Chronic Inflammatory Bowel Disease, Ulcerative Colitis, Crohn’s Disease and Colorectal Cancer

2004 ◽  
pp. 301-333
Author(s):  
Norma Whittaker
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Chronic Inflammatory Bowel Disease ◽  
Inflammatory Bowel ◽  
Chronic Inflammatory Bowel

scholarly journals Cancer Risk in Inflammatory Bowel Disease

1995 ◽  
Vol 9 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Anders M Ekbom
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Colonic Involvement ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Risk Of Cancer

There is an increased risk of cancer in both ulcerative colitis and Crohn's disease. In 3121 patients with ulcerative colitis, 225 cases of cancer were diagnosed compared with 142.1 expected (standardized incidence ratio [SIR] 1.6, 95% CI 1.4 to 1.8), and in 1655 patients with Crohn's disease, 58 cases of cancer were detected compared with 47.1 expected (SIR 1.2, 95% CI 0.9 to 1.6). After excluding colorectal cancer the observed number of malignancies was very close to that expected for ulcerative colitis (SIR 1.0, 95% CI 0.9 to 1.2) and for Crohn's disease (SIR 1.1, 95% CI 0.8 to 1.5). Thus, the increased risk of cancer in inflammatory bowel disease is confined to colorectal cancer. In Crohn's disease 12 cases of colorectal cancer were observed (SIR 2.5, 95% CI 1.3 to 4.3). The increased risk was confined to those with colonic involvement and young age at diagnosis. In patients with colonic involvement and younger than age 30 years at diagnosis, the SIR was 20.9 (95% CI 6.8 to 48.7) versus 2.2 for those older than 30 years at diagnosis (95% CI 0.6 to 5.7). In ulcerative colitis 91 cases of colorectal cancer were observed with an SIR of 5.7 (95% CI 4.6 to 7.0). Extensive disease and young age at diagnosis were independent risk factors. Pancolitis at diagnosis resulted in an SIR of 14.8 (95% CI 11.4 to 18.9), 2.8 in left-sided colitis (95% CI 1.6 to 4.4) and 1.7 in proctitis (95% CI 0.8 to 3.2). There is great variation in the risk estimates in different studies worldwide. Different treatment strategies could be an explanation, a hypothesis that was substantiated in a study of 102 cases of colorectal cancer among patients with ulcerative colitis compared with 196 controls. Pharmacological therapy with sulfasalazine entailed a strong protective effect against colorectal cancer (relative risk of 0.34, 95% CI 0.190 to 0.62).

scholarly journals Crohn’s-like reaction in diverticular disease

Gut ◽  
1998 ◽  
Vol 42 (3) ◽  
pp. 392-395 ◽  
Author(s):  
A Gledhill ◽  
M F Dixon
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Chronic Inflammatory Bowel Disease ◽  
Older Individuals ◽  
Histological Features ◽  
Inflammatory Bowel ◽  
Inflammatory Changes ◽  
Chronic Inflammatory Bowel

Background—Diverticulitis and Crohn’s disease affecting the colon occur at similar sites in older individuals, and in combination are said to carry a worse prognosis than either disease in isolation. It is possible that diverticulitis may initiate inflammatory changes which resemble Crohn’s disease histologically, but do not carry the clinical implications of chronic inflammatory bowel disease.Aims—To evaluate histological features and clinical outcome in individuals initially diagnosed histologically as having both Crohn’s colitis and diverticulitis.Patients—Eleven consecutive individuals having a colonic resection showing histological features of both Crohn’s disease and diverticulitis.Methods—Retrospective review of histological specimens, case notes, and discharge letters.Results—In nine patients, the Crohn’s-like reaction was confined to the segment bearing diverticula. They had no clinical evidence of Crohn’s disease.Conclusion—A Crohn’s-like inflammatory response can be a localised reaction to diverticulitis and does not necessarily indicate chronic inflammatory bowel disease.

scholarly journals FRI0476 RHEUMATIC MANIFESTATIONS DURING INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 835.2-835
Author(s):  
M. Boudabbous ◽  
H. Gdoura ◽  
L. Chtourou ◽  
A. Amouri ◽  
L. Mnif ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Chronic Inflammatory Bowel Disease ◽  
Canadian Association ◽  
Rheumatic Manifestations ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
Chronic Inflammatory Bowel

