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Crohns antibiotic treatment

Yu Qi Qiao, Chen Wen Cai, Zhi Hua Ran
Inflammatory bowel disease (IBD) patients exhibit impaired control of the microbiome in the gut. "Dysbiosis" is commonly observed. A Western diet is a risk factor for the development of IBD but may have different effects on the gut microbiota in IBD and non-IBD individuals. Exclusive enteral nutrition (EEN) can induce remission in pediatric Crohn's disease (CD) with a decrease in gut microbiome diversity after EEN treatment. Although there are some theoretical benefits, the actual treatment effects of prebiotics and probiotics in IBD patients can vary...
October 15, 2016: Journal of Digestive Diseases
Ahmad Qasem, Mitra Safavikhasraghi, Saleh A Naser
BACKGROUND: Most recently we reported that RHB‑104 triple antibiotics combination in culture is bactericidal and should be effective for treatment of Crohn's disease (CD)-associated with Mycobacterium avium subspecies paratuberculosis (MAP) (Alcedo et al. in Gut Pathog 14:32, 2016). The combination exhibited unique synergistic antimicrobial growth activity. The proprietary RHB-104 capsule formulation contains active ingredients (63.3 % Clarithromycin (CLA), 6.7 % Clofazimine (CLO) and 30 % Rifabutin (RIF))...
2016: Gut Pathogens
Mei-Sing Ong, Richard J Grand, Kenneth D Mandl
BACKGROUND: Prophylactic treatment of postoperative Crohn's disease (CD) plays a critical role in maintaining clinical remission. We performed the first study in the last decade to examine secular trends in the use of pharmacologic interventions after ileocolonic resection in the United States, to understand whether clinical practice converges with recent advances in scientific knowledge. METHODS: A retrospective study of a U.S. national claims database was performed...
October 2016: Inflammatory Bowel Diseases
Antonella Gallo, Giovanna Passaro, Antonio Gasbarrini, Raffaele Landolfi, Massimo Montalto
Alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. There is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). To summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, PubMed was searched using terms microbiota, intestinal flora, probiotics, prebiotics, fecal transplantation...
August 28, 2016: World Journal of Gastroenterology: WJG
Xutao Lin, Dejun Fan, Zerong Cai, Lei Lian, Xiaowen He, Min Zhi, Xiaojian Wu, Xiaosheng He, Ping Lan
Anal fistula is common in patients with Crohn's disease (CD) and leads to significant morbidity. The efficacy of seton drainage combined with anti-tumor necrosis factor-α monoclonal antibody (anti-TNF-α) or immunosuppressant in the treatment of CD-related anal fistula remains unclear. The aim of the present study was to compare the efficacy between seton drainage combined with anti-TNF-α and seton drainage combined with immunosuppressant postoperatively on the treatment of CD-related anal fistula. A total of 65 patients with CD-related anal fistula who had received seton drainage combined with postoperative medication were divided into an antibiotics only group, anti-TNF-α group and immunosuppressant group; all patients were treated with antibiotics...
September 2016: Experimental and Therapeutic Medicine
Ting Zhang, Qian-Yun Lin, Jia-Xi Fei, Yan Zhang, Min-Yi Lin, Shuang-Hong Jiang, Pu Wang, Ye Chen
The prevalence of Clostridium difficile infection (CDI) in patients suffering from inflammatory bowel disease (IBD) has increased rapidly over the past several decades in North America and Europe. However, the exact global epidemiology remains unclear because of insufficient data from developing countries. A total of 646 hospitalized adult IBD patients were enrolled; and their fresh stool specimens were obtained and used for Clostridium difficile detection. The incidence of CDI in Crohn's disease (CD) patients (12...
2016: Scientific Reports
Simon Peter Wespi, Remus Frei, Michael Christian Sulz
Oesophageal involvement in Crohn's disease (CD) is uncommon and most often accompanied by involvement of more distal parts. Its presentation is mostly non-specific, and therefore a diagnosis, especially in isolated oesophageal disease, is difficult. We present the case of a 42-year-old male patient who was referred to our gastroenterology department because of a para-oesophageal abscess. Under antibiotic treatment the abscess healed, but despite great diagnostic efforts, its aetiology remained unclear. Three years later the patient was hospitalized again because of an abscess at the same site...
