Does dairy product consumption impact the prevalence of inflammatory bowel disease? An ecological cross-sectional analysis

Abstract Background Currently the incidence of patients with Metabolic Syndrome (MS) tends to increase among patients with inflammatory bowel disease (IBD). The purpose of the study is to investigate the course of IBD depending on the presence of MS. Methods This cross-sectional analysis was performed on the database of patients with IBD to estimate the frequency of MS presence and study the clinical course (extension of pathologic process, severity and phenotype) of Crohn’s disease (CD) and ulcerative colitis (UC). Results 347 patients with IBD were included in the investigation: 259 patients with UC and 88 patients with CD. MS was revealed with the same frequency among patients with UC (26 patients, 10.04%) and CD (9 patients, 10.23%). Proctitis (48 patients, 20.6%) and left-sided colitis (121 patients, 51.93%) are usually found among patients with UC without MS while total colitis is significantly more frequent among patients with underlying MS (12, 46.15%, p < 0,05). It was found that patients without MS more often suffered from mild UC (116 patients, 49.79%, p < 0,01) while among patients with MS severe UC occurred more frequently (6 patients, 23.08%, p < 0.05). Among patients with CD and MS, there was no significant correlation between underlying MS and localisation, severity and course of CD. Conclusion Patients with UC and MS suffer from a more severe course of UC (as to both the extension of pathologic process and severity) in comparison with the patients with UC without MS. Due to the small quantity of patient with CD and MS insufficient evidence for the influence of MS on the course of CD has been obtained.

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Conflicts of Interest in Inflammatory Bowel Disease Articles on UpToDate

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz030 ◽

2019 ◽

Author(s):

Rishad Khan ◽

Juana Li ◽

Michael A Scaffidi ◽

Nikko Gimpaya ◽

Bianca Pivetta ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Clinical Decision Making ◽

Conflicts Of Interest ◽

Point Of Care ◽

Clinical Decision ◽

Cross Sectional ◽

Inflammatory Bowel ◽

Sectional Analysis ◽

Open Payments

Abstract Background Financial conflicts of interest (FCOIs) are widespread in inflammatory bowel disease (IBD) and may be particularly important in point-of-care (POC) resources, such as UpToDate, that are used to aid clinical decision making. In this study, we determined the prevalence of industry payments from companies making biologic medications for IBD to contributors of UpToDate articles on IBD. Methods This cross-sectional analysis included UpToDate articles that mention the use of biologic medications for IBD. We collected the names of the contributors (authors and editors) and their disclosures on UpToDate. We then searched for their names on the Center for Medicare and Medicaid Open Payments database and compared the payment information from 2013 to 2018 with UpToDate's disclosures. We presented data per episode, which describes one instance of participation by one person in one article, regardless of whether that person contributed to multiple articles. Results We identified 23 articles on the treatment of Crohn's disease and ulcerative colitis that mentioned the use of biologic medications, with 86 total episodes. Sixty-two (72%) episodes involved FCOIs. The median payment associated with each episode was $$55 (interquartile range = $44 to $145,241). Contributors did not fully disclose FCOIs in 41 (48%) episodes. Deputy editors, who are required to be free of FCOIs, in general did not have substantial episodes involving FCOI. Conclusions We found that UpToDate articles on inflammatory bowel disease involve substantial FCOI, many of which are not disclosed. The presence of these FCOIs may hamper trust in the objectivity of treatment recommendations.

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