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Complications of Crohn's Disease

Christina Ong, Marion M Aw, Maria Janelle Liwanag, Quak Seng Hock, Phua Kong Boo
BACKGROUND AND AIMS: Epidemiological studies on pediatric-onset inflammatory bowel disease (PIBD) are scarce in Southeast Asia (SEA). Phenotypes of PIBD in Asian were reportedly more complicated than Caucasian in the same western centres. This study aims to evaluate the incidence trend and clinical characteristics of PIBD in a SEA cohort in Singapore over a 22-year period (1994-2015). METHODS: Case records of PIBD ≤ 18years from the only two tertiary pediatric hospitals in Singapore were reviewed for relevant data...
June 21, 2018: Journal of Digestive Diseases
Patrícia Guedes Garcia, Liliana Andrade Chebli, Tarsila Campanha da Rocha Ribeiro, Pedro Duarte Gaburri, Fabio Heleno de Lima Pace, Kátia Valéria Bastos Dias Barbosa, Lívia Almeida Costa, William de Almeida Cruz, Isabelle Carvalho de Assis, Bernardo Rodriguez Mendes Moraes, Alexandre Zanini, Julio Maria Fonseca Chebli
PURPOSE: The prospective assessment of Clostridium difficile infection (CDI) impact in inflammatory bowel disease (IBD) flare in outpatient setting has been poorly investigated. We aimed to evaluate the prevalence and the associated factors with CDI in IBD outpatients presenting colitis flares as well as the outcomes following treatment. METHODS: In this prospective cohort study, conducted from October, 2014, to July, 2016, 120 IBD patients (55% presenting colitis flare) and 40 non-IBD controls were assessed for CDI...
June 21, 2018: International Journal of Colorectal Disease
Y Wang, Y P Pan, L N Ye
No abstract text is available yet for this article.
June 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
N Falco, T Fontana, D Scrivano, R Tutino, L Licari, C Raspanti, G I Melfa, G Cocorullo
AIM: The purpose of this work is to demonstrate the correlation between the p-POSSUM score and the severity of Crohn's Disease (CD) postoperative complications, evaluated by using the Clavien-Dindo score. PATIENTS AND METHODS: We have selected data of 22 patients (11 males, 11 females) that had been recovered in the Operative Unit of General Surgery of the University of Palermo General Hospital and undergone surgery for CD from 2010 to 2017. RESULTS: Patients who underwent surgery for complicated CD was divided in three different group on the base of Clavien Dindo score, C1 (Clavien-Dindo ≤ 1), C2 (Clavien Dindo = 2), and C3 (Clavien Dindo ≥ 3)...
May 2018: Il Giornale di Chirurgia
F Rieder, D Bettenworth, C Ma, C E Parker, L A Williamson, S A Nelson, G van Assche, A Di Sabatino, Y Bouhnik, R W Stidham, A Dignass, G Rogler, S A Taylor, J Stoker, J Rimola, M E Baker, J G Fletcher, J Panes, W J Sandborn, B G Feagan, V Jairath
BACKGROUND: Fibrotic stricture is a common complication of Crohn's disease (CD) affecting approximately half of all patients. No specific anti-fibrotic therapies are available; however, several therapies are currently under evaluation. Drug development for the indication of stricturing CD is hampered by a lack of standardised definitions, diagnostic modalities, clinical trial eligibility criteria, endpoints and treatment targets in stricturing CD. AIM: To standardise definitions, diagnosis and treatment targets for anti-fibrotic stricture therapies in Chron's disease...
June 19, 2018: Alimentary Pharmacology & Therapeutics
Tingbin Xie, Chenyan Zhao, Chao Ding, Liang Zhang, Minhua Cheng, Cao Chun, Wenkui Yu, Jianfeng Gong, Weiming Zhu
Background: The role of interleukin-6 (IL-6) in the prediction of intra-abdominal septic complications (IASCs) in patients with Crohn's disease (CD) remains unclear. We assessed the serum IL-6 time course and its association with postoperative IASCs in patients undergoing elective intestinal operations for CD. Methods: In total, 118 patients who underwent intestinal operations for CD were prospectively evaluated. They were divided into an IASC group and non-IASC group...
June 15, 2018: Inflammatory Bowel Diseases
Irene Marafini, Giovanni Monteleone
Inflammatory bowel diseases (IBD) are chronic inflammatory conditions of the gastrointestinal tract encompassing two main clinical entities: Crohn's disease (CD) and ulcerative colitis (UC). These disorders are characterized by various grades of tissue damage and development of local complications and extra-intestinal manifestations. The cause of IBD remains unknown but accumulating evidence indicates that both CD and UC arise in genetically-predisposed individuals as a result of the action of multiple environmental factors, which ultimately trigger excessive and poorly-controlled immune response against antigens of the luminal flora...
