One-year risk of opioid use disorder after index hospitalization for inflammatory bowel disease

2020 ◽  
Vol 35 (11) ◽  
pp. 2081-2087
Author(s):  
Mishal Reja ◽  
Nitya Hajela ◽  
Michael Makar ◽  
Daniel Marino ◽  
Abhishek Bhurwal ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Opioid Use Disorder ◽  
Index Hospitalization ◽  
Opioid Use ◽  
Inflammatory Bowel ◽  
One Year

Opioid Use Disorder Increases 30-Day Readmission Risk in Inflammatory Bowel Disease Hospitalizations: a Nationwide Matched Analysis

2019 ◽  
Vol 14 (5) ◽  
pp. 636-645 ◽  
Author(s):  
Paris Charilaou ◽  
Sonmoon Mohapatra ◽  
Tejas Joshi ◽  
Kalpit Devani ◽  
Chiranjeevi Gadiparthi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Time To Event ◽  
Post Discharge ◽  
Readmission Rates ◽  
Inflammatory Bowel ◽  
Opioid Medications ◽  
Readmission Risk

Abstract Background and Aims The opioid epidemic has become increasingly concerning, with the ever-increasing prescribing of opioid medications in recent years, especially in inflammatory bowel disease [IBD] patients with chronic pain. We aimed to isolate the effect of opioid use disorder [OUD] on 30-day readmission risk after an IBD-related hospitalization. Methods We retrospectively extracted IBD-related adult hospitalizations and 30-day, any-cause, readmissions from the National Readmissions Database [period 2010–2014]. OUD and 30-day readmission trends were calculated. Conventional and exact-matched [EM] logistic regression and time-to-event analyses were conducted among patients who did not undergo surgery during the index hospitalization, to estimate the effect of OUD on 30-day readmission risk. Results In total, 487 728 cases were identified: 6633 [1.4%] had documented OUD And 308 845 patients [63.3%] had Crohn’s disease. Mean age was 44.8 ± 0.1 years, and 54.3% were women. Overall, 30-day readmission rate was 19.4% [n = 94,546], being higher in OUD patients [32.6% vs 19.2%; p < 0.001]. OUD cases have been increasing [1.1% to 1.7%; p-trend < 0.001], while 30-day readmission rates were stable [p-trend = 0.191]. In time-to-event EM analysis, OUD patients were 47% more likely (hazard ratio 1.47; 95% confidence interval [CI]:1.28–1.69; p < 0.001) to be readmitted, on average being readmitted 32% earlier [time ratio 0.68; 95% CI: 0.59–0.78; p < 0.001]. Conclusion OUD prevalence has been increasing in hospitalized IBD patients from 2010 to 2014. On average, one in five patients will be readmitted within 30 days, with up to one in three among the OUD subgroup. OUD is significantly associated with increased 30-day readmission risk in IBD patients and further measures relating to closer post-discharge outpatient follow-up and pain management should be considered to minimize 30-day readmission risk.

Su1861 - Rising Trends in Opioid use Disorder-Related Diagnoses Among Hospitalized Inflammatory Bowel Disease Patients

2018 ◽  
Vol 154 (6) ◽  
pp. S-611
Author(s):  
Shirley A. Cohen-Mekelburg ◽  
Russell Rosenblatt ◽  
Stephanie Gold ◽  
Adam F. Steinlauf ◽  
Robert Burakoff ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Inflammatory Bowel

scholarly journals How Fatigue Is Experienced and Handled by Female Outpatients with Inflammatory Bowel Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Anne Beck ◽  
Palle Bager ◽  
Peter Errboe Jensen ◽  
Jens F. Dahlerup
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Semistructured Interview ◽  
Fatigue Score ◽  
Work Related ◽  
Mental Symptoms ◽  
Related Quality ◽  
Health Related ◽  
Inflammatory Bowel ◽  
One Year

Background. Fatigue is a significant aspect of everyday life for patients with inflammatory bowel disease (IBD), and it influences their health-related quality of life. Little is known about fatigue from the patient’s perspective.Aim. To investigate how female IBD patients experience and handle fatigue.Methods. The study included 11 female outpatients. These patients were 40–59 years old and had IBD ≥ one year and a significantly increased fatigue score. Patients with severe active IBD, anaemia, comorbidity, or pregnancy were excluded. The included patients agreed to participate in a semistructured interview. The interviews were analysed using Malterud’s principles of systematic text condensation.Results. The patients described physical and mental symptoms of fatigue that led to social-, physical-, and work-related limitations with emotional consequences. To handle fatigue, the patients used planning, priority, acceptance, exercise, and support. Two of the eleven patients used exercise on a regular basis. Surprisingly, some patients indicated that they did not need to talk with professionals about their fatigue unless a cure was available. Conclusion. Fatigue in IBD includes physical and mental symptoms that limit the patients’ social-, physical-, and work-related lives. Despite this, some patients expressed that they had chosen to accept their fatigue.

scholarly journals Obstructive Giant Inflammatory Polyposis: Is It Related to the Severity or the Duration of the Inflammatory Bowel Disease? Two Case Reports

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Antoine Abou Rached ◽  
Jowana Saba ◽  
Leila El Masri ◽  
Mary Nakhoul ◽  
Carla Razzouk
Keyword(s):  
Inflammatory Bowel Disease ◽  
Surgical Resection ◽  
Bowel Disease ◽  
Transverse Colon ◽  
Case Reports ◽  
Rare Complication ◽  
Inflammatory Bowel ◽  
Inflammatory Polyposis ◽  
One Year