Background:Rheumatologic manifestations are frequent extraintestinal manifestations (MEI) of chronic inflammatory bowel disease (IBD). Some of these manifestations develop in parallel with the underlying disease, others evolve on their own account. They sometimes lead to reconsider the initial therapy for intestinal purposes.Objectives:The aim of our study is to specify the epidemioclinical characteristics of osteoarticular manifestations of chronic inflammatory bowel disease and their possible impact on intestinal diseaseMethods:This is a retrospective study conducted between January 2000 and December 2015 including patients hospitalized in our department for chronic inflammatory bowel disease (IBD).Results:During the study period, 206 patients with IBD were hospitalized in our department, 78 of whom had rheumatic MEI (frequency equal to 37.8%). These 78 patients were divided into 48 men and 30 women with a sex ratio of 1.6 and an average age of 40.7 ± 13.6 years (18–79). They had Crohn’s disease in 60% of the cases. The average length of service for IBDs was 83 ± 73 months (4–360). Osteoarticular MEIs were peripheral in 56.4% of cases, axial in 29.5% of cases, mixed in 6.41% of cases with the presence of osteopenia in 6.41% of cases and osteoporosis in 1 28%. The activity of IBD associated with these MEI was moderate with an average number of outbreaks / year of 1.6 ± 0.8. These patients were treated with salicylates in 30.7% of the cases using corticosteroid therapy at least once in 23% of the cases. Maintenance treatment based on immunosuppressants was found in 38.46% of cases and anti-TNF alfa in 10.25% of cases. During follow-up, 3 patients died (3.84%). There was no significant difference between patients with IBD with rheumatic MEI and without rheumatic MEI regarding epidemiological data and disease activity.Conclusion:Rheumatic MEIs are found in almost 40% of IBDs. They affect men more frequently than women and Crohn’s disease than UC. They are rather peripheral and do not associate with a more important activity of the disease.References:[1]Journal of the Canadian Association of Gastroenterology, 2019, 2(S1), S73–S80 doi: 10.1093/jcag/gwy053 Supplement ArticleDisclosure of Interests:None declared

scholarly journals P200 Celiac disease (CD) and CHRONIC INFLAMMATORY BOWEL DISEASE (IBD) association

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S264-S265
Author(s):  
S Hmimass ◽  
I Benelbarhdadi ◽  
N Lagdali ◽  
M Borahma ◽  
F Z Ajana
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Celiac Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
The Other ◽  
Chronic Inflammatory Bowel Disease ◽  
Inflammatory Bowel ◽  
Chronic Inflammatory Bowel

Abstract Background Association Celiac disease (CD) and CHRONIC INFLAMMATORY BOWEL DISEASE (IBD) is rare. the aim of the study is to determine the frequency as well as the anatomical and evolutionary characteristics of this association. Methods This is a retrospective descriptive and analytical study of 10 patients between 2005 and 2020. The diagnosis of CD was established after careful clinical examination and questioning, on the determination of specific auto antibodies against transglutaminase type Ig A and endomysium and on the histological study of duodenal biopsies showing a IEL> 30%. And that of IBD was based on a range of clinical, endoscopic, histological and radiological arguments Results 10 cases of association CD and IBD were diagnosed in a cohort of 267 CD, 960 Crohn’s disease and 520 Haemorrhagic rectocolitis. The frequency of association was 3.7% in the cohort of CD, 0.9% In the Crohn’s disease cohort and 0.2% in the cohort of Haemorrhagic rectocolitis. Predominantly female, 80% female and 20% male. The diagnosis of CD preceded that of Crohn’s disease in 80% (n=8), with an average delay of 32 months (12–72 months). All patients were put on a gluten-free diet (GFD). Despite good therapeutic compliance for at least 18 months, the evolution was marked by the persistence of anaemic syndrome and dysenteric syndrome in six cases (60%), diarrhoea and colic-type abdominal pain in four cases (40%). And an occurrence of rectorragie, anaemic syndrome and dysenteric syndrome in two cases (20%). In front of the persistence of symptoms, we first eliminated a resistance to GFD. Then an upper and lower digestive, radiological and histological endoscopic assessment concluded that there was an isolated colonic crohn’s disease in five (50%) of the patients; gastric and colonic in three (30%). 60% (n=6) of the patients had luminal and stenotic involvement in two patients. The diagnosis of IBD preceded that of celiac disease in 20% (n=2), one patient had luminal colonic Crohn’s disease and one patient had left Haemorrhagic rectocolitis. The diagnosis of CD was clinically retained by the appearance of an associated anemic syndrome in one case with atypical abdominal pain, and with dysenteric syndrome in the other case. Serologically, one was positive for anti transglutaminase type Ig A and the other was seronegative. Histologically, both patients had a IEL >30% with subtotal atrophy. The evolution was favourable on the GFD, which was always followed up alongside the treatment of IBD, with good clinical and endoscopic improvement Conclusion The association between CD and IBD is possible, albeit rare. It is necessary to think about the search for it whenever there is a persistence or appearance of other evocative symptoms despite good therapeutic compliance.

