scholarly journals Predictors of surgical intervention in patients with inflammatory bowel disease (two-center study)

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Khaled Hamdy Abd El Megeed ◽  
Shereen Abou Bakr Saleh ◽  
Ahmed Elkattary Mohamed ◽  
Christina Alphonse Anwar
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Severity Scores ◽  
Inflammatory Bowel

Abstract Background Sixty percent of Crohn’s disease (CD) patients require intestinal resection, and 20% of ulcerative colitis (UC) patients undergo proctocolectomy for medically refractory disease. Scarcity of literature about predictors for surgical intervention in inflammatory bowel disease (IBD) encouraged the conduction of this study to assess risk factors for surgical intervention in IBD patients. Results This cohort study included 80 Egyptian inflammatory bowel disease patients recruited from two medical centers. Patients were classified into two groups, 40 patients each, according to their need for surgical intervention to control inflammatory bowel disease. The two groups were compared regarding age of onset, type and location of disease, smoking, extraintestinal manifestations, perianal disease, granuloma, severity scores, stool calprotectin, complete blood count, erythrocyte sedimentation rate, C-reactive protein, and serum albumin at diagnosis for Crohn’s disease patients. Twelve ulcerative colitis and 28 Crohn’s disease patients required surgical intervention in the form of total colectomy (30%), fistulectomy (32.5%), resection anastomosis (17.5%) or abscess drainage (20%). Perianal disease, smoking, and disease severity scores showed high significant differences (P value < 0.001); disease type and presence of granuloma showed statistically significant difference (P value < 0.05) between both groups. But, patient age at onset, location of the disease or extraintestinal manifestation had no statistical significance (P value > 0.5). Surgical interventions were more likely to be needed in patients with higher stool calprotectin level, C-reactive protein, erythrocyte sedimentation rate, and lower serum albumin for Crohn’s disease patients (P value < 0.001 for each). Conclusion Smoking, perianal disease, higher severity scores, stool calprotectin, C-reactive protein, and erythrocyte sedimentation rate levels are predictors of surgical treatment.

scholarly journals Tünetek, laboratóriumi paraméterek és a betegségpercepció eltérései irritábilis bél szindróma és gyulladásos bélbetegség esetén. Segíthetnek-e a kérdőívek a két betegség elkülönítésében?

2015 ◽  
Vol 156 (23) ◽  
pp. 933-938 ◽  
Author(s):  
Renáta Bor ◽  
Zsolt Balanyi ◽  
Klaudia Farkas ◽  
Anita Bálint ◽  
Mariann Rutka ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Illness Perception ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Inflammatory Bowel ◽  
Irritable Bowel

Introduction: Symptoms-based differential diagnosis of irritable bowel syndrome and inflammatory bowel disease is often difficult. Aims: To determine the differential diagnostic ability of clinical activity indexes and psychological questionnaires in these conditions, which have never been simultaneously analyzed. Method: 37 irritable bowel syndrome, 54 Crohn’s disease and 41 ulcerative colitis patients were enrolled in the study. The patients completed the Crohn’s Disease Activity Index test, Illness Perception Questionnaire and Inflammatory Bowel Disease Questionnaire. Hematocrit and C-reactive protein level of patients were also analyzed. Results: Patients with irritable bowel syndrome felt their abdominal pain more severe than the other two groups (p = 0.005), while the quality of life was the worst in Crohn’s disease (p = 0.0000001). Significantly more patients with inflammatory bowel disease considered that their condition is lifelong (p = 0.000781). The knowledge about disease was more appropriate in patients with inflammatory bowel disease (p = 0.00629). No significant difference was found in hematocrit levels, but the C-reactive protein level was significantly lower in patients with irritable bowel syndrome (p = 0.001). Conclusions: Illness perception questionnaires and C-reactive protein can help in the differentiation of inflammatory bowel disease from irritable bowel syndrome. Orv. Hetil., 2015, 156(23), 933–938.

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

2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Therapy ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
Inflammatory Bowel

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.

