Predicting Outcomes in Pediatric Crohn’s Disease for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and is characterized by inflammation of the gastrointestinal tract. One of the possible treatments for this pathology is a change in the type of diet, of which enteral nutrition (EN) is one. This study is to understand how the use of EN can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and a meta-regression. On the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 363 registers with an accuracy of 12% (44 registers). After a full-text review, only 30 research studies were selected for qualitative synthesis and 11 for meta-analysis and meta-regression. The variables used were Crohn’s disease activity index (CDAI), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). EN has been shown to have efficacy for the treatment of Crohn’s disease and is compatible with other medicines. As for the CDAI or rates of remission, there were no differences between enteral and parenteral nutrition. Polymeric formulas have shown better results with respect to the CRP. The long-term treatment could dilute the good CDAI results that are obtained at the start of the EN treatment.

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Parenteral Nutrition in Patients with Inflammatory Bowel Disease Systematic Review, Meta-Analysis and Meta-Regression

Nutrients ◽

10.3390/nu11122865 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2865 ◽

Cited By ~ 2

Author(s):

Jose M. Comeche ◽

Iris Comino ◽

Cesare Altavilla ◽

Jose Tuells ◽

Ana Gutierrez-Hervas ◽

...

Keyword(s):

Systematic Review ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Parenteral Nutrition ◽

Bowel Disease ◽

Activity Index ◽

Meta Analysis ◽

Inflammatory Bowel ◽

Meta Regression

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the inflammation of the gastrointestinal tract. This study is to understand how the use of parenteral nutrition (PN) can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and meta-regression. From the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 119 registers with an accuracy of 16% (19 registers). After a full-text review, only 15 research studies were selected for qualitative synthesis and 10 for meta-analysis and meta-regression. The variables used were Crohn’s Disease Activity Index (CDAI), albumin, body weight (BW), and postoperative complications (COM). PN has shown to have efficacy for the treatment of IBD and is compatible with other medicines. The CDAI and albumin improve, although the effect of PN is greater after a while. However, the effect on the albumin could be less than the observed value in the meta-analysis due to possible publication bias. The BW does not change after intervention. COM utilizing PN has been observed, although the proportion is low. More studies specifically referring to ulcerative colitis (UC) and Crohn’s disease (CD) are needed to develop more concrete clinical results.

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Trends in Early Outpatient Drug Therapy in Pediatric Inflammatory Bowel Disease in Finland: A Nationwide Register-Based Study in 1999–2009

ISRN Gastroenterology ◽

10.5402/2012/462642 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Lauri J. Virta ◽

Kaija-Leena Kolho

Keyword(s):

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Drug Therapy ◽

Crohn's Disease ◽

Bowel Disease ◽

Early Years ◽

Aminosalicylic Acid ◽

Pediatric Inflammatory Bowel Disease ◽

Inflammatory Bowel ◽

Pediatric Ibd

Objective. There are limited data on the changes of treatment strategies of disease-modifying drugs used to treat pediatric inflammatory bowel disease (IBD). Methods. We utilized data from two national registers: the Drug Reimbursement Register for drug costs (for identifying children with IBD) and the Drug Purchase Register (for exposure to drugs), both of which are maintained by the Social Insurance Institution of Finland. The frequencies and trends of drug therapy strategies during the first year of pediatric IBD were evaluated between 1999 and 2009. Results. A total of 481 children diagnosed with IBD were identified. During the first six months, 68% of the patients purchased systemic corticosteroids; these combined with 5-aminosalicylic acid in almost all cases. The use of corticosteroids was stable from the early years compared with the end of the study period. In Crohn's disease, there was a trend towards more active use of azathioprine: the therapy was introduced earlier and proportion of pediatric patients purchasing azathioprine increased by up to 51% (P<0.05). Conclusions. In pediatric IBD, the majority of patients purchased corticosteroid within the first six months, reflecting moderate-to-severe disease. During recent years in pediatric Crohn's disease, the therapeutic strategies of oral medication have changed towards more active immunosuppression with azathioprine.

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Omega-3 fatty acids and inflammatory bowel diseases – a systematic review

British Journal Of Nutrition ◽

10.1017/s0007114512001626 ◽

2012 ◽

Vol 107 (S2) ◽

pp. S240-S252 ◽

Cited By ~ 72

Author(s):

Eduard Cabré ◽

Míriam Mañosa ◽

Miquel A. Gassull

Keyword(s):