Occurrence of Colorectal Cancer and the Influence of Medical Treatment in Patients With Inflammatory Bowel Disease: A Danish Nationwide Cohort Study, 1997 to 2015

2021 ◽  
Author(s):  
Petra Weimers ◽  
Dorit Vedel Ankersen ◽  
Ellen Christine Leth Løkkegaard ◽  
Johan Burisch ◽  
Pia Munkholm
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Treatment ◽  
Bowel Disease ◽  
Cox Regression ◽  
Biologic Treatment ◽  
Inflammatory Bowel

Abstract Background The risk of colorectal cancer (CRC) for patients with inflammatory bowel disease (IBD) has previously been investigated with conflicting results. We aimed to investigate the incidence and risk of CRC in IBD, focusing on its modification by treatment. Methods All patients with incident IBD (n = 35,908) recorded in the Danish National Patient Register between 1997 and 2015 (ulcerative colitis: n = 24,102; Crohn’s disease: n = 9739; IBD unclassified: n = 2067) were matched to approximately 50 reference individuals (n = 1,688,877). CRC occurring after the index date was captured from the Danish Cancer Registry. Exposure to medical treatment was divided into categories including none, systemic 5-aminosalicylates, immunomodulators, and biologic treatment. The association between IBD and subsequent CRC was investigated by Cox regression and Kaplan-Meier estimates. Results Of the IBD patients, 330 were diagnosed with CRC, resulting in a hazard ratio (HR) of 1.15 (95% confidence interval [CI], 1.03-1.28) as compared with the reference individuals. However, when excluding patients diagnosed with CRC within 6 months of their IBD diagnosis, the HR decreased to 0.80 (95% CI, 0.71-0.92). Patients with ulcerative colitis receiving any medical treatment were at significantly higher risk of developing CRC than patients with ulcerative colitis who were not given medical treatment (HR, 1.35; 95% CI, 1.01-1.81), whereas a similar effect of medical treatment was not observed in patients with Crohn’s disease or IBD unclassified. Conclusions Medical treatment does not appear to affect the risk of CRC in patients with IBD. The overall risk of developing CRC is significantly increased in patients with IBD as compared with the general population. However, when excluding patients diagnosed with CRC within 6 months of their IBD diagnosis, the elevated risk disappears.

Prebiotics and Probiotics in Inflammatory Bowel Disease: Where are we now and where are we going?

2020 ◽  
Vol 15 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Syed Ali ◽  
Sami Samiullah ◽  
Veysel Tahan
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Clinical Trials ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adverse Effects ◽  
Bowel Disease ◽  
Relapse Prevention ◽  
Remission Induction ◽  
Inflammatory Bowel

The incidence, prevalence, and cost of care associated with diagnosis and management of inflammatory bowel disease are on the rise. The role of gut microbiota in the causation of Crohn's disease and ulcerative colitis has not been established yet. Nevertheless, several animal models and human studies point towards the association. Targeting intestinal dysbiosis for remission induction, maintenance, and relapse prevention is an attractive treatment approach with minimal adverse effects. However, the data is still conflicting. The purpose of this article is to provide the most comprehensive and updated review on the utility of prebiotics and probiotics in the management of active Crohn’s disease and ulcerative colitis/pouchitis and their role in the remission induction, maintenance, and relapse prevention. A thorough literature review was performed on PubMed, Ovid Medline, and EMBASE using the terms “prebiotics AND ulcerative colitis”, “probiotics AND ulcerative colitis”, “prebiotics AND Crohn's disease”, “probiotics AND Crohn's disease”, “probiotics AND acute pouchitis”, “probiotics AND chronic pouchitis” and “prebiotics AND pouchitis”. Observational studies and clinical trials conducted on humans and published in the English language were included. A total of 71 clinical trials evaluating the utility of prebiotics and probiotics in the management of inflammatory bowel disease were reviewed and the findings were summarized. Most of these studies on probiotics evaluated lactobacillus, De Simone Formulation or Escherichia coli Nissle 1917 and there is some evidence supporting these agents for induction and maintenance of remission in ulcerative colitis and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited. The results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be more beneficial and effective in patients with inflammatory bowel disease.

scholarly journals The Changing Prognosis of Ulcerative Colitis and Crohn’s Disease by Decades

2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Therapy ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
Inflammatory Bowel

Abstract We present a bird’s eye view of the prognosis for both ulcerative colitis and Crohn’s disease as contained in the database of an Inflammatory Bowel Disease gastroenterologist covering the period from 1950 until the present utilizing the variables of medical therapy, surgical intervention, complications and deaths by decades.

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