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By Jeff Bank Internal Medicine R2 at the University of Utah
Jordan E Axelrad, Ola Olén, Johan Askling, Benjamin Lebwohl, Hamed Khalili, Michael C Sachs, Jonas F Ludvigsson
BACKGROUND & AIMS: Gastrointestinal infections have been associated with later development of inflammatory bowel diseases (IBD). However, studies have produced conflicting results. We performed a nationwide case-control study in Sweden to determine whether gastroenteritis is associated with the development of Crohn's disease (CD) or ulcerative colitis (UC). METHODS: Using the Swedish National Patient Register, we identified 44,214 patients with IBD (26,450 with UC; 13,387 with CD; and 4,377 with IBD-unclassified) from 2002 to 2014 and matched them with 436,507 individuals in the general population (controls)...
October 30, 2018: Clinical Gastroenterology and Hepatology
Bo Shen, Gursimran Kochhar, Udayakumar Navaneethan, Xiuli Liu, Francis A Farraye, Yago Gonzalez Lama, David Bruining, Darrell S Pardi, Martin Lukas, Martin Bortlik, Kaicun Wu, Ajit Sood, David A Schwartz, William J Sandborn
Interventional (or therapeutic) inflammatory bowel disease (IBD) endoscopy has an expanding role in the treatment of disease and surgical adverse events. Endoscopic therapy has been explored and used in the management of strictures, fistulas/abscesses, colitis-associated neoplasia, post-surgical acute or chronic leaks, and obstructions. The endoscopic therapeutic modalities include balloon dilation, stricturotomy, stent placement, fistulotomy, fistula injection and clipping, sinusotomy, endoscopic mucosal resection, and endoscopic submucosal dissection...
October 23, 2018: Gastrointestinal Endoscopy
Tsuyoshi Ozawa, Soichiro Ishihara, Mitsuhiro Fujishiro, Hiroaki Saito, Youichi Kumagai, Satoki Shichijo, Kazuharu Aoyama, Tomohiro Tada
BACKGROUND AND AIMS: Evaluation of endoscopic disease activity for patients with ulcerative colitis (UC) is important when determining the treatment of choice. However, endoscopists require a certain period of training to evaluate the activity of inflammation properly, and interobserver variability exists. Therefore, we constructed a computer-assisted diagnosis (CAD) system using a convolutional neural network (CNN) and evaluated its performance using a large data set of endoscopic images from patients with UC...
October 24, 2018: Gastrointestinal Endoscopy
Eric J Mao, Uma Mahadevan
Data in support of the safety of biologic use during pregnancy continues to grow. Utilizing a national French database with linkage between mothers and children, Luu et al. demonstrated that anti-tumor necrosis factor (anti-TNF) therapy exposure did not increase infection risk in children, though the mothers had higher rates of infection. Stopping therapy prior to 24 weeks gestation led to a higher rate of disease flares in the mother with no benefit to the infant compared to continued therapy.
October 18, 2018: American Journal of Gastroenterology
Clayton M Spiceland, Nilesh Lodhia
Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel disease (IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Furthermore, chromoendoscopy has enhanced our ability to detect dysplasia in IBD. In this review article, we will focus on the roles, indications, and limitations of these tools in IBD...
September 21, 2018: World Journal of Gastroenterology: WJG
Nabeel Khan, Chinmay Trivedi, Himanshu Kavani, Elina Medvedeva, James Lewis, Yu-Xiao Yang
BACKGROUND & AIMS: The risk of herpes zoster virus infection is increased among patients with inflammatory bowel diseases (IBD). The herpes zoster vaccine (HZV) is therefore recommended for these patients, but little is known about its effectiveness, resulting in low use. METHODS: We conducted a retrospective cohort study using data from the national veterans Affairs Healthcare System (VAHS) from January 1, 2000 through June 30, 2016. We collected data from 39,983 veterans with IBD who had not received the HZV by an age of 60 years...
October 13, 2018: Clinical Gastroenterology and Hepatology
Takahide Shinagawa, Keisuke Hata, Teppei Morikawa, Hirotoshi Takiyama, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Masashi Fukayama, Hiroaki Nozawa
BACKGROUND AND AIMS: The appropriate site for targeted biopsy during surveillance colonoscopy for ulcerative colitis (UC) is still unclear. We aimed to clarify key endoscopic findings suggestive of neoplastic lesions for targeted biopsy in UC. METHODS: First, we created 769 stereomicroscopic pictures (509 neoplastic, 260 non-neoplastic) mimicking magnifying colonoscopic images from surgically resected specimens, including areas surrounding 25 neoplastic lesions in 15 patients with colitis-associated cancer at a single referral center...
