqueta, J Luján, Q Hernández, P Parrilla
BACKGROUND: It is believed that loosing ileocecal valve is well tolerated in patients who do not have short bowel syndrome or Crohn disease. From the hypothesis of colonic peristalsis and transit is regulated by that ileocecal valvular mechanism, we try to find out if the creation of a new pseudo-valvular mechanism as antiperistaltic anastomosis could be considered after right hemicolectomy can cause any short- or long-term changes in gastrointestinal habits. PURPOSE: The purpose of the study at primary endpoint is to compare early (occurring within 30 days of surgery) and late (occurring during the follow-up) postoperative complications between both groups The purpose of the study at secondary endpoint is to compare intraoperative and postoperative events between experimental and control groups in terms of operating time, first oral tolerance day, first flatus and faeces, length of hospital stay and orocecal transit; comparing rates of gastrointestinal life quality and comparing mortality rates between both groups...
June 21, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#5
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28630777/magnetic-resonance-enterography-findings-of-intestinal-beh%C3%A3-et-disease-in-a-child
#6
Tommaso D'Angelo, Romina Gallizzi, Claudio Romano, Giuseppe Cicero, Silvio Mazziotti
Behçet's disease (BD) is a multisystem disorder of unknown aetiology, characterized by recurrent oral ulcers, genital ulcers, uveitis, skin lesions, and pathergy. Gastrointestinal disease outside the oral cavity is well recognized and usually takes the form of small intestinal ulcers, with the most significant lesions frequently occurring in the ileocaecal region. Symptoms usually include nausea, vomiting, colicky abdominal pain, and change in bowel habit and it is not unusual that patients may present late, with life-threatening complications requiring surgery...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/28622435/single-port-laparoscopic-ileocaecal-resection-for-crohn-s-disease-a-multicentre-comparison-with-multi-port-laparoscopy
#7
Michele Carvello, E Joline de Groof, Anthony de Buck van Overstraeten, Matteo Sacchi, Albert M Wolthuis, Christianne J Buskens, André D'Hoore, Willem A Bemelman, Antonino Spinelli
BACKGROUND AND AIMS: Single port (SP) ileocecal resection (ICR) is an established technique but there are no large studies comparing SP and multi-port (MP) laparoscopic surgery in Crohn's disease (CD). The aim of this study was to compare postoperative pain scores and analgesia requirements after SP and MP laparoscopic ICR for CD. METHODS: This was a retrospective study of patients undergoing SP or MP ICR for CD in three tertiary referral centres from February 1999-October 2014...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28622356/elevated-c-reactive-protein-level-during-clinical-remission-can-predict-poor-outcomes-in-patients-with-crohn-s-disease
#8
Kyunghwan Oh, Eun Hye Oh, Seunghee Baek, Eun Mi Song, Gwang-Un Kim, Myeongsook Seo, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Intestinal inflammation and mucosal damage in Crohn's disease (CD) are believed to progress even during clinical remission. We investigated the long-term prognosis of CD patients in clinical remission according to serum C-reactive protein (CRP) levels. This study included 339 CD patients in clinical remission (Crohn's disease activity index < 150) for more than 6 months between January 2008 and December 2010. Clinical outcomes were compared between patients with normal and elevated CRP levels during clinical remission...
2017: PloS One
https://www.readbyqxmd.com/read/28614620/a-systematic-review-of-segmental-vs-subtotal-colectomy-and-subtotal-colectomy-vs-total-proctocolectomy-for-colonic-crohn-s-disease
#9
REVIEW
Imerio Angriman, Giovanni Pirozzolo, Romeo Bardini, Francesco Cavallin, Carlo Castoro, Marco Scarpa
AIM: Surgical management of colonic Crohn's disease (CD) is still unclear because different procedures can be adopted. The choice of operation is dependent on the involvement of colonic disease but the advantages and disadvantages of the extent of resection are still debated. METHOD: The aim of the present study is to evaluate the differences in short-term and long-term outcomes of adult patients with colonic CD, who underwent either subtotal colectomy and ileorectal anastomosis (STC) or segmental colectomy (SC) or total proctocolectomy and end ileostomy (TPC)...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28614561/association-of-preoperative-anti-tumor-necrosis-factor-therapy-with-adverse-postoperative-outcomes-in-patients-undergoing-abdominal-surgery-for-ulcerative-colitis
#10
Audrey S Kulaylat, Afif N Kulaylat, Eric W Schaefer, Andrew Tinsley, Emmanuelle Williams, Walter Koltun, Christopher S Hollenbeak, Evangelos Messaris
Importance: Despite the increasing use of anti-tumor necrosis factor (TNF) therapy in ulcerative colitis, its effects on postoperative outcomes remain unclear, with many patients requiring surgical intervention despite optimal medical management. Objective: To assess the association of preoperative use of anti-TNF agents with adverse postoperative outcomes. Design, Setting, and Participants: This analysis used insurance claims data from a large national database to identify patients 18 years or older with ulcerative colitis...
