Pharmabiotics and Inflammatory Bowel Disease - On the Verge of Evidence-based Medicine

2008 ◽  
pp. 144-153
Author(s):  
Fergus Shanahan ◽  
Jude Ryan ◽  
Shomik Sibartie
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Inflammatory Bowel ◽  
Based Medicine

Faecal Calprotectin as an evidence-based medicine biomarker of inflammatory bowel disease

2019 ◽  
Vol 493 ◽  
pp. S509
Author(s):  
M.A. Caro Miró ◽  
S. Gómez Vera ◽  
L. Herranz Arriero ◽  
J.J. Morales Lomas
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Faecal Calprotectin ◽  
Inflammatory Bowel ◽  
Based Medicine

scholarly journals Types of colorectal cancer and dysplasia associated with inflammatory bowel disease

2022 ◽  
Author(s):  
Hisham Abdullah Almottowa ◽  
Abdulmohsen Yaseer Alkhars ◽  
Maram Hussam Hassan ◽  
Hamad Adel Alhamad ◽  
Saad Munawwikh Alshammari ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Diagnostic Procedures ◽  
Intestinal Wall ◽  
Management Algorithm ◽  
Online Databases ◽  
Major Development ◽  
Histological Characteristics ◽  
Inflammatory Bowel ◽  
Based Medicine

Ulcerative colitis (UC) and Crohn’s disease (CD) are two major inflammatory disorders of the intestinal wall collectively known as inflammatory bowel disease (IBD). Colorectal carcinoma (CRC) is the most significant and grave consequence of IBD and is preceded by dysplasia in majority of the cases. In this review we aim to discuss the various types of dysplasia found in patients with CRC due to IBD. A thorough literature search was conducted in online databases such as PubMed, Google Scholar, from which all studies published in the last ten years were included in this review. The major development in diagnostic procedures and visualization modalities have aided our understanding of dysplasia, which is now known to be the strongest predictor and marker for CRC development. However, the unpredictable behavior and progression of dysplasia still warrants vigilant surveillance. Dysplasia has been classified on histological characteristics using grades of dysplasia from ‘negative for dysplasia’ to ‘high grade dysplasia’. On visibility via an endoscope from ‘visible dysplasia’ to ‘invisible dysplasia’ and macroscopic features of ‘conventional dysplasia’ and ‘non-conventional dysplasia’. No single classification can be utilized to define the stage of dysplasia and more importantly predict its progression and outcome of CRC. Using evidence-based medicine an integrated classification expanding on a management algorithm must be formulated by a panel of experts to steer management of the disease. A multidisciplinary, tailored approach with a strong emphasis on regular and timely surveillance to ensure early detection of CRC can enhance quality of life and patient outcomes.

An Evidence-Based Systematic Review on Medical Therapies for Inflammatory Bowel Disease

2011 ◽  
Vol 106 ◽  
pp. S2-S25 ◽  
Author(s):  
Nicholas J Talley ◽  
Maria T Abreu ◽  
Jean-Paul Achkar ◽  
Charles N Bernstein ◽  
Marla C Dubinsky ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Evidence Based ◽  
Inflammatory Bowel ◽  
Medical Therapies

Developing a web-based self-management intervention for symptoms of fatigue, pain and urgency in Inflammatory Bowel Disease (Preprint)

2021 ◽  
Author(s):  
Louise Sweeney ◽  
Sula Windgassen ◽  
Micol Artom ◽  
Christine Norton ◽  
Sophie Fawson ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Self Management ◽  
Delivery Mode ◽  
Evidence Based ◽  
Management Intervention ◽  
Emotional Factors ◽  
Digital Intervention ◽  
Cognitive Behavioural ◽  
Inflammatory Bowel

