scholarly journals PATIENT CHARACTERISTICS AND TREATMENT AMONG ELDERLY INFLAMMATORY BOWEL DISEASE PATIENTS: A RESTROSPECTIVE DATABASE ANALYSIS

2016 ◽  
Vol 19 (3) ◽  
pp. A318
Author(s):  
N. Khan ◽  
S. Unniachan ◽  
C. Vallarino ◽  
K. Lasch ◽  
T. Lissoos ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Patient Characteristics ◽  
Database Analysis ◽  
Inflammatory Bowel

scholarly journals P314 C-Reactive protein is associated with depression and anxiety in patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S311-S311
Author(s):  
T Rodriguez ◽  
J Karpin ◽  
C Traboulsi ◽  
V Rai ◽  
D Rubin
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Patient Characteristics ◽  
Adaptive Testing ◽  
Prior History ◽  
Depression And Anxiety ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Severity Scores ◽  
Inflammatory Bowel

Abstract Background Depression and anxiety are comorbidities of inflammatory bowel disease (IBD). Though previous studies have proposed a relationship between anxiety, depression and IBD, causality and directionality are unknown. We used a novel computerised adaptive testing technology to screen IBD patients for depression and anxiety and compared the screening results to recent measures of C-reactive protein (CRP). Methods Consecutive patients at our tertiary IBD clinic were asked to complete the validated CAT-MH™ survey from Adaptive Testing Technologies (Chicago, IL); we then reviewed disease and patient characteristics. CRP measures from within 6 months of survey administration were used and levels ≥5 mg/l were considered positive. Patients who are CRP non-reactive were excluded. Pearson Chi-Square test was used to assess correlation. Results 134 patients (75 women, 112 Caucasian, 84 Crohn’s disease) participated in the study, 85 of whom had no prior history of psychiatric disorders. We identified 51 patients with depression (46 mild, 3 moderate, 2 severe) and 36 subjects with anxiety (24 mild, 10 moderate, 2 severe). Of the 134 patients recruited for this study, 57 had CRP reported. Median time between CRP measurement and CAT-MH™ administration was 2 days (IQR = 70). Categorical analysis stratified patients with positive and negative CRP who are also positive for depression and/or anxiety. Compared with patients with negative CRP values, patients with positive CRP were more likely to also test positive for depression and anxiety. These results were statistically significant for depression (p = 0.008) and nearly significant for anxiety (p = 0.058) (Figure 1). Quartile analysis of the 21 patients with elevated CRP levels revealed an increasing trend of average depression and anxiety severity scores. However, this correlation was lost when CRP >21 mg/l (Figure 2). Conclusion We illustrate the significant association between CRP and depression and anxiety severity scores on the CAT-MH™ survey. These findings suggest a positive relationship between inflammation and depression and anxiety in IBD patients. Physicians should consider patients with elevated CRP levels at risk for these mental health conditions.

Alterations in Bile Acid Metabolism Associated With Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Na Li ◽  
Shukai Zhan ◽  
Zhenyi Tian ◽  
Caiguang Liu ◽  
Zonglin Xie ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Gut Microbiota ◽  
Bowel Disease ◽  
Patient Characteristics ◽  
Bile Acid Metabolism ◽  
Inflammatory Disorder ◽  
Sample Type ◽  
Fecal Samples ◽  
Inflammatory Processes ◽  
Inflammatory Bowel

Abstract Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder closely related to gut dysbiosis, which is associated with alterations in an important bacterial metabolite, bile acids (BAs). Although certain findings pertinent to BA changes in IBD vary among studies owing to the differences in sample type, quantitated BA species, study methodology, and patient characteristics, a specific trend concerning variations of BAs in IBD has been identified. In elaborating on this observation, it was noted that primary BAs and conjugated BAs are augmented in fecal samples but there is a reduction in secondary BAs in fecal samples. It is not entirely clear why patients with IBD manifest these changes and what role these changes play in the onset and development of IBD. Previous studies have shown that IBD-associated BA changes may be caused by alterations in BA absorption, synthesis, and bacterial modification. The complex relationship between bacteria and BAs may provide additional and deeper insight into host-gut microbiota interactions in the pathogenesis of IBD. The characteristic BA changes may generate profound effects in patients with IBD by shaping the gut microbiota community, affecting inflammatory processes, causing BA malabsorption associated with diarrhea, and even leading to intestinal dysplasia and cancer. Thus, therapeutic strategies correcting the alterations in the composition of BAs, including the elimination of excess BAs and the supplementation of deficient BAs, may prove promising in IBD.

