scholarly journals The pathomorphosis of inflammatory bowel diseases

2020 ◽  
Vol 75 (1) ◽  
pp. 27-35
Author(s):  
Igor V. Maev ◽  
Yurii A. Shelygin ◽  
Maria I. Skalinskaya ◽  
Alexey V. Veselov ◽  
Ekaterina V. Skazyvaeva ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Clinical Symptoms ◽  
Term Treatment ◽  
Diagnostic Methods ◽  
Induction Treatment ◽  
Differential Analysis ◽  
Number Of Patients ◽  
Long Term Treatment ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel diseases (IBD) are immune-mediated diseases and usually manifest at a young age. They are requires in a long-term treatment or surgery with a high probability of surgical intervention. IBDs are accompanied by a decrease in working capacity, impaired quality of life and social disadaptation. However, timely diagnosis with using modern diagnostic methods, the use of evidence-based immunosuppressive and biological therapy significantly changed the pathomorphosis of this disease. But despite the achievements of the pharmacotherapy, the incidence and prevalence