October 13, 2018: Gastrointestinal Endoscopy
Christopher Alexakis, Sonia Saxena, Vivek Chhaya, Elizabeth Cecil, Azeem Majeed, Richard Pollok
BACKGROUND: The impact of smoking at diagnosis and subsequent smoking cessation on clinical outcomes in Crohn's disease (CD) has not been evaluated in a population-based cohort. METHODS: Using a nationally representative clinical research database, we identified incident cases of CD between 2005 and 2014. We compared the following outcomes: overall corticosteroid (CS) use; flares requiring CS; CS dependency and intestinal surgery between smokers and non-smokers at time of CD diagnosis...
October 15, 2018: American Journal of Gastroenterology
Pauline Rivière, Séverine Vermeire, Marie Irles-Depe, Gert Van Assche, Paul Rutgeerts, Anthony de Buck van Overstraeten, Quentin Denost, Albert Wolthuis, Andre D'Hoore, David Laharie, Marc Ferrante
No abstract text is available yet for this article.
October 3, 2018: Clinical Gastroenterology and Hepatology
Corey A Siegel
Medications are available that can be highly effective for the treatment of inflammatory bowel disease (IBD). However, there are multiple barriers in place to offer these treatments to the right patients at the right time. In addition to obstacles created by payers, there are concerns over medication side effects by patients and providers, and the logistic challenges of navigating the maze of initiating someone on biological therapy. As a gastroenterology community, we need to push the field forward for the sake of our patients...
October 2018: American Journal of Gastroenterology
Livia Lindoso, Kajari Mondal, Suresh Venkateswaran, Hari K Somineni, Cortney Ballengee, Thomas D Walters, Anne Griffiths, Joshua D Noe, Wallace Crandall, Scott Snapper, Shervin Rabizadeh, Joel R Rosh, Neal LeLeiko, Stephen Guthery, David Mack, Richard Kellermayer, Ajay S Gulati, Marian D Pfefferkorn, Dedrick E Moulton, David Keljo, Stanley Cohen, Maria Oliva-Hemker, Melvin B Heyman, Anthony Otley, Susan S Baker, Jonathan S Evans, Barbara S Kirschner, Ashish S Patel, David Ziring, Michael C Stephens, Robert Baldassano, Marla C Dubinsky, James Markowitz, Lee A Denson, Jeffrey Hyams, Subra Kugathasan, Ashwin N Ananthakrishnan
OBJECTIVES: Environmental factors play an important role in the pathogenesis of Crohn's Disease (CD). In particular, by virtue of the instability of the microbiome and development of immunologic tolerance, early life factors may exert the strongest influence on disease risk and phenotype. METHODS: We used data from 1119 CD subjects recruited from RISK inception cohort to examine the impact of early life environment on disease progression. Our primary exposures of interest were breastfeeding in infancy and exposure to maternal, active, or passive smoke...
October 2018: American Journal of Gastroenterology
Siew C Ng, Gilaad G Kaplan, Whitney Tang, Rupa Banerjee, Bhargavi Adigopula, Fox E Underwood, Divine Tanyingoh, Shu-Chen Wei, Wei-Chen Lin, Hung-Hsin Lin, Jin Li, Sally Bell, Olga Niewiadomski, Michael A Kamm, Zhirong Zeng, Minhu Chen, Pinjin Hu, David Ong, Choon Jin Ooi, Khoon-Lin Ling, Yinglei Miao, Jiarong Miao, H Janaka de Silva, Madunil Niriella, Satimai Aniwan, Julajak Limsrivilai, Pises Pisespongsa, Kaichun Wu, Hong Yang, Ka Kei Ng, Hon Ho Yu, Yufang Wang, Qin Ouyang, Murdani Abdullah, Marcellus Simadibrata, Jeffri Gunawan, Ida Hilmi, Khean Lee Goh, Qian Cao, Hong Sheng, Arlinking Ong-Go, Vui Heng Chong, Jessica Y L Ching, Justin C Y Wu, Francis K L Chan, Joseph J Y Sung
INTRODUCTION: Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region. METHODS: Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model...
