scholarly journals A74 INCREASING RATES OF CT IMAGING IN THE EMERGENCY DEPARTMENT AMONG PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 40-41
Author(s):  
R Kandel ◽  
M Merlano ◽  
P Tan ◽  
G Brar ◽  
J D McCurdy
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Imaging Finding ◽  
Ct Imaging ◽  
Ct Scans ◽  
Steady Increase ◽  
Abdominal Ct ◽  
Ct Utilization ◽  
Inflammatory Bowel

Abstract Background Computed tomography (CT) imaging of the abdomen is often performed in the emergency department (ED) to exclude urgent pathology in patients with Inflammatory Bowel Disease (IBD). However, concerns over excessive radiation exposure from repeated use have led to expert consensus guidelines advising against CT imaging unless there is suspicion of complications (obstruction, perforation, abscess) or a non-IBD cause for symptoms. Aims Our study aimed to determine trends in abdominal CT utilization and findings among patients with IBD in the ED. Methods We performed a retrospective cohort study between 01/01/2009 and 31/12/2018 at a single academic center. We identified ED encounters for adults (age ≥17 years) with a pre-existing diagnosis of IBD from our institutional database and determined the proportion resulting in an abdominal CT scan within 72 hours of presentation. IBD subtypes were classified based on ICD-10 claims: K50.90* for Crohn’s disease (CD), K51.90* for Ulcerative colitis (UC) and IBD undifferentiated (IBDU) for patients with both claims. A time trend analysis was performed using a generalized linear model that assumed a Poisson distribution. CT scans were classified according to the dominant imaging finding. For this part we excluded studies performed within 1-month of surgery or those re-assessing a known abscess or malignancy. Results A total of 14783 encounters were identified. Among these encounters 3000 CT scans were performed: 2000 for patients with CD (21.9%), 652 for UC (16.5%) and 348 for IBDU (20.4%). The rates of CT utilization significantly increased by 2.7% (95% CI, 1.2–4.3; p=0.0004) in patients with CD, by 4.2% (95% CI, 1.7–6.7; p=0.0009) in patients with UC and by 6.3% in patients with IBDU (95% CI, 2.5–10.0; p=0.0011). Among the eligible CT scans performed for CD, the following dominant findings were reported: normal (25%), inflammation (23%), obstruction (23%), penetrating (18%) and unrelated to IBD (8.6%). In contrast, the following findings for patients with UC were reported: normal (20%), inflammation (39%), obstructive (19%), penetrating (8%) and unrelated to IBD (15%). Conclusions In this single center study, a steady increase in CT utilization in the ED was observed in patients with IBD. Interestingly, only a small proportion of the CT scans demonstrated urgent findings. Future studies are required to determine the factors that contribute to the ongoing increase in CT utilization in this patient population. Funding Agencies None

Inflammatory Bowel Disease and the Emergency Department: Risk Factors for Repeated Visits and Role of CT Imaging

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S333-S334
Author(s):  
Lauren George ◽  
Jennifer Cahill ◽  
Fauzia Ullah ◽  
Brendan Martin ◽  
Nikiya Asamoah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Ct Imaging ◽  
Inflammatory Bowel

scholarly journals P-107 Excess Abdominal CT Scans May Be Performed in Some Inflammatory Bowel Disease Patients Due to Multi-specialty Involvement in Management

2013 ◽  
Vol 19 ◽  
pp. S67
Author(s):  
Justin Ertle ◽  
Matthew Krafft ◽  
Bradley Anderson ◽  
Jessica Davis ◽  
Adam Kittai ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Inflammatory Bowel

691 Risk Factors for and Frequency of CT Scans in Inflammatory Bowel Disease Patients Seen in the Emergency Department

2019 ◽  
Vol 114 (1) ◽  
pp. S404-S405
Author(s):  
Kerri Glassner ◽  
Lindsay Euers ◽  
Prianka Gajula ◽  
Michelle Jones-Pauley ◽  
Chika F. Ezeana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Ct Scans ◽  
Inflammatory Bowel

scholarly journals P-108 African Americans with Inflammatory Bowel Disease Undergo More Abdominal CT Scans than Caucasians

2013 ◽  
Vol 19 ◽  
pp. S67
Author(s):  
Jessica Davis ◽  
Wadha Al Jaser ◽  
Adam Kittai ◽  
Samir Vermani ◽  
Shelton McMullan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
African Americans ◽  
Bowel Disease ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Inflammatory Bowel

scholarly journals P-100 Multiple Abdominal CT Scans May Result in Excess Radiation Exposure in Some Patients with Inflammatory Bowel Disease