Descriptive epidemiology of children hospitalized for inflammatory bowel disease in Japan: Inpatient database analysis

2015 ◽  
Vol 57 (3) ◽  
pp. 443-448 ◽  
Author(s):  
Masato Takeuchi ◽  
Takeshi Tomomasa ◽  
Hideo Yasunaga ◽  
Hiromasa Horiguchi ◽  
Kiyohide Fushimi
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Descriptive Epidemiology ◽  
Database Analysis ◽  
Inflammatory Bowel ◽  
Inpatient Database

scholarly journals Utilization of Preventive Measures for Glucocorticoid-Induced Osteoporosis among Veterans with Inflammatory Bowel Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Aikaterini Thanou ◽  
Tauseef Ali ◽  
Omar Haq ◽  
Sindhu Kaitha ◽  
Jordan Morton ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Medical Center ◽  
Standard Of Care ◽  
Patient Characteristics ◽  
Physician Education ◽  
Osteoporosis Prevention ◽  
Mineral Density ◽  
Bmd Testing ◽  
Inflammatory Bowel

Purpose. We examined current osteoporosis prevention practices in patients with inflammatory bowel disease (IBD) on chronic steroid using the 2003 American Gastroenterological Association guidelines as standard of care. Methods. We identified all IBD patients followed at the Oklahoma City VA Medical Center from January 2003 to December 2010, who had been on daily oral steroids (prednisone ≥5 mg or budesonide ≥6 mg) for ≥3 consecutive months. Associations of calcium and vitamin D (vitD) prescribing and bone mineral density (BMD) testing with patient characteristics were examined by logistic regression. Results. Sixty-three of 384 consecutive patients met inclusion criteria. Among 86 steroid courses, calcium and vitD were concurrently prescribed in 46%, and BMD was tested in 30%. There was no association of demographic and clinical characteristics with calcium/vitD prescribing and BMD testing. By multivariate analysis, steroid initiation after 2006, compared to before 2006, was associated with a significant increase in calcium (OR = 3.17 and P=0.02) and vitD (OR = 2.96 and P=0.02) prescribing and BMD testing (OR = 4.63 and P=0.004). Conclusions. We observed a low, yet increasing, adherence to osteoporosis prevention guidelines in IBD since 2003, which highlights the need for continued physician education to enhance guideline awareness and implementation.

scholarly journals DOP25 Medication use and comorbidities among elderly when compared with younger patients with inflammatory bowel disease in the TARGET-IBD cohort

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S063-S066
Author(s):  
E Barnes ◽  
J Hanson ◽  
M Regueiro ◽  
S Saha ◽  
B E Sands ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Elderly Patients ◽  
Bowel Disease ◽  
Medication Use ◽  
Patient Characteristics ◽  
The Elderly ◽  
Younger Patients ◽  
Academic Practices ◽  
Inflammatory Bowel ◽  
Factor Α