June 16, 2018: Annals of Medicine
Abhijeet Yadav, Satya Kurada, Joshua Foromera, Kenneth R Falchuk, Joseph D Feuerstein
BACKGROUND: Long-term inflammatory complications of IPAA include Crohn's Disease (CD) or "CD-like" (CDL) condition. We performed a meta-analysis to evaluate the efficacy of anti-tumor necrosis factor (anti-TNF) with or without immunomodulator (IM) therapy in this group of patients. METHODS: Literature databases were searched from inception to October 4, 2017. Further searches using references from papers of interest were conducted and, abstracts from major GI conferences were searched...
May 30, 2018: Digestive and Liver Disease
Kazuaki Shibuya, Shigenori Homma, Tadashi Yoshida, Yosuke Ohno, Nobuki Ichikawa, Hideki Kawamura, Teppei Imamoto, Yoshihiro Matsuno, Akinobu Taketomi
The development of colorectal cancer in long-standing Crohn's disease (CD) patients has become a major complication. Therapeutic guidelines for CD-associated cancer (CDAC) have already been established in Western countries; however, specific guidelines are not currently available in Japan. Surveillance of the residual intestine for cancer screening is important for long-standing CD patients. The present case report describes the occurrence of rectal carcinoma in a patient with a 25-year history of CD. A 37-year-old male with a 17-year history of CD underwent semi-emergent subtotal colectomy and ileostomy for bowel obstruction secondary to the transverse colon stenosis, and multiple severe stenosis and inflammation...
July 2018: Molecular and Clinical Oncology
Eanna Ryan, Daniel McNicholas, Ben Creavin, Michael Eamon Kelly, Tom Walsh, David Beddy
Background: Sarcopenia is associated with increased morbidity and mortality in oncologic and transplant surgery. It has a high incidence in chronic inflammatory states including inflammatory bowel disease (IBD). The validity of existing data in IBD and of sarcopenia's correlation with surgical outcomes is limited. Methods: We performed a systematic review to assess the correlation of sarcopenia with the requirement for surgery and surgical outcomes in patients with IBD...
June 7, 2018: Inflammatory Bowel Diseases
Torsten Kucharzik, Christian Maaser
As Crohn's disease (CD) is predominantly located within the small bowel, imaging of the small bowel plays an intriguing role in the primary diagnosis as well as in the monitoring of patients with CD. Intestinal ultrasound (IUS) offers several advantages over endoscopy and other imaging modalities. Obvious advantages of IUS include noninvasiveness, rapid availability and cost effectiveness. IUS has been shown to have high accuracy in detecting small bowel CD and determining intra- and extramural complications such as stenoses, fistulae and abscesses...
2018: Therapeutic Advances in Gastroenterology
G Briganti, J-P Falla, T Roumeguère
We present the case of a 54 year old male complaining of abdominal pain localised in the right flank and irradiating in other abdominal regions. The pain was previously associated with kidney stones, but persisted months after their total evacuation. Suffering from Crohn's disease, low dose corticosteroids likely caused a particularly invalidating chronic prostatitis, which antibiotic treatment aggravated the symptoms of Crohn's disease, therefore complicating the therapeutic care by causing a vicious circle...
May 30, 2018: Revue Médicale de Bruxelles
Gloria Sz Tun, Sarah Cripps, Alan J Lobo
Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract. Individuals with CD present with acute inflammatory exacerbations as well as acute and chronic complications. Management requires specialist input from gastroenterologists, colorectal surgeons, nurse specialists and pharmacists as well as general and primary care physicians to allow appropriate selection of treatment options including surgery and rapid assessment and treatment of those with acute exacerbations. Monitoring of the individual and their medication is crucial in preventing and recognising complications including those associated with treatment...
June 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Rui Feng, Kang Chao, Shu Ling Chen, Can Hui Sun, Yun Qiu, Bai Li Chen, Ren Mao, Yao He, Qing Hua Cao, Ling Xue, Zhi Rong Zeng, Sheng Hong Zhang, Min Hu Chen
OBJECTIVE: Clinically it is difficult to differential diagnose of Intestinal Behcet's Disease (BD) with Crohn's Disease (CD) especially those cases with only ileocolonic involvement. HSPA6 (Heat Shock Protein Family A (Hsp70) Member 6) has been shown to participate in innate immunity. However, little is known about the role of HSPA6 in the intestinal inflammatory diseases. In the current study, our goal is to investigate the role of HSPA6 expression when combined with other clinical characteristics in differential diagnosis of patients with intestinal BD and CD...