BACKGROUND Empirical studies and systematic reviews demonstrate the role of biological, cognitive, behavioural and emotional factors in fatigue, pain and urgency in inflammatory bowel disease (IBD). Behavioural management that addresses the cognitive, behavioural and emotional factors, that is offered alongside medical treatments is seldom available to people with IBD. Digital interventions provide a potentially scalable and cost-effective way of providing behavioural support to patients. OBJECTIVE This paper aims to describe the process of developing a supported digital self-management intervention for fatigue, pain and urgency in IBD using theory, evidence-based approaches and stakeholder input. METHODS The Medical Research Council framework for complex health interventions and the Person-Based Approach were used to guide intervention development consulting with 87 IBD patients and 60 nurses. These frameworks informed the selection and use of a theoretical model, which subsequently guided cognitive behaviourally-based intervention content. They also guided the design of tailored digital intervention pathways for individuals with IBD, matched to predominant symptoms. RESULTS A trans-symptomatic cognitive behavioural framework of symptom perpetuation was developed for the symptoms of fatigue, pain and urgency in IBD. A logic model was used to define intervention techniques. Patient feedback and qualitative interviews refined website content and functionalities, including use of visual aids, email reminders and graphical tracking of symptoms. Nurse focus groups informed the volume and delivery mode of therapist ‘facilitator’-support. Feasibility testing with 31 patients demonstrated accessibility (scoring 9.43/10), ease (scoring 8.07/10), clarity and relevant tone of the intervention. The final intervention consisted of 12 online sessions (8 core and 4 symptom-specific) with one 30-minute facilitator phone call following Session 1 and subsequent in-site messaging. CONCLUSIONS Use of theory and integration of stakeholders’ views throughout informed development of an evidence-based digital intervention for fatigue, pain and urgency in IBD. This is the first online self-management intervention designed to address these multiple symptoms with the aim of improving quality of life and reducing symptom burden in IBD. The intervention is being tested in a large multi-centre randomised controlled trial.

scholarly journals DOP082 Identified areas of need to enhance evidence-based inflammatory bowel disease management and patient care

2014 ◽  
Vol 8 ◽  
pp. S54-S55
Author(s):  
G. D'Haens ◽  
B.L. Bressler ◽  
S. Danese ◽  
P.R. Gibson ◽  
S.B. Hanauer ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Management ◽  
Patient Care ◽  
Bowel Disease ◽  
Evidence Based ◽  
Inflammatory Bowel

scholarly journals Utilization of an Electronic Medical Record–integrated Dashboard Improves Identification and Treatment of Anemia and Iron Deficiency in Pediatric Inflammatory Bowel Disease

2020 ◽  
Author(s):  
Jessica Breton ◽  
Char M Witmer ◽  
Yuchen Zhang ◽  
Maura Downing ◽  
Jamie Stevenson ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Quality Improvement ◽  
Iron Deficiency ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Bowel Disease ◽  
Care Pathway ◽  
Evidence Based ◽  
Inflammatory Bowel ◽  
Evidence Based Care

Abstract Background Iron deficiency (ID) and anemia are one of the most common extraintestinal manifestations of inflammatory bowel disease (IBD), usually complicating the course both in ulcerative colitis and Crohn’s disease. Despite their high prevalence and significant impact on patients, this particular aspect is still underestimated by clinicians. Although guidelines have been recently published to address this problem, these recommendations do not address pediatric specific concerns and do not provide guidance as to how implement these guidelines in clinical practice. The aims of this quality improvement (QI) initiative were to improve the rates of detection and treatment of anemia in children with IBD. Methods After the creation of a multidisciplinary team of skateholders in IBD and anemia, we launched a multifaceted QI strategy that included the development of a pediatric evidence-based care pathway, utilization of an electronic medical record (EMR)-integrated dashboard to track patients, and generation of an automated provider-based monthly report. Data were collected and graphed into statistical process control charts. Results These key strategies resulted in improved rates of ID screening from 31.7% to 63.6%, in increased treatment rates from 38.2% to 49.9%, and in decreased prevalence of anemia from 35.8% to 29.7%, which was reflected by a greater decline in patients with quiescent disease. Conclusions Quality improvement strategies incorporating the creation of a pediatric evidence-based care pathway with an EMR-supported electronic dashboard were the foundation of a successful intervention in the management of ID and anemia in pediatric IBD. Our positive results demonstrate the potential of QI initiatives using automated technology to assist clinicians in their commitment to provide evidence-based IBD care and enhance patient outcomes.

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