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 &gt;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.

scholarly journals Predictors and Management of Loss of Response to Vedolizumab in Inflammatory Bowel Disease

2018 ◽  
Vol 24 (11) ◽  
pp. 2461-2467 ◽  
Author(s):  
Eugenia Shmidt ◽  
Gursimran Kochhar ◽  
Justin Hartke ◽  
Prianka Chilukuri ◽  
Joseph Meserve ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Bowel Disease ◽  
C Reactive Protein ◽  
Dose Intensification ◽  
Reactive Protein ◽  
Loss Of Response ◽  
Increased Risk ◽  
Tnf Antagonist ◽  
Inflammatory Bowel

Abstract Background We quantified loss of response (LOR) to vedolizumab (VDZ) in clinical practice and assessed the effectiveness of VDZ dose intensification for managing LOR. Methods Retrospective review (May 2014–December 2016) of a prospectively maintained inflammatory bowel disease (IBD) registry. Kaplan-Meier estimates were used to determine rates of LOR to VDZ . Independent predictors of LOR were identified using univariate and multivariable Cox proportional hazard regression. Success of recapturing response (>50% reduction in symptoms from baseline) and remission (complete resolution of symptoms) after dose intensification was quantified. Results Cumulative rates for VDZ LOR were 20% at 6 months and 35% at 12 months, with slightly lower rates in Crohn’s disease than in ulcerative colitis (6 months 15% vs 18% and 12 months 30% vs 39%, P = 0.03). On multivariable analysis, LOR to a tumor necrosis factor (TNF) antagonist before VDZ use was associated with an increased risk for LOR to VDZ [hazard ratio (HR) 1.93; 95% confidence interval (CI) 1.25–2.97] in all patients. For Crohn’s disease patients specifically, higher baseline C-reactive protein concentration was associated with increased risk for LOR to VDZ (HR 1.01 per mg/dL increase, 95% CI 1.01–1.02). Shortening of VDZ infusion interval from 8 to every 4 or 6 weeks recaptured response in 49% and remission in 18% of patients. Conclusions LOR to a TNF antagonist before VDZ use and higher baseline C-reactive protein are important predictors of VDZ LOR. Treatment response can be recaptured in almost half of these patients with VDZ infusion interval shortening.

scholarly journals Validation of Neutrophil CD64 Blood Biomarkers to Detect Mucosal Inflammation in Pediatric Crohn’s Disease

2017 ◽  
Vol 24 (1) ◽  
pp. 198-208 ◽  
Author(s):  
Phillip Minar ◽  
Kimberly Jackson ◽  
Yi-Ting Tsai ◽  
Heidi Sucharew ◽  
Michael J Rosen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Surface Expression ◽  
Fecal Calprotectin ◽  
Mucosal Inflammation ◽  
Neutrophil Cd64 ◽  
Severity Scores ◽  
Inflammatory Bowel

Abstract Background In a pilot study, neutrophil CD64 surface expression was significantly elevated in newly diagnosed, pediatric-onset Crohn’s disease. We aimed to test the CD64 biomarkers (neutrophil CD64 surface expression and soluble CD64) as determinates for mucosal inflammation in a larger pediatric Crohn’s cohort with the hypotheses that the CD64 biomarkers would reliably detect intestinal inflammation and correlate with endoscopic severity scores. Methods We enrolled patients referred for colonoscopy for either suspected inflammatory bowel disease or with established Crohn’s. Neutrophil CD64 index was determined by flow cytometry using a commercial kit (Leuko64, Trillium) and soluble CD64 by ELISA (LifeSpan). Results A total of 209 patients (72 controls, 76 new inflammatory bowel disease patients, and 61 established Crohn’s) were enrolled. Both neutrophil CD64 index and soluble CD64 were significantly elevated in new Crohn’s compared with controls. The area under the curve (AUC) for neutrophil CD64 index ≥1 was 0.85 (95% confidence interval, 0.77–0.92), 75% sensitive and 89% specific for new Crohn’s. Comparatively, soluble CD64 ≥39 ng/mL was 92% sensitive and 85% specific (AUC, 0.93) for new Crohn’s. Neutrophil CD64 index, soluble CD64, and fecal calprotectin discriminated endoscopic inactive from moderate and severe activity while soluble CD64 differentiated endoscopic mild from moderate and severe activity. Neutrophil CD64 index (r = 0.46, P &lt; 0.001) and fecal calprotectin (r = 0.55, P &lt; 0.001) correlated well with the Simple Endoscopic Score–Crohn’s disease. Spearman correlation between the CD64 index and calprotectin was 0.39 (P &lt; 0.001). Conclusions In a large Crohn’s disease cohort, we found that neutrophil CD64 index and soluble CD64 were significantly elevated during active gastrointestinal inflammation. 10.1093/ibd/izx022_video1 izx022.video1 5732761255001

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