Systematic Review ◽

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Omega 3 ◽

Pufa Supplementation ◽

Negative Results ◽

Inflammatory Bowel

Background & Aim: Despite their well known anti-inflammatory actions, the clinical usefulness of omega-3 PUFA in inflammatory bowel disease is controversial. We aimed to systematically review the available data on the performance of omega-3 PUFA as therapeutic agents in these patients. Methods: Electronic databases were systematically searched for RCT of fish oil or omega-3 PUFA therapy in both active and inactive ulcerative colitis or Crohn's disease, without limitation on either the length of therapy or the form it was given, including nutritional supplements and enteral formula diets. Eligible articles were assessed for methodological quality on the basis of the adequacy of the randomisation process, concealment of allocation, blinding of intervention and outcome, possible biases, and completeness of follow-up. The five-point Oxford quality score was calculated. Results: A total of 19 RCT were finally selected for this review. Overall, available data do not allow to support the use of omega-3 PUFA supplementation for the treatment of both active and inactive inflammatory bowel disease. Negative results are quite consistent in trials assessing the use of omega-3 PUFA to maintain disease remission, particularly ulcerative colitis, and to a lesser extent Crohn's disease. Trials on their use in active disease do not allow to draw firm conclusions mainly because the heterogeneity of design (ulcerative colitis) or their short number (Crohn's disease). In most trials, the appropriateness of the selected placebo is questionable. Conclusion: The present systematic review does not allow to make firm recommendations about the usefulness of omega-3 PUFA in inflammatory bowel disease.

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Safety and steroid-sparing experience using infliximab for Crohn’s disease at a pediatric inflammatory bowel disease center

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2004.03.006 ◽

2004 ◽

Vol 39 (5) ◽

pp. 785-786

Author(s):

Richard R Ricketts

Keyword(s):

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Pediatric Inflammatory Bowel Disease ◽

Inflammatory Bowel ◽

Steroid Sparing

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Incidence and Geographical Variability of Pediatric Inflammatory Bowel Disease in Croatia: Data From the Croatian National Registry for Children With Inflammatory Bowel Disease

Clinical Pediatrics ◽

10.1177/0009922820941202 ◽

2020 ◽

Vol 59 (13) ◽

pp. 1182-1190

Author(s):

Lana Ivković ◽

Iva Hojsak ◽

Ivana Trivić ◽

Sara Sila ◽

Pero Hrabač ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Northern Region ◽

National Registry ◽

Annual Incidence ◽

Pediatric Inflammatory Bowel Disease ◽

Inflammatory Bowel

The aim of this study was to determine the annual incidence and geographic distribution of pediatric inflammatory bowel disease (IBD) in Croatia. This is a prospective, cohort, multicenter observational study based on the data obtained from the Croatian national registry for children with IBD. Children and adolescents younger than 18 years diagnosed with IBD, in time period between June 1, 2016, and May 31, 2017, were recruited. In total, 51 new cases were identified; 19 Crohn’s disease, 28 ulcerative colitis, and 8 IBD-unclassified. Male preponderance of all 3 types of the disease was noticed. The median age at diagnosis was 14.8 years. The calculated annual incidence of pediatric IBD per 100 000 persons per year was 7.05 (2.63 for Crohn’s disease, 3.87 for ulcerative colitis, and 0.55 for IBD-unclassified). A north to south gradient was observed with almost 2 times higher incidence in the northern region of the country.

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Prevalence of Oral Lesions and Correlation with Intestinal Symptoms of Inflammatory Bowel Disease: A Systematic Review

Diagnostics ◽

10.3390/diagnostics9030077 ◽

2019 ◽

Vol 9 (3) ◽

pp. 77 ◽

Cited By ~ 9

Author(s):

Lauritano ◽

Boccalari ◽

Stasio ◽

Vella ◽

Carinci ◽

...

Keyword(s):

Systematic Review ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Oral Manifestations ◽

Care Providers ◽

Pyostomatitis Vegetans ◽

Inflammatory Bowel ◽

Intestinal Symptoms

Background: Extra-intestinal manifestations of inflammatory bowel disease (IBD) are widely studied. Oral manifestations are manifold, miscellaneous, and hardly detected by general practitioners and gastroenterologists. Objectives: The main purpose of this systematic review is to find all the possible correlations between inflammatory bowel disease and the oral cavity in order to underline the importance of multidisciplinary cooperation with dental care providers, and to secure better treatments for patients. Materials and methods: Articles were searched up to June 2019 through Ebsco’s, Google Scholar, and PubMed databases. The search terms included IBD, oral manifestations of inflammatory bowel disease, oral manifestations of Crohn’s disease or Ulcerative colitis, an extra-intestinal manifestation of IBD, oral Crohn’s disease, and paediatric inflammatory bowel disease. Discussion: The prevalence of the oral manifestation of IBD ranges from 0.7% to 37% in adults and from about 7% to 23% in children. They can be divided into specific manifestations (cobblestoning mucosa, mucosal tags, cheilitis granulomatosa, pyostomatitis vegetans) and nonspecific manifestations (halitosis, dysphagia, aphthous ulcerations, deep oral fissuring, cheilitis angularis, taste changes, lichen planus). Moreover, the link between IBD and the higher prevalence of dental caries and periodontitis have also been studied. Conclusions: The presence of oral manifestations that precede or follow intestinal symptoms of IBD, must be taken into serious consideration from both gastroenterologists and dentists in order to allow for early diagnosis and improve patients’ quality of life.

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