Inflammatory bowel disease: introduction

Crohn’S Disease ◽

Family History ◽

Crohn's Disease ◽

Bowel Disease ◽

History Of ◽

Inflammatory Bowel ◽

The Uk

Inflammatory bowel disease 288• 25 % of inflammatory bowel disease (IBD) presents in childhood, usually as Crohn's disease or ulcerative colitis. The UK incidence is 5.2/100 000 children <16 years of age. Crohn's disease is the more common. Family history of Crohn's disease or ulcerative colitis is common. Both diseases can occur in the same family....

Inflammatory bowel disease: a beast of burden

10.33178/boolean.2011.13 ◽

2011 ◽

pp. 57-61

Author(s):

Dawn Farrell

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Social Life ◽

Symptom Burden ◽

Complex Disorders ◽

Inflammatory Bowel ◽

The Uk

Imagine having to empty your bowel eight or ten times a day and experiencing constant panic and fear about the location of toilet facilities. Imagine experiencing constant tiredness that impacts on all aspects of your life including work, family and social life. These are just two examples of experiences commonly suffered by individuals with a condition called inflammatory bowel disease. These people are burdened with symptoms which impact on their daily lives. This research aims to provide healthcare professionals with an understanding of the extent to which individuals with inflammatory bowel disease experience symptom burden and to identify what symptoms are most problematic. Crohn’s disease and ulcerative colitis collectively termed as inflammatory bowel disease are complex disorders. In the United Kingdom, collectively Crohn’s disease and ulcerative colitis affects approximately one person in every 250 of the population. Ulcerative colitis affects up to 120,000 people in the UK, or every 1 ...

Crohn’s disease severity in familial and sporadic cases

Gut ◽

10.1136/gut.44.1.91 ◽

1999 ◽

Vol 44 (1) ◽

pp. 91-95 ◽

Cited By ~ 44

Author(s):

F Carbonnel ◽

G Macaigne ◽

L Beaugerie ◽

J P Gendre ◽

J Cosnes

Keyword(s):

Crohn’S Disease ◽

Family History ◽

Crohn's Disease ◽

Disease Severity ◽

Bowel Disease ◽

History Of ◽

Sporadic Cases ◽

Inflammatory Bowel ◽

Excisional Surgery

BackgroundHaving a relative with inflammatory bowel disease increases the risk for Crohn’s disease but may also increase its severity in affected patients.AimsTo evaluate the influence of a family history on Crohn’s disease course and severity.Methods1316 patients followed in the same unit were studied retrospectively. Age at onset, duration of illness, site, and extent of disease were determined in patients with and without a family history. Additionally, disease severity was estimated by the need for medical therapy (steroid and immunosuppressive requirement) and the frequency and extent of excisional surgery.Results152 (12%) patients had a family history of inflammatory bowel disease. Duration of follow up was longer in patients with a family history and there were more operations for perforating complications in familial cases. However, the importance of medical therapy, and the incidence and extent of excisional surgery were similar in familial and and sporadic cases. Kaplan-Meier estimated time to prescription of immunosuppressive drugs and first intestinal resection were similar in familial and sporadic cases. When the 152 patients with familial Crohn’s disease were paired for sex, location of disease at onset, date of birth, and date of diagnosis with 152 patients with sporadic Crohn’s disease, the disease severity remained similar in the two groups of paired patients.ConclusionPatients with Crohn’s disease and a family history of inflammatory bowel disease do not have a more severe course.

Natural History of Very Early Onset Inflammatory Bowel Disease in North America: A Retrospective Cohort Study

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa080 ◽

2020 ◽

Cited By ~ 2

Author(s):