May 30, 2018: Journal of Digestive Diseases
Paulo Gustavo Kotze, Daniela Oliveira Magro, Carlos Augusto Real Martinez, Antonino Spinelli, Takayuki Yamamoto, Janindra Warusavitarne, Claudio Saddy Rodrigues Coy
Background: There is lack of data analyzing short-term postoperative complications and time from diagnosis to surgery in Crohn's disease (CD). Aim: To compare complication rates after elective abdominal operations in CD patients with different durations of disease. Methods: Retrospective observational study with CD patients who submitted to elective intestinal resections. Patients were allocated in 2 groups according to time to surgery (TS) in less or more than 5 years...
2018: Gastroenterology Research and Practice
Helena Tavares de Sousa, Jorge Brito, Fernando Magro
PURPOSE OF REVIEW: Cross-sectional imaging, namely ultrasound, CT and MR enterography, complements clinical and endoscopic monitoring of activity and complications in IBD, and emerging new radiological technologies may have clinical applications in the near future. This review offers an update on the potential role of these new imaging methods in the management of IBD. RECENT FINDINGS: Specific MR techniques [diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI) and magnetization transfer] allow accurate detection of inflammation (DWI and maybe DKI) and fibrosis (magnetization transfer) in Crohn's disease, without the need of intravenous gadolinium administration...
July 2018: Current Opinion in Gastroenterology
Mitchell R Ladd, Alejandro V Garcia, Ira L Leeds, Courtney Haney, Maria M Oliva-Hemker, Samuel Alaish, Emily Boss, Daniel S Rhee
BACKGROUND: Pediatric patients with Crohn disease (CD) are frequently malnourished, yet how this affects surgical outcomes has not been evaluated. This study aims to determine the effects of malnourishment in children with CD on 30-day outcomes after surgery. STUDY DESIGN: The ACS NSQIP-Pediatric database from 2012 to 2015 was used to select children aged 5-18 with CD who underwent bowel surgery. BMI-for-age Z-scores were calculated based on CDC growth charts and 2015 guidelines of pediatric malnutrition were applied to categorize severity of malnutrition into none, mild, moderate, or severe...
April 27, 2018: Journal of Pediatric Surgery
Venkata Subhash Gorrepati, Negar Rassaei, Kofi Clarke
After ileal pouch anal anastomosis, one of the frequently encountered complications is polyposis of the pouch. We describe a case of proximal neoterminal ileal polyposis associated with deep ulceration suggestive of Crohn's disease and review the available literature. A 36-year-old male presented with resistant pouchitis 11 years after surgery for ulcerative colitis. With all-negative initial workup, pouchoscopy showed multiple deep ulcers in the proximal ileum with some polyps. Biopsy of polyps showed inflammatory polyps with negative immunohistological staining for IgG pouchitis...
January 2018: Case Reports in Gastroenterology
Lin Wei Khoo, Michelle Attzs, Sathish Srinivasan, Fiona Roberts
PURPOSE: To report a case of limbal stem cell deficiency (LSCD) secondary to diffuse non-necrotizing anterior scleritis (DNNAS). METHOD: Interventional case report with clinicopathologic correlation. A 69-year-old white woman with known Crohn disease presented with DNNAS. The acute inflammatory phase was treated with topical and systemic steroids. After DNNAS, she developed secondary LSCD with loss of limbal palisades of Vogt and conjunctivalization of the corneal surface and corneal haze...
May 23, 2018: Cornea
Seyedehsan Navabi, Venkata Subhash Gorrepati, Sanjay Yadav, Jaykrishna Chintanaboina, Sarah Maher, Peter Demuth, Benjamin Stern, August Stuart, Andrew Tinsley, Kofi Clarke, Emmanuelle D Williams, Matthew D Coates
Background: Individuals with inflammatory bowel disease (IBD) are at increased risk of developing anxiety or depression (A&D). Crohn's disease (CD) and ulcerative colitis (UC) with comorbid A&D are both more challenging to manage. IBD providers need to better understand the causes and impact of A&D in order to improve care for IBD patients. We sought to identify clinical factors that influence development of A&D and healthcare utilization in IBD. Methods: This is a retrospective analysis using an IBD natural history registry from a single tertiary care referral center...
May 17, 2018: Inflammatory Bowel Diseases
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