scholarly journals P200 Faecal calprotectin as a marker of relapse in inflammatory bowel disease – its place in the management algorithm and cost effectiveness in Poland

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S178-S178
Author(s):  
P. Petryszyn ◽  
N. Wieckowska ◽  
A. Trznadel ◽  
P. Ekk-Cierniakowski ◽  
A. Staniak ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cost Effectiveness ◽  
Bowel Disease ◽  
Faecal Calprotectin ◽  
Management Algorithm ◽  
Inflammatory Bowel

scholarly journals Impact of COVID-19 on the diagnosis, assessment and management of children with inflammatory bowel disease in the UK: implications for practice

2020 ◽  
Vol 4 (1) ◽  
pp. e000786
Author(s):  
Abbie Maclean ◽  
James J Ashton ◽  
Vikki Garrick ◽  
R Mark Beattie ◽  
Richard Hansen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Delayed Diagnosis ◽  
High Standard ◽  
Current Evidence ◽  
Faecal Calprotectin ◽  
Paediatric Patients ◽  
Inflammatory Bowel ◽  
Working Practices ◽  
The Impact

The assessment and management of patients with known, or suspected, paediatric inflammatory bowel disease (PIBD) has been hugely impacted by the COVID-19 pandemic. Although current evidence of the impact of COVID-19 infection in children with PIBD has provided a degree of reassurance, there continues to be the potential for significant secondary harm caused by the changes to normal working practices and reorganisation of services.Disruption to the normal running of diagnostic and assessment procedures, such as endoscopy, has resulted in the potential for secondary harm to patients including delayed diagnosis and delay in treatment. Difficult management decisions have been made in order to minimise COVID-19 risk for this patient group while avoiding harm. Initiating and continuing immunosuppressive and biological therapies in the absence of normal surveillance and diagnostic procedures have posed many challenges.Despite this, changes to working practices, including virtual clinic appointments, home faecal calprotectin testing kits and continued intensive support from clinical nurse specialists and other members of the multidisciplinary team, have resulted in patients still receiving a high standard of care, with those who require face-to-face intervention being highlighted.These changes have the potential to revolutionise the way in which patients receive routine care in the future, with the inclusion of telemedicine increasingly attractive for stable patients. There is also the need to use lessons learnt from this pandemic to plan for a possible second wave, or future pandemics as well as implementing some permanent changes to normal working practices.In this review, we describe the diagnosis, management and direct impact of COVID-19 in paediatric patients with IBD. We summarise the guidance and describe the implemented changes, evolving evidence and the implications of this virus on paediatric patients with IBD and working practices.

scholarly journals Types of colorectal cancer and dysplasia associated with inflammatory bowel disease

2022 ◽  
Author(s):  
Hisham Abdullah Almottowa ◽  
Abdulmohsen Yaseer Alkhars ◽  
Maram Hussam Hassan ◽  
Hamad Adel Alhamad ◽  
Saad Munawwikh Alshammari ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Diagnostic Procedures ◽  
Intestinal Wall ◽  
Management Algorithm ◽  
Online Databases ◽  
Major Development ◽  
Histological Characteristics ◽  
Inflammatory Bowel ◽  
Based Medicine

Ulcerative colitis (UC) and Crohn’s disease (CD) are two major inflammatory disorders of the intestinal wall collectively known as inflammatory bowel disease (IBD). Colorectal carcinoma (CRC) is the most significant and grave consequence of IBD and is preceded by dysplasia in majority of the cases. In this review we aim to discuss the various types of dysplasia found in patients with CRC due to IBD. A thorough literature search was conducted in online databases such as PubMed, Google Scholar, from which all studies published in the last ten years were included in this review. The major development in diagnostic procedures and visualization modalities have aided our understanding of dysplasia, which is now known to be the strongest predictor and marker for CRC development. However, the unpredictable behavior and progression of dysplasia still warrants vigilant surveillance. Dysplasia has been classified on histological characteristics using grades of dysplasia from ‘negative for dysplasia’ to ‘high grade dysplasia’. On visibility via an endoscope from ‘visible dysplasia’ to ‘invisible dysplasia’ and macroscopic features of ‘conventional dysplasia’ and ‘non-conventional dysplasia’. No single classification can be utilized to define the stage of dysplasia and more importantly predict its progression and outcome of CRC. Using evidence-based medicine an integrated classification expanding on a management algorithm must be formulated by a panel of experts to steer management of the disease. A multidisciplinary, tailored approach with a strong emphasis on regular and timely surveillance to ensure early detection of CRC can enhance quality of life and patient outcomes.

scholarly journals P430 Feasibility and reliability of gastrointestinal ultrasound in pregnant inflammatory bowel disease patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S391-S393
Author(s):  
F de Voogd ◽  
H Joshi ◽  
E Van Wassenaer ◽  
G D’Haens ◽  
K Gecse
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Terminal Ileum ◽  
Bowel Disease ◽  
Activity Index ◽  
Third Trimester ◽  
Faecal Calprotectin ◽  
Gastrointestinal Ultrasound ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background Disease activity during pregnancy in women with inflammatory bowel disease (IBD) is associated with miscarriage, preterm delivery and low birth weight. Monitoring disease activity throughout the pregnancy is therefore important. Gastrointestinal ultrasound (GIUS) has a high potential as a point-of-care tool for monitoring disease activity in IBD as it has been shown to correlate well with endoscopy and magnetic resonance imaging. However, data are scarce on the use of GIUS in IBD throughout pregnancy. The aim of this prospective study is to determine the feasibility and reliability of GIUS in pregnant IBD patients. Methods Patients were included when visiting the outpatient IBD pregnancy clinic. At each trimester, clinical and biochemical disease activity was evaluated and GIUS was performed. Feasibility was assessed by the ability to visualise each bowel segment (terminal ileum (TI), ascending (AC), transverse (TC), descending (DC) and sigmoid colon (SC)). Reliability was evaluated by using clinical and biochemical disease activity as a gold standard. This was defined as a Harvey–Bradshaw Index ≥4 in Crohn’s disease (CD) or a Simple Clinical Colitis Activity Index ≥5 in ulcerative colitis and a faecal calprotectin (FCP)³ 250 mg/g. Bowel wall thickness (BWT) of > 3 mm in the colon and > 2mm in the terminal ileum was considered as signs of active inflammation on ultrasound. A Mann–Whitney U-test and chi-square were used for statistical analysis. Results Thirty-two IBD patients (54% CD) were studied. Both a GIUS and FCP was available in 18, 11 and 6 patients for the first, second and third trimester, respectively. Eleven of 32 (34%) patients had clinically active disease at least at one time point during the pregnancy. Table 1 shows the visibility per segment. When the active disease was defined as an FCP ≥ 250 mg/g, GIUS could distinguish active from the non-active disease in the first, second and third trimester with a sensitivity of 80%, 75% and 75% and specificity of 85%, 86% and 100%, respectively. FCP levels were significantly higher in patients with an active disease on GIUS regardless of the trimester (mean 1095.5 ± 1453.8 mg/g vs. 265.25 ± 649.8 mg/g, p < 0.0001). Conclusion GIUS is accurate to distinguish active from the quiescent disease in pregnancy. Feasibility to visualise the TI and the SC decreased during the second and third trimester, although active disease could still be detected. Consequently, GIUS is feasible and reliable to assess disease activity throughout pregnancy in IBD.

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