Basavaraj Kerur ◽

Eric I Benchimol ◽

Karoline Fiedler ◽

Marisa Stahl ◽

Jeffrey Hyams ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Early Onset ◽

Bowel Surgery ◽

Age Of Diagnosis ◽

History Of ◽

Abstract Background The incidence of very early onset inflammatory bowel disease (VEOIBD) is increasing, yet the phenotype and natural history of VEOIBD are not well described. Methods We performed a retrospective cohort study of patients diagnosed with VEOIBD (6 years of age and younger) between 2008 and 2013 at 25 North American centers. Eligible patients at each center were randomly selected for chart review. We abstracted data at diagnosis and at 1, 3, and 5 years after diagnosis. We compared the clinical features and outcomes with VEOIBD diagnosed younger than 3 years of age with children diagnosed with VEOIBD at age 3 to 6 years. Results The study population included 269 children (105 [39%] Crohn’s disease, 106 [39%] ulcerative colitis, and 58 [22%] IBD unclassified). The median age of diagnosis was 4.2 years (interquartile range 2.9–5.2). Most (94%) Crohn’s disease patients had inflammatory disease behavior (B1). Isolated colitis (L2) was the most common disease location (70% of children diagnosed younger than 3 years vs 43% of children diagnosed 3 years and older; P = 0.10). By the end of follow-up, stricturing/penetrating occurred in 7 (6.6%) children. The risk of any bowel surgery in Crohn’s disease was 3% by 1 year, 12% by 3 years, and 15% by 5 years and did not differ by age at diagnosis. Most ulcerative colitis patients had pancolitis (57% of children diagnosed younger than 3 years vs 45% of children diagnosed 3 years and older; P = 0.18). The risk of colectomy in ulcerative colitis/IBD unclassified was 0% by 1 year, 3% by 3 years, and 14% by 5 years and did not differ by age of diagnosis. Conclusions Very early onset inflammatory bowel disease has a distinct phenotype with predominantly colonic involvement and infrequent stricturing/penetrating disease. The cumulative risk of bowel surgery in children with VEOIBD was approximately 14%–15% by 5 years. These data can be used to provide anticipatory guidance in this emerging patient population.

Thiopurine monotherapy is effective in ulcerative colitis but significantly less so in Crohn’s disease: long-term outcomes for 11 928 patients in the UK inflammatory bowel disease bioresource

Gut ◽

10.1136/gutjnl-2019-320185 ◽

2020 ◽

pp. gutjnl-2019-320185 ◽

Cited By ~ 2

Author(s):

Evangelos Stournaras ◽

Wendi Qian ◽

Apostolos Pappas ◽

You Yi Hong ◽

Rasha Shawky ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Increased Risk ◽

Long Term Treatment ◽

Inflammatory Bowel ◽

The Uk

ObjectiveThiopurines are widely used as maintenance therapy in inflammatory bowel disease (IBD) but the evidence base for their use is sparse and their role increasingly questioned. Using the largest series reported to date, we assessed the long-term effectiveness of thiopurines in ulcerative colitis (UC) and Crohn’s disease (CD), including their impact on need for surgery.DesignOutcomes were assessed in 11 928 patients (4968 UC, 6960 CD) in the UK IBD BioResource initiated on thiopurine monotherapy with the intention of maintaining medically induced remission. Effectiveness was assessed retrospectively using patient-level data and a definition that required avoidance of escalation to biological therapy or surgery while on thiopurines. Analyses included overall effectiveness, time-to-event analysis for treatment escalation and comparison of surgery rates in patients tolerant or intolerant of thiopurines.ResultsUsing 68 132 patient-years of exposure, thiopurine monotherapy appeared effective for the duration of treatment in 2617/4968 (52.7%) patients with UC compared with 2378/6960 (34.2%) patients with CD (p<0.0001). This difference was corroborated in a multivariable analysis: after adjusting for variables including treatment era, thiopurine monotherapy was less effective in CD than UC (OR 0.47, 95% CI 0.43 to 0.51, p<0.0001). Thiopurine intolerance was associated with increased risk of surgery in UC (HR 2.44, p<0.0001); with a more modest impact on need for surgery in CD (HR=1.23, p=0.0015).ConclusionThiopurine monotherapy is an effective long-term treatment for UC but significantly less effective in CD.

Inflammatory bowel disease

Oxford Handbook of Gastrointestinal Nursing ◽

10.1093/med/9780198833178.003.0015 ◽

2021 ◽

pp. 367-394

Author(s):

Jennie Burch ◽

Brigitte Collins

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Microscopic Colitis ◽

Indeterminate Colitis ◽

Clinical Environment ◽

Inflammatory Bowel ◽

The Uk

The inflammatory bowel disease (IBD) chapter explores the umbrella term that encompasses Crohn’s disease, ulcerative colitis, indeterminate colitis and microscopic colitis. These diseases are increasing in incidence in the UK and worldwide. Symptoms can be debilitating and may not be curable. Treatment can include medication, diet and surgery but there can be extra-intestinal of IBD. There will be an in-depth focus on Crohn’s disease and ulcerative colitis to explore the definitions, symptoms, causes and incidence of each disease. Investigations for both diseases are then explained. Concise explorations on the issues related to inflammatory bowel disease, particularly ulcerative colitis and Crohn’s disease can be used within clinical environment by the nurse.

Prebiotics and Probiotics in Inflammatory Bowel Disease: Where are we now and where are we going?

