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Inflammatory Issues related to Crohn's Disease

Charumathi Raghu Subramanian, George Triadafilopoulos
Inflammatory bowel disease (IBD) comprises two distinct conditions: ulcerative colitis and Crohn's disease, both of which are chronic, relapsing disorders carrying significant morbidity, mortality and healthcare costs. With growing attention to coordinated healthcare for patients with chronic systemic diseases, this review focuses on the care of IBD patients in remission, their concerns, quality of life, follow-up, the role of primary care physicians and the IBD-specific aspects of long-term care. We did an extensive PubMed search for articles pertaining to IBD patients in remission and, along with the authors' experience, formulated a comprehensive review...
November 2016: Gastroenterology Report
Akshay Kapoor, Vidyut Bhatia, Anupam Sibal
Background: The incidence of inflammatory bowel disease is increasing in the pediatric population worldwide. NEED AND PURPOSE OF REVIEW: There is paucity of high quality scientific data regarding pediatric inflammatory bowel disease. Most of the guidelines are offshoots of work done in adults, which have been adapted over time to diagnose and treat pediatric patients. This is in part related to the small numbers in pediatric inflammatory bowel disease and less extensive collaboration for multicentric trials both nationally and internationally...
November 15, 2016: Indian Pediatrics
Gabriela Figueroa-González, Verónica García-Castillo, Jossimar Coronel-Hernández, Eduardo López-Urrutia, Sonia León-Cabrera, Luis E Arias-Romero, L I Terrazas, Miriam Rodríguez-Sosa, Alma Delia Campos-Parra, Eduardo Zúñiga-Calzada, Cesar Lopez-Camarillo, Fermín Morales-González, Nadia J Jacobo-Herrera, Carlos Pérez-Plasencia
Colorectal cancer (CRC) is an important health issue worldwide, accounting for the third place of cancer incidence. Chronic inflammation, as seen in Crohn's disease and ulcerative colitis, is the most important risk factor for developing CRC, as it favours neoplastic transformation by enhancing epithelial cell turnover in the colonic mucosa. Treatments for CRC need to be improved; currently they are not specific and have several secondary effects in patients. The main objective of this work was to evaluate a new therapeutic strategy against a colitis-related colorectal cancer in vivo and in vitro by targeting mTOR-signaling and lactate dehydrogenase A...
2016: Journal of Cancer
Takeshi Shin, Hiroshi Okada
Inflammatory bowel disease (IBD) predominantly affects young adults. Fertility-related issues are therefore important in the management of patients with IBD. However, relatively modest attention has been paid to reproductive issues faced by men with IBD. To investigate the effects of IBD and its treatment on male fertility, we reviewed the current literature using a systematic search for published studies. A PubMed search were performed using the main search terms "IBD AND male infertility", "Crohn's disease AND male infertility", "ulcerative colitis AND male infertility"...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
Joachim L Schultze
Intestinal macrophages are functionally specialized to phagocytose bacteria, including harmful and invading pathogens, without releasing pro-inflammatory mediators. This unique functional combination guarantees an optimal defense against millions of gut bacteria while at the same time protecting the host from inflammation-related tissue damage. IL-10 seems to be a critical tissue factor involved in this balance and deficiencies in IL-10 in humans and mice have been shown to deteriorate this fine balance, leading to chronic inflammation and diseases such as Crohn's disease...
August 2016: European Journal of Immunology
David J Gracie, Christopher J M Williams, Ruchit Sood, Saqib Mumtaz, M Hassan Bholah, P John Hamlin, Alexander C Ford
BACKGROUND & AIMS: Symptoms compatible with irritable bowel syndrome (IBS) are common in patients with inflammatory bowel disease (IBD), but it is unclear whether this relates to occult IBD activity. We attempted to resolve this issue in a secondary care population using a cross-sectional study design. METHODS: We analyzed Rome III IBS symptoms; disease activity indices; and psychological, somatization, and quality of life data from 378 consecutive, unselected adult patients with IBD seen in clinics at St...
May 14, 2016: Clinical Gastroenterology and Hepatology
Jason Martin, Sunanda V Kane, Linda A Feagins
Inflammatory bowel disease (IBD) carries a high burden in women during their reproductive years, and family planning issues are often a significant cause of concern. Fertility is normal in women with nonsurgically treated ulcerative colitis and similar or slightly reduced in women with Crohn's disease. Women who undergo ileal pouch anastomosis have reduced fertility. Fertility is likely worsened by disease activity but unaffected by medications used to treat IBD. Infertile patients with IBD respond as well as non-IBD patients to in vitro fertilization (IVF)...