2013 ◽  
Vol 19 ◽  
pp. S64
Author(s):  
Matthew Krafft ◽  
Justin Ertle ◽  
Adam Kittai ◽  
Samir Vermani ◽  
Jessica Davis ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Radiation Exposure ◽  
Bowel Disease ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Inflammatory Bowel

scholarly journals Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study

2021 ◽  
Vol 10 (12) ◽  
pp. 2679
Author(s):  
Lindsay Euers ◽  
Shaadi Abughazaleh ◽  
Kerri Glassner ◽  
Prianka Gajula ◽  
Michelle Jones-Pauley ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Ct Scan ◽  
Bowel Disease ◽  
Retrospective Cohort ◽  
Ct Scans ◽  
Steroid Use ◽  
Increased Risk ◽  
Inflammatory Bowel

Patients with inflammatory bowel disease often present to the emergency department due to the chronic relapsing nature of the disease. Previous studies have shown younger patients to have an increased frequency of emergency department visits, resulting in repeated exposure to imaging studies and steroids, both of which are associated with risks. We performed a retrospective cohort analysis of inflammatory bowel disease patients seen at Houston Methodist Hospital’s emergency department from January 2014 to December 2017 using ICD codes to identify patients with Crohn’s disease, ulcerative colitis, or indeterminate colitis from the electronic medical record. Data were collected on demographics, medications, and imaging. Five hundred and fifty-nine patients were randomly selected for inclusion. Older age was associated with decreased risk of CT scan or steroid use. Patients with ulcerative colitis compared to Crohn’s had decreased risk of CT scan, while there was an increased risk of CT in patients on a biologic, immunomodulator, or when steroids were given. Steroid use was also more common in those with inflammatory bowel disease as the primary reason for the visit. Patients in our study frequently received steroids and had CT scans performed. The increased risk of CT in those on a biologic, immunomodulator, or steroids suggests more severe disease may contribute. Guidelines are needed to reduce any unnecessary corticosteroid use and limit repeat CT scans in young inflammatory bowel disease patients to decrease the risk of radiation-associated malignancy over their lifetime.

scholarly journals Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 643
Author(s):  
Angela Saviano ◽  
Mattia Brigida ◽  
Alessio Migneco ◽  
Gayani Gunawardena ◽  
Christian Zanza ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Human Health ◽  
Bowel Disease ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Inflammatory Bowel

Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

scholarly journals Cardiovascular risks in patients with inflammatory bowel disease: what should be taken into account?

2021 ◽  
Vol 1 (6) ◽  
pp. 112-120
Author(s):  
G. B. Bikbavova ◽  
M. A. Livzan
Keyword(s):  
Cardiovascular Disease ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Diseases ◽  
Treat To Target ◽  
Steady Increase ◽  
Cardiovascular Risks ◽  
Specialized Care ◽  
Pathogenetic Therapy ◽  
Inflammatory Bowel

In recent years, there has been a steady increase in the incidence of inflammatory bowel disease (IBD) worldwide. Treatment of ulcerative colitis and Crohn’s disease has become more effective thanks to the emergence of biological therapies, increased access to specialized care and a “treat to target” approach. However, with an increase in the life expectancy of patients with IBD, there is an increase in the number of persons with comorbidity, primarily with a combination of IBD with cardiovascular pathology. Environmental factors lead to a change in the diversity and density of colonization of the intestinal microbiota, a violation of its barrier function, immune dysregulation, which in turn leads to the development of chronic inflammatory diseases and atherosclerosis. Levels of proinflammatory cytokines, C-reactive protein, and homocysteine increase in IBD, leading to endothelial dysfunction and atherosclerosis. In addition, inflammatory processes in IBD promote hypercoagulation, which occurs both in the thromboembolic complications and in the pathogenesis of the disease itself. It has been suggested that medical pathogenetic therapy for IBD is also associated with the risk of cardiovascular disease. In this review, we systematize the available data on the risks of cardiovascular diseases in patients with IBD. A literature search containing information on relevant studies was carried out in PubMed and Google Scholar systems with the keywords: inflammatory bowel disease, cardiovascular disease, inflammation, atherosclerosis.

1140 PATIENTS WITH INFLAMMATORY BOWEL DISEASE ARE FREQUENTLY PRESCRIBED OPIOID ANALGESICS WHEN DISCHARGED FROM THE EMERGENCY DEPARTMENT

2020 ◽  
Vol 158 (6) ◽  
pp. S-225-S-226
Author(s):  
Tarun Chhibba ◽  
Remo Panaccione ◽  
Cynthia H. Seow ◽  
Cathy Lu ◽  
Kerri L. Novak ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Opioid Analgesics ◽  
Inflammatory Bowel
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