June 14, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28608250/the-efficacy-of-active-drainage-for-preventing-postoperative-organ-space-surgical-site-infections-in-patients-with-crohn-s-disease
#11
Ryo Ikeshima, Tsunekazu Mizushima, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Masakazu Ikenaga, Kiyokazu Nakajima, Hirofumi Yamamoto, Kohei Murata, Yuichiro Doki, Masaki Mori
PURPOSE: Patients with Crohn's disease (CD) show a higher incidence of surgical site infections (SSIs) after bowel resection in comparison to other patient populations because CD patients commonly suffer from anemia, malnutrition, and immunosuppression. In comparison to conventional passive drainage, active drainage using a closed-suction drain reportedly reduces postoperative wound-related complications in several diseases. In the present study, we aimed to investigate the incidence of SSI and to identify the risk factors for SSI in patients with CD...
June 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/28606755/recommendations-of-the-spanish-working-group-on-crohn-s-disease-and-ulcerative-colitis-geteccu-on-the-monitoring-prevention-and-treatment-of-post-operative-recurrence-in-crohn-s-disease
#12
Eugeni Domènech, Antonio López-Sanromán, Pilar Nos, Maribel Vera, María Chaparro, María Esteve, Javier P Gisbert, Míriam Mañosa
Despite the availability of new, powerful drugs for Crohn's disease, a significant proportion of patients will undergo an intestinal resection to control the disease as it develops. In the absence of an effective preventative treatment, the appearance of new intestinal lesions after surgery for Crohn's disease is the norm; this is known as post-operative recurrence and may appear very early on, even a few weeks after the surgical resection. Furthermore, the drugs that are currently available for the prevention of post-operative recurrence have a limited effect; up to 50% of cases present recurrent Crohn's disease activity despite the preventative treatment, which may require further surgery with the consequent loss of intestinal function, leading some patients to suffer from short bowel syndrome as an irreversible complication...
June 9, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28604512/changes-in-hepcidin-and-hemoglobin-after-anti-tnf-alpha-therapy-in-children-and-adolescents-with-crohn-s-disease
#13
Meredith A Atkinson, Mary B Leonard, Rita Herskovitz, Robert N Baldassano, Michelle R Denburg
BACKGROUND: Anemia is the most common systemic complication of inflammatory bowel disease, is more common in affected children than adults, and is mediated in large part by chronic inflammation. Inflammation increases levels of the iron-regulatory protein hepcidin, which have been elevated in adults with Crohn's disease. METHODS: We measured serum hepcidin-25 and hemoglobin (Hgb) in 40 children and adolescents with Crohn's disease at baseline and 10 weeks after initiation of anti-TNF-α therapy...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28604511/incidence-and-risk-factors-for-perianal-disease-in-pediatric-crohn-s-disease-patients-followed-in-cedata-gpge-registry
#14
Annecarin Brückner, Katharina J Werkstetter, Jan de Laffolie, Claudia Wendt, Christine Prell, Tanja Weidenhausen, Klaus P Zimmer, Sibylle Koletzko
BACKGROUND AND AIMS: Perianal disease (PD) with fistula and/or abscess formation is a severe complication in Crohn's disease (CD). We examined prevalence, incidence and risk factors for PD development in a pediatric CD cohort. METHODS: CD patients from the prospective, multi-center registry for inflammatory bowel disease from Germany and Austria (CEDATA-GPGE) were included if diagnosed ≤18 years of age, registered within three months after diagnosis, and having at least two follow-up visits within the first year of registration...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28601423/crohn-disease-epidemiology-diagnosis-and-management
#15
REVIEW
Joseph D Feuerstein, Adam S Cheifetz
Crohn disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation that can affect the entire gastrointestinal tract from the mouth to the anus. For this review article, we performed a review of articles in PubMed through February 1, 2017, by using the following Medical Subject Heading terms: crohns disease, crohn's disease, crohn disease, inflammatory bowel disease, and inflammatory bowel diseases. Presenting symptoms are often variable and may include diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills...