February 2016: Gastroenterology & Hepatology
L Kinsey, S Burden
Survey aims were to investigate the dietary concerns, beliefs and opinions of people with inflammatory bowel disease (IBD), and differences between those with Crohn's disease (CD) or ulcerative colitis (UC). A cross-sectional postal questionnaire was sent to people with IBD who were booked into an adult IBD or Gastroenterology clinic over a 6-week period. There were 416 eligible people and 168 (40%) responded. Sixty-four (42%) people indicated that food affects their symptoms a lot or severely. Eighty (51%) respondents indicated that diet was important or extremely important in controlling symptoms...
July 2016: European Journal of Clinical Nutrition
Edyta Szymańska, Sylwia Szymańska, Michał Szczepański, Piotr Landowski, Grażyna Czaja-Bulsa, Elżbieta Jarocka-Cyrta, Bartosz Korczowski, Elżbieta Krzesiek, Jarosław Kierkuś
INTRODUCTION: Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a chronic condition of the colon and small intestine. The disease is common in young people (children and young adults), but it is rare in children younger than five years of age. Therefore, IBD developing during the first years of life (under the age of 5) is known as an early-onset IBD (EO-IBD), and it is considered to be a specific entity with a distinct phenotype. However, the available data on that issue are still insufficient...
2016: Przegla̜d Gastroenterologiczny
Verlaine J Timms, George Daskalopoulos, Hazel M Mitchell, Brett A Neilan
The association of Mycobacterium avium subspecies paratuberculosis (M. paratuberculosis) with Crohn's disease is a controversial issue. M. paratuberculosis is detected by amplifying the IS900 gene, as microbial culture is unreliable from humans. We determined the presence of M. paratuberculosis in patients with Crohn's disease (CD) (n = 22), ulcerative colitis (UC) (n = 20), aphthous ulcers (n = 21) and controls (n = 42) using PCR assays validated on bovine tissue. Culture from human tissue was also performed...
2016: PloS One
Kimberly A Harris, Sara Horst, Akash Gadani, Anne Nohl, Kim Annis, Caroline Duley, Dawn Beaulieu, Leyla Ghazi, David A Schwartz
BACKGROUND: Ustekinumab is a new biologic therapy targeting interleukin-12 and interleukin -23. It is currently approved for the treatment of psoriasis, but clinical trials have shown that it can induce and maintain remission in Crohn's disease (CD). We aim to evaluate effectiveness of ustekinumab in the treatment of CD. METHODS: A retrospective chart review was performed including patients (pts) from 2 academic medical centers with complicated, refractory CD started on ustekinumab between June 2011 and June 2014...
February 2016: Inflammatory Bowel Diseases
M Scharitzer, A Ba-Ssalamah
CLINICAL METHODOLOGICAL ISSUES: The radiological diagnostics of diseases of the small intestine have undergone a great change in the last two decades. Through rapid progress with new treatments and an increasing therapeutic focus on transmural healing, a complete evaluation of the gastrointestinal tract is now crucial. STANDARD RADIOLOGICAL METHODS: With the introduction of endoscopy, gastrointestinal imaging with a relatively high radiation exposure had only limited applications...
December 2015: Der Radiologe
Soleiman B Kashkooli, Jane M Andrews, Matthew B Roberts, Christian P Selinger, Rupert W Leong
BACKGROUND: Patients with inflammatory bowel disease (IBD) tend to have smaller family sizes. Health care professionals (HCPs) may inadvertently provide inaccurate advice to patients resulting in voluntary childlessness or unfavourable pregnancy outcomes. OBJECTIVE: The study aims to objectively measure IBD-specific pregnancy-related knowledge of general practitioners (GPs) and obstetricians/gynaecologists (OB/GYNs) in comparison with gastroenterologists (GEs) using the validated Crohn's and Colitis Pregnancy Knowledge (CCPKnow) questionnaire...