Current Clinical Pharmacology ◽

10.2174/1574884715666200312100237 ◽

2020 ◽

Vol 15 (3) ◽

pp. 216-233 ◽

Cited By ~ 1

Author(s):

Maliha Naseer ◽

Shiva Poola ◽

Syed Ali ◽

Sami Samiullah ◽

Veysel Tahan

Keyword(s):

Ulcerative Colitis ◽

Clinical Trials ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Adverse Effects ◽

Bowel Disease ◽

Relapse Prevention ◽

Remission Induction ◽

The incidence, prevalence, and cost of care associated with diagnosis and management of inflammatory bowel disease are on the rise. The role of gut microbiota in the causation of Crohn's disease and ulcerative colitis has not been established yet. Nevertheless, several animal models and human studies point towards the association. Targeting intestinal dysbiosis for remission induction, maintenance, and relapse prevention is an attractive treatment approach with minimal adverse effects. However, the data is still conflicting. The purpose of this article is to provide the most comprehensive and updated review on the utility of prebiotics and probiotics in the management of active Crohn’s disease and ulcerative colitis/pouchitis and their role in the remission induction, maintenance, and relapse prevention. A thorough literature review was performed on PubMed, Ovid Medline, and EMBASE using the terms “prebiotics AND ulcerative colitis”, “probiotics AND ulcerative colitis”, “prebiotics AND Crohn's disease”, “probiotics AND Crohn's disease”, “probiotics AND acute pouchitis”, “probiotics AND chronic pouchitis” and “prebiotics AND pouchitis”. Observational studies and clinical trials conducted on humans and published in the English language were included. A total of 71 clinical trials evaluating the utility of prebiotics and probiotics in the management of inflammatory bowel disease were reviewed and the findings were summarized. Most of these studies on probiotics evaluated lactobacillus, De Simone Formulation or Escherichia coli Nissle 1917 and there is some evidence supporting these agents for induction and maintenance of remission in ulcerative colitis and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited. The results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be more beneficial and effective in patients with inflammatory bowel disease.

The Changing Prognosis of Ulcerative Colitis and Crohn’s Disease by Decades

Crohn's & Colitis 360 ◽

10.1093/crocol/otab008 ◽

2021 ◽

Author(s):

Burton I Korelitz ◽

Judy Schneider

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Medical Therapy ◽

Bowel Disease ◽

Surgical Intervention ◽

Abstract We present a bird’s eye view of the prognosis for both ulcerative colitis and Crohn’s disease as contained in the database of an Inflammatory Bowel Disease gastroenterologist covering the period from 1950 until the present utilizing the variables of medical therapy, surgical intervention, complications and deaths by decades.

Mo1375 Prevalence of Family History of Inflammatory Bowel Disease Among Ulcerative Colitis Patients

Gastroenterology ◽

10.1016/s0016-5085(13)62406-3 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-649-S-650

Author(s):

Ryan E. Childers ◽

Swathi Eluri ◽

Christine Vazquez ◽

Theodore M. Bayless ◽

Susan Hutfless

Keyword(s):

Ulcerative Colitis ◽

Family History ◽

Bowel Disease ◽

History Of ◽

Physiological Basis for Novel Drug Therapies Used to Treat the Inflammatory Bowel Diseases I. Immunology and therapeutic potential of antiadhesion molecule therapy in inflammatory bowel disease

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00423.2004 ◽

2005 ◽

Vol 288 (2) ◽

pp. G169-G174 ◽

Cited By ~ 56

Author(s):

Gert Van Assche ◽

Paul Rutgeerts

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Adhesion Molecules ◽

Bowel Disease ◽

Intestinal Inflammation ◽

Therapeutic Potential ◽

Physiological Basis ◽

Adhesion molecules regulate the influx of leukocytes in normal and inflamed gut. They are also involved in local lymphocyte stimulation and antigen presentation within the intestinal mucosa. In intestinal inflammation, many adhesion molecules are upregulated, but α4-integrins most likely hold a key position in directing leukocytes into the inflamed bowel wall. Therapeutic compounds directed against trafficking of leukocytes have been designed and are being developed as a novel class of drugs in the treatment of Crohn's disease and ulcerative colitis. This review deals with the immunological aspects of leukocyte trafficking focused on gut homing of T cells. Second, the changes in adhesion molecules and T cell trafficking during intestinal inflammation are discussed. Finally, we review the clinical data that have been gathered with respect to the therapeutic potential and the safety of antiadhesion molecule treatment. Antegren, or natalizumab, a humanized anti-α4 integrin IgG4 antibody, has been most extensively evaluated and may be close to registration. A more specific humanized α4β7-integrin MLN-02 has shown preliminary clinical efficacy in ulcerative colitis, and both antergren and MLN-02 appear to be very safe. Trials with the anti-ICAM-1 antisense oligonucleotide ISIS-2302 in steroid refractory Crohn's disease have provided conflicting efficacy data. In the near future, some of these novel biological agents may prove valuable therapeutic tools in the management of refractory inflammatory bowel disease, although it is too early to define the patient population that will benefit most from these agents.