June 7, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#16
Qingfan Yang, Xiang Gao, Huiping Chen, Miao Li, Xiaojian Wu, Min Zhi, Ping Lan, Pinjin Hu
AIM: To investigate the efficacy of exclusive enteral nutrition (EEN) in induction of remission in adult active Crohn's disease (CD) complicated with intestinal fistula/abdominal abscess or inflammatory intestinal stricture. METHOD: Patients diagnosed with active CD with complications were recruited between July 2013 and July 2015. Patients were offered EEN for 12 weeks. Patients with abscess received antibiotic treatment with or without percutaneous drainage. Clinical variables were recorded (ClinicalTrials...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28592228/anti-fibrogenic-effect-of-ppar-%C3%AE-agonists-in-human-intestinal-myofibroblasts
#17
Jun Bon Koo, Myeong-Ok Nam, Younshin Jung, Jongman Yoo, Duk Hwan Kim, Gwangil Kim, Sung Jae Shin, Kee Myung Lee, Ki Baik Hahm, Jong Woo Kim, Sung Pyo Hong, Kwang Jae Lee, Jun Hwan Yoo
BACKGROUND: Intestinal fibrosis is a serious complication of inflammatory bowel disease, including Crohn's disease and ulcerative colitis. There is no specific treatment for intestinal fibrosis. Studies have indicated that peroxisome proliferator-activated receptor- γ (PPAR-γ) agonists have anti-fibrogenic properties in organs besides the gut; however, their effects on human intestinal fibrosis are poorly understood. This study investigated the anti-fibrogenic properties and mechanisms of PPAR-γ agonists on human primary intestinal myofibroblasts (HIFs)...
June 7, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28591060/body-mass-index-is-a-practical-preoperative-nutritional-index-for-postoperative-infectious-complications-after-intestinal-resection-in-patients-with-crohn-s-disease
#18
Yibin Zhu, Wei Zhou, Weilin Qi, Wei Liu, Mingyu Chen, Hepan Zhu, Jianjian Xiang, Qingwen Xie, Pengpeng Chen
The patients with Crohn's disease (CD) are often accompanied with nutritional deficiencies. Compared with other intestinal benign disease, patients with CD have the higher risk of developing postoperative complications following intestinal resection. The aim of this study was to investigate the risk factors for postoperative infectious complications (PICs) after intestinal resection for CD, as well as search a practical preoperative nutritional index for PICs in patients with CD. A total of 122 patients who underwent intestinal resection for CD during 2011 to 2015 were retrospectively analyzed...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28590344/the-characteristics-and-long-term-outcomes-of-pediatric-crohn-s-disease-patients-with-perianal-disease
#19
Yonatan Herman, Firas Rinawi, Benjamin Rothschild, Osnat Nir, Raanan Shamir, Amit Assa
BACKGROUND: Data on the outcomes of children with perianal Crohn's disease are limited. We aimed to assess phenotypic features at diagnosis and long-term disease-specific outcomes of this phenotype. METHODS: The medical records of 296 pediatric onset patients with Crohn's disease, diagnosed from 2001 to 2015, were reviewed retrospectively. Baseline characteristics included age, sex, severity indices, laboratory data, endoscopic findings, and anthropometric measurements...
June 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28587182/preoperative-nutritional-conditioning-of-crohn-s-patients-systematic-review-of-current-evidence-and-practice
#20
Fabian Grass, Basile Pache, David Martin, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
Crohn's disease is an incurable and frequently progressive entity with major impact on affected patients. Up to half of patients require surgery in the first 10 years after diagnosis and over 75% of operated patients require at least one further surgery within lifetime. In order to minimize surgical risk, modifiable risk factors such as nutritional status need to be optimized. This systematic review on preoperative nutritional support in adult Crohn's patients between 1997 and 2017 aimed to provide an overview on target populations, screening modalities, routes of administration, and expected benefits...
June 1, 2017: Nutrients
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