October 2015: United European Gastroenterology Journal
Jean-François Rahier
In an era of increasing use of immunomodulator therapy and biologics, opportunistic infections (OI) have emerged as a pivotal safety issue in patients with inflammatory bowel disease (IBD). Clinical studies, registries and case reports warn about the increased risk for infections, particularly OIs. Today, the challenge for a physician is not only to manage IBD, but also to recognize, prevent and treat common and uncommon infections. The 2014 European Crohn's and Colitis Organisation (ECCO) guidelines on the management and prevention of OIs in patients with IBD provide clinicians with guidance on the prevention, detection and management of OIs...
September 14, 2015: Digestive Diseases
Anne Jarry, Céline Bossard, Laure Droy-Dupré, Christelle Volteau, Arnaud Bourreille, Guillaume Meurette, Jean-François Mosnier, Christian L Laboisse
In Crohn's disease (CD), hierarchical architecture of the inflammatory network, including subordination of IL-18, an IFN-γ-inducing cytokine, to the inflammasome, have remained undeciphered. Heterogeneity among patients of such a subordination cannot be evaluated by animal models, monofactorial in their etiology and homogenous in disease progression. To address these issues, we set up an ex vivo model of inflamed mucosa explant cultures from patients with active long-standing CD. Th1 cytokine production, especially IFN-γ and IL-18, was assessed in relation with inflammation intensity...
October 2015: Laboratory Investigation; a Journal of Technical Methods and Pathology
Jacqueline Sammut, Josianne Scerri, Rita Borg Xuereb
AIMS AND OBJECTIVES: The purpose of this study was to explore the experiences of adults living with ulcerative colitis. BACKGROUND: Research to date has focused on the impact of inflammatory bowel disease, by analysing the responses of persons with ulcerative colitis and Crohn's disease collectively. This article addresses the dearth in literature by exploring the experiences of adults living with ulcerative colitis. DESIGN: An exploratory qualitative phenomenological design was used...
September 2015: Journal of Clinical Nursing
Judy Nee, Joseph D Feuerstein
Inflammatory bowel disease (IBD) including both ulcerative colitis and Crohn's disease is increasing worldwide. Although diagnosis is equally found in men and women, the chronicity of IBD poses a unique impact on the milestones of a woman's life. As the gastroenterologist becomes increasingly important in the health maintenance of patients with IBD, this review stresses the unique gender issues in women with IBD related to menstruation, cervical cancer, sexual health, contraception, and menopause that may affect the course of disease, treatment decisions, and quality of life...
2015: Gastroenterology Research and Practice
Sasha Taleban
Among inflammatory bowel disease (IBD) patients, 4-12 % is diagnosed after the age of 60. Both the rates of elderly and IBD are increasing worldwide. In older patients, the diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) is made more difficult due to polypharmacy and multimorbidity along with disease processes that mimic IBD. The clinical presentation in older-onset IBD differs from younger patients, and there is minimal disease progression over time. The management of the older IBD patient involves a combination of medical and surgical strategies...
September 2015: Current Treatment Options in Gastroenterology
Rieke Alten, Bruce N Cronstein
OBJECTIVES: Discuss issues regarding clinical trial design for the development of biosimilars in the European Union and the United States, with special focus on monoclonal antibodies used in the treatment of inflammatory diseases. METHODS: A search of the Internet as well as PubMed was conducted through June 2014 for information related to the clinical development of biosimilars using the keywords biosimilar, rheumatoid arthritis, juvenile idiopathic arthritis, psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis, and ankylosing spondylitis...
June 2015: Seminars in Arthritis and Rheumatism
Valderílio Feijó Azevedo, Eduardo de Souza Meirelles, Jussara de Almeida Lima Kochen, Ana Cristina Medeiros, Sender J Miszputen, Fábio Vieira Teixeira, Adérson Osmar Mourão Cintra Damião, Paulo Gustavo Kotze, Ricardo Romiti, Marcelo Arnone, Renata Ferreira Magalhães, Cláudia Pires Amaral Maia, André Vicente E de Carvalho
The Brazilian Societies of Rheumatology (SBR) and Dermatology (SBD), the Brazilian Federation of Gastroenterology (FBG) and the Brazilian Study Group on Inflammatory Bowel Disease (GEDIIB) gathered a group of their respective specialists on the topic of interest to discuss the most relevant issues regarding the clinical use of biosimilar medicines in Brazil. The main aim of that meeting was to prepare a document with recommendations to guide medical specialists and to help the national regulatory and policy-making agencies as concerns the authorization for marketing biosimilars used in autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, juvenile idiopathic arthritis and ulcerative colitis...
September 2015: Autoimmunity Reviews
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