January 2016: Case Reports in Gastroenterology
Elizabeth S John, Kristina Katz, Mark Saxena, Sita Chokhavatia, Seymour Katz
A substantial and growing proportion of patients with inflammatory bowel disease (IBD) are elderly, and these patients require tailored treatment strategies. However, significant challenges exist in the management of this population due to the paucity of data. Establishing the initial diagnosis and assessing the etiology of future symptoms and flares can be challenging as several other prevalent diseases can masquerade as IBD, such as ischemic colitis, diverticular disease, and infectious colitis. Important pharmacologic considerations include reduced glomerular filtration rate and drug-drug interactions in the elderly...
September 2016: Current Treatment Options in Gastroenterology
Karel P Alcedo, Saisathya Thanigachalam, Saleh A Naser
BACKGROUND: Mycobacterium avium subspecies paratuberculosis (MAP) has been implicated as an etiological agent of Crohn's disease (CD), a debilitating chronic inflammatory bowel disease. Clarithromycin (CLA), clofazimine (CLO), rifabutin (RIF) and other antibiotics have been used individually or in combinations with other drugs to treat mycobacterial diseases including CD. The treatment has varied by regimen, dosage, and duration, resulting in conflicting outcomes and additional suffering to the patients...
2016: Gut Pathogens
Parambir S Dulai, Siddharth Singh, Xiaoqian Jiang, Farhad Peerani, Neeraj Narula, Khadija Chaudrey, Diana Whitehead, David Hudesman, Dana Lukin, Arun Swaminath, Eugenia Shmidt, Shuang Wang, Brigid S Boland, John T Chang, Sunanda Kane, Corey A Siegel, Edward V Loftus, William J Sandborn, Bruce E Sands, Jean-Frederic Colombel
OBJECTIVES: We assessed the real-world effectiveness and safety of vedolizumab (VDZ) in moderate-severe Crohn's disease (CD). METHODS: Retrospective cohort study of seven medical centers, from May 2014 to December 2015. Adults with moderate-severe CD treated with VDZ, with follow-up after initiation of therapy, were included. Using the multivariable Cox proportional hazard analyses, we identified independent predictors of clinical remission or mucosal healing with VDZ...
August 2016: American Journal of Gastroenterology
K Chandra Mouli, D Pragathi, U Naga Jyothi, V Shanmuga Kumar, M Himalaya Naik, P Balananda, B Suman, V Seshadri Reddy, T Vijaya
Treatment of obesity and its associated immune mediated diseases is challenging due to impaired function of leptin system. Thus leptin is providing an interesting target for therapeutic intervention. Leptin, an adipose tissue-derived adipokine, displays a variety of immune functions, and regulate both innate and adaptive immune responses. The increased secretion of leptin (hyperleptinemia) and production of proinflammatory cytokines has been implicated in the pathogenesis of obesity-related immune diseases such as diabetes mellitus, hypertension, atherosclerosis, cancer, systemic lupus erythematosus, rheumatoid arthritis, crohn's disease and multiple sclerosis...
July 2016: Medical Hypotheses
B T Welch, N Coelho Prabhu, L Walkoff, S W Trenkner
CLINICAL BACKGROUND: A 71 year old male with 50 year history of Crohn's disease was evaluated for acute onset fogginess, dizziness, and slurred speech. Blood ethanol levels were elevated despite abstinence from alcohol for over thirty years. CT enterography demonstrated massive dilation of the small bowel with anastomotic stricture. DISCUSSION: Auto-brewery syndrome may be considered in a patient with chronic obstruction or hypomotility presenting with elevated serum ethanol levels in the setting of high carbohydrate intake...
May 9, 2016: Journal of Crohn's & Colitis
Paul Moayyedi
PURPOSE OF REVIEW: Fecal microbiota transplant (FMT) has emerged as an important treatment for antibiotic resistant or recurrent Clostridium difficile infection. There has been a great deal of media coverage of the efficacy of FMT, and patients with inflammatory bowel disease (IBD) understandably wonder if this approach would also work for them. There are also instructions on 'do it yourself' FMT therapy on the web. It is important to understand whether there is evidence that this approach is effective in IBD so that we can advise our patients appropriately...
July 2016: Current Opinion in Gastroenterology
Akio Hayashi, Yoshiyuki Susaki, Naoko Ose, Yukiyasu Takeuchi, Hajime Maeda
A colopleural fistula is a rare condition reported to be caused by Crohn's disease, a malignant tumor of the gastrointestinal tract, and other clinical conditions. Some studies have noted that a sub-diaphragmatic abscess, usually organized following abdominal surgery, may play some role in the formation of this type of fistula. Therefore, a colopleural fistula is a complication very rarely encountered by thoracic surgeons after lung resection.We experienced an extremely rare case of colopleural fistula following a left lower lobectomy for lung aspergillosis...
December 2016: Surgical Case Reports
Petr Hrabák, Pavel Hrabák, Markéta Štajnerova, Aleš Novotný, Karel Lukáš
Crohns disease and ulcerative colitis has affected people for many centuries however its incidence most likely used to be very low. The knowledge of the idiopathic intestinal inflammation at that time was also very limited - an interest about the disease has emerged since the second half of 19th century. Despite all the progress in medicine its etiology still remains unclear.Diagnosis had for a long been based only on clinical investigation and later radiography, endoscopy came in to use in the 1970s. First significant advances in therapy came during the 1940s and 1950s with the invention of aminosalicylates, antibiotics and corticoids...
2016: Casopís Lékar̆ů C̆eských
Suk-Bae Moon
A sinus between the colon and a retroperitoneal abscess is a rare entity that usually occurs as a complication of a primary condition such as Crohn's disease, radiation enteritis, or diverticular disease. Herein, we report a 72-year-old woman with a retroperitoneal abscess and a sinus formation between the abscess and the colon after an iatrogenic injury to her left colon. The retroperitoneal abscess was detected 1 week after the patient had undergone a left nephroureterectomy for recurrent ureteral cancer...
April 4, 2016: International Surgery
Jee Hye Kwon, Jong Pil Im, Byong Duk Ye, Jae Hee Cheon, Hyun Joo Jang, Kang Moon Lee, You Sun Kim, Sang Wook Kim, Young Ho Kim, Geun Am Song, Dong Soo Han, Won Ho Kim, Joo Sung Kim
BACKGROUND/AIMS: C-reactive protein (CRP) is an easily measured index of disease activity, but its ability to predict clinical course is controversial. We therefore designed a study to determine whether the CRP level at Crohn's disease (CD) diagnosis is a valuable indicator of the disease phenotype, activity, and clinical course. METHODS: We retrospectively analyzed 705 CD patients from 32 institutions. The patients were classified into two groups according to CRP level...
July 15, 2016: Gut and Liver
Richard N Fedorak, Kathleen P Ismond
The inflammatory bowel diseases, Crohn's and ulcerative colitis, have been treated with a range of antibiotics for inducing and maintaining remission, as well as the prevention of post-operative symptoms. To date, many studies have been performed assessing the efficacy of antibiotics when used alone, in combination with other antibiotics, or as an adjunctive therapy to other pharmaceutical treatments. Literature evidence supporting the use of antibiotics in IBD can be ambiguous, especially when considering the potential role of dysbiosis in the gastrointestinal tract...
2016: Digestive Diseases
Geeta Shroff
BACKGROUND: Crohn's disease is a chronic inflammatory disease of the intestines, mainly the colon and ileum, related with ulcers and fistulae. It is estimated to affect 565,000 people in the United States. Currently available therapies, such as antibiotics, thiopurines, and anti-tumor necrosis factor-alpha agents, are only observed to reduce the complications associated with Crohn's disease and to improve quality of life, but cannot cure the disease. Stem cell therapy appears to have certain advantages over conventional therapies...
2016: American Journal of Case Reports
Laura R Marks, Hema Dodd, Thomas A Russo, Charles S Berenson
Burkholderia ginsengisoli is a non-pathogenic Gram-negative bacterium that ordinarily serves as a plant endosymbiont. We report the first case of human infection with B. ginsengisoli presenting as bacteraemia in a young man with severe Crohn's disease. Definitive identification of the pathogen could not be accomplished with conventional techniques and required DNA sequencing. The bacteraemia may have been related to ingestion of organic vegetables and compromised gastrointestinal mucosa, coupled with treatment with tumour necrosis factor α inhibitors...
2016: BMJ Case Reports
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