Abstract Background When compared with younger patients, much less is known regarding inflammatory bowel disease (IBD)-related medications in the elderly (>65 years) patients. This analysis uses a large cohort of patients with IBD to describe the distribution of patient characteristics and patterns of medication use. Methods TARGET-IBD is a longitudinal cohort of patients with IBD receiving usual care at community and academic practices in the US. Patients with IBD enrolled between July 2017 and May 2019 were included in this analysis. The prevalence of medication use by drug class at the time of enrolment among patients with both ulcerative colitis (UC) and Crohn’s disease (CD) was estimated. Age was stratified into the following categories: <30, 30–49, 50–65 and >65 years. Proportions and means of patient characteristics were compared using tests of association. The odds of biologic use at enrolment was modelled as was the 95% CI by patient characteristics using logistics regression. Results 681 patients with UC and 979 patients with CD were included in the analysis. At enrolment, mesalamine was the most common medication used among patients with CD >65 years (34%) and among patients with UC across all age categories (58%–77%, Table 1). The use of mesalamine generally increased with advancing age. Patients with CD >65 years were more than twice as likely to be users of mesalamine at enrolment than patients <30 years (p < 0.0001). Among patients with either disease type, anti-tumour necrosis factor α (anti-TNF) use decreased in patients >65 years compared with patients <30 years. Thiopurine use did not vary across age categories. Among patients >65 at enrolment, use of a 5-ASA derivative, anti-TNF, steroid, or thiopurine did not differ by established and newly diagnosed patients. There was no association between age, type of IBD, insurance, gender, race or cardiovascular disease and the odds of biologic use in patients >65 years (Figure 1). Conclusion Elderly patients with IBD, whether those with new diagnoses or individuals with the longstanding disease make up a substantial portion of the IBD population. Given that elderly patients demonstrate significant differences in medication use patterns compared with younger patients with IBD, studies of efficacy and adverse events specific to this population are warranted.

scholarly journals P691 Corticosteroids usage in patients with inflammatory bowel disease: Results of a multi-national audit in Asia

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S562-S562
Author(s):  
D H Kim ◽  
D I Park ◽  
T Kobayashi ◽  
V Ahuja ◽  
B I Jang ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Side Effects ◽  
Bowel Disease ◽  
Disease Duration ◽  
Significant Proportion ◽  
Patient Characteristics ◽  
Case Report Form ◽  
Indeterminate Colitis ◽  
Significant Difference ◽  
Inflammatory Bowel

Abstract Background The use of corticosteroids (CS) has been a well-established treatment for active Inflammatory bowel disease (IBD). While many investigators have reported the efficacy of CS in treating IBD, systemic CS are often associated with various side-effects. The aim of this study was to investigate the present status of CS usage in Asian patients with IBD. Methods Authors reviewed medical records of IBD patients who were regularly followed at multiple centres in South Korea, China, Japan, and India. Patient characteristics including diagnosis, phenotype, severity at diagnosis, and treatment history of CS usage in the prior 12 months were collected using web-based case report form. All cases of CS usage were reviewed of its suitability and were categorised as ‘non-IBD’, ‘appropriate’, and ‘avoidable’ groups. Results A total of 1,291 patients (434 Crohn’s disease [CD], 848 ulcerative colitis [UC], and 9 Indeterminate colitis) from 4 countries (18 physicians from 8 hospitals) were reviewed between May and September 2019. Among them, 339 patients (26.3%) received CS during the past year. There was no significant difference in the incidence of CS use between CD and UC patients. Multiple CS exposure over the recent 12 months were identified in 16 patients (4.7%). The mean duration of CS use was 96.5 days. Short-term and long-term side-effects of CS occurred in 21 (6.1%) and 4 (1.2%) patients, respectively. 285 patients (84.1%) were able to reduce the dosage of CS below the prednisolone equivalent of 10mg/day within 3 months from CS initiation without recurrence of the disease. However, 15 patients (4.4%) relapsed after stopping CS. A total of 340 CS used cases were confirmed in the 339 patients when cases with undeterminable suitability of its use were excluded and 36 events (10.6%) were classified as avoidable CS use. Patients who received ‘avoidable’ CS had longer disease duration than who received ‘appropriate’ CS (3227.5 days and 1450.5 days, respectively. p = 0.007). Both ‘avoidable’ and ‘appropriate’ group had started with similar CS dosage (37.2 and 38.8mg, respectively. p = 0.694). However, ‘avoidable’ group received CS longer than ‘appropriate’ group (125.7 and 37.7 days, respectively. p = 0.013). Multivariate analysis revealed that longer disease duration was significantly related with ‘avoidable’ CS exposure (OR=1.166; 95% CI=1.023–1.329; p = 0.022). Conclusion Treatment for IBD is advancing; however, a significant proportion of patients still receive CS. In particular, the longer the disease duration, ‘avoidable’ CS uses in patients tend to increase. Application of CS in patients with IBD should be delivered with much caution, as ‘avoidable’ CS use is associated with longer CS use.

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