September 3, 2018: American Journal of Gastroenterology
Freddy Caldera, Francis A Farraye, Sunanda Kane
No abstract text is available yet for this article.
August 25, 2018: Clinical Gastroenterology and Hepatology
Rish K Pai, Vipul Jairath, Niels Vande Casteele, Florian Rieder, Claire E Parker, Gregory Y Lauwers
BACKGROUND AND AIMS: Assessment of disease activity is essential for developing and determining appropriate therapy in patients with ulcerative colitis (UC). Validated clinical and endoscopic scoring systems have been established to accurately define disease activity. Clinical and endoscopic treatment targets have also been proposed, with gastroenterologists encouraged to optimize medical therapy to achieve these targets. Recently, histology has been recognized as an important prognostic factor and potential treatment target in patients with UC...
August 22, 2018: Gastrointestinal Endoscopy
Gil Y Melmed, Marla C Dubinsky, David T Rubin, Mark Fleisher, Shabana F Pasha, Atsushi Sakuraba, Felix Tiongco, Ira Shafran, Ignacio Fernandez-Urien, Bruno Rosa, Neofytos P Papageorgiou, Jonathan A Leighton
BACKGROUND AND AIMS: This prospective, multicenter study evaluated small-bowel capsule endoscopy (CE) for the longitudinal assessment of mucosal inflammation in subjects with Crohn's disease (CD). METHODS: Subjects with known CD underwent clinical evaluation with ileocolonoscopy and CE at baseline and 6-month follow-up. Small-bowel patency was confirmed before CE at both time points. The Simple Endoscopic Score for CD (SES-CD) was used for ileocolonoscopy, and the Lewis score and the CE CD Endoscopic Index of Severity (CECDEIS) were used for CE...
August 4, 2018: Gastrointestinal Endoscopy
Catalina Berenblum
No abstract text is available yet for this article.
July 23, 2018: American Journal of Gastroenterology
Jordan E Axelrad, Andrew Joelson, Peter H R Green, Garrett Lawlor, Simon Lichtiger, Ken Cadwell, Benjamin Lebwohl
OBJECTIVES: Few studies have examined the role of non-Clostridium difficile enteric infections in flares of inflammatory bowel disease (IBD). Our objective was to investigate enteric infection detected by multiplex PCR stool testing in patients with IBD. METHODS: We performed a cross-sectional analysis of 9403 patients who underwent 13,231 stool tests with a gastrointestinal pathogen PCR panel during a diarrheal illness from March 2015 to May 2017. Our primary outcome was the presence of an infection...
October 2018: American Journal of Gastroenterology
Hai Yun Shi, Siew Chien Ng
Crohn's disease (CD) is a chronic, progressive, and destructive disease of the gastrointestinal tract. Although its incidence appears to be stable or decreasing in most countries in the North America and Europe, the incidence is rising rapidly in Asian countries. Immunomodulators and biologics are increasingly used to avoid long-term bowel damage and subsequent disability. Therapeutic drug monitoring facilitates optimizing thiopurines and anti-TNFs use. New biologic agents targeting various pathological pathways of CD are blooming in recent years, and the high cost of biologics and expiration of patents for several biologic agents have driven the utility of biosimilars for CD treatment...
September 2018: Journal of Gastroenterology
Kaci Christian, Raymond K Cross
No abstract text is available yet for this article.
July 20, 2018: Clinical Gastroenterology and Hepatology
Laurent Beaugerie, Julien Kirchgesner
Inflammatory bowel diseases (IBD) and their treatments, particularly immunosuppressive drugs, increase risk of infections and cancers. However, by promoting mucosal healing, these agents should reduce risks of infections related to intestinal lesions, malnutrition, intravenous devices, and IBD surgeries and reduce risk of cancers associated with chronic mucosal inflammation-although there are few data to support this concept. Corticosteroids increase the risk of vascular thromboembolic events, yet other immunosuppressive drugs that induce deep remission from IBD could decrease the incidence of cardiovascular events attributable to systemic inflammation and IBD-related hospitalizations and/or surgeries...
July 18, 2018: Clinical Gastroenterology and Hepatology
2018-07-23 20:33:25
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