We report two cases of giant inflammatory polyposis (GIP) with totally different presentation and evolution. The first patient had two giant pseudopolyps after one year of the diagnosis of UC. The second patient had one obstructive giant pseudopolyp secondary to CD at the level of the transverse colon, being totally asymptomatic years before the presentation. GIP is a rare complication of inflammatory bowel disease (IBD). It consists of numerous filiform polyps that look like a “mass of worms” or a “fungating” mass. Surgical resection is inevitable when GIP presents with obstructive symptoms.

scholarly journals Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study

2019 ◽  
Vol 8 (5) ◽  
pp. 654 ◽  
Author(s):  
Kookhwan Choi ◽  
Jaeyoung Chun ◽  
Kyungdo Han ◽  
Seona Park ◽  
Hosim Soh ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
General Population ◽  
Bowel Disease ◽  
Population Based ◽  
Anxiety And Depression ◽  
Healthcare Insurance ◽  
Inflammatory Bowel ◽  
One Year ◽  
Constant Slope

Background and Aims: Inflammatory bowel disease (IBD) may be associated with anxiety and depression. The aim of this study was to evaluate the incidence of anxiety and depression in patients with IBD compared to the general population. Methods: A nationwide population-based cohort study was conducted using claims data from the National Healthcare Insurance service in Korea. We compared the incidence of anxiety and depression between 15,569 IBD patients and 46,707 non-IBD controls, age and sex matched at a ratio of 1:3. Results: During a mean follow-up of six years, IBD patients experienced significantly more anxiety (12.2% vs. 8.7%; p < 0.001) and depression (8.0% vs. 4.7%; p < 0.001) compared to controls. The curves showing cumulative incidences of anxiety and depression showed a steep rise within one year following a diagnosis of IBD, leading to lines with a constant slope. The hazard ratio (HR) for new onset anxiety following a diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC) was 1.63 and 1.60, respectively, compared to controls (p < 0.001). Compared to controls, the HR for developing depression after a diagnosis of CD and UC was 2.09 and 2.00, respectively (p < 0.001). The risks of anxiety and depression in patients with IBD were higher compared to controls, except in those with diabetes mellitus, hypertension, and dyslipidemia, or who required immunomodulators and biologics within one year of the IBD diagnosis. Conclusions: The risk of anxiety and depression increased after a diagnosis of IBD compared to the general population.

scholarly journals Trends of Liver Stiffness in Inflammatory Bowel Disease with Chronic Hepatitis C

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1037
Author(s):  
Giuseppe Losurdo ◽  
Andrea Iannone ◽  
Antonella Contaldo ◽  
Michele Barone ◽  
Enzo Ierardi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Hepatitis C ◽  
Bowel Disease ◽  
Antiviral Treatment ◽  
Sustained Viral Response ◽  
Liver Stiffness ◽  
Control Group ◽  
Viral Response ◽  
Inflammatory Bowel ◽  
One Year

Concomitant inflammatory bowel disease (IBD) and hepatitis C virus (HCV) infection is a relevant comorbidity since IBD itself exposes to a high risk of liver damage. We aimed to evaluate liver stiffness (LS) in IBD-HCV after antiviral treatment. We enrolled IBD patients with HCV. All patients at baseline underwent LS measurement by elastography. Patients who were eligible for antiviral therapy received direct antiviral agents (DAAs) and sustained viral response was evaluated at the 12th week. A control group was selected within IBD patients without HCV. One year later, all IBD-HCV patients and controls repeated LS measurement. Twenty-four IBD-HCV patients and 24 IBD controls entered the study. Only twelve out of 24 received DAAs and all achieved sustained viral response (SVR). All IBD subjects were in remission at enrollment and maintained remission for one year. After one year, IBD patients who eradicated HCV passed from a liver stiffness of 8.5 ± 6.2 kPa to 7.1 ± 3.9, p = 0.13. IBD patients who did not eradicate HCV worsened liver stiffness: from 7.6 ± 4.4 to 8.6 ± 4.6, p = 0.01. In the IBD control group, stiffness decreased from 7.8 ± 4.4 to 6.0 ± 3.1, p < 0.001. In conclusion, HCV eradication is able to stop the evolution of liver fibrosis in IBD, while failure to treat may lead to its progression. A stable IBD remission may improve LS even in non-infected subjects.

scholarly journals Clostridioides difficile Enteritis in Patients Following Total Colectomy—a Rare but Genuine Clinical Entity

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Robert J Ulrich ◽  
Jonathan Bott ◽  
Hannah Imlay ◽  
Kerri Lopez ◽  
Sandro Cinti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Total Colectomy ◽  
Severe Disease ◽  
Clinical Entity ◽  
Acid Suppression ◽  
Clostridioides Difficile ◽  
Inflammatory Bowel ◽  
One Year

Clostridioides difficile enteritis (CDE) after colectomy is an understudied infectious syndrome. We reviewed 20 years of post-colectomy data and found CDE in 44/855 (5.1%) patients, usually within one year of surgery. Risk factors include acid suppression, inflammatory bowel disease, and antibiotics with enteral feeds. Clostridioides difficile enteritis often presents with severe disease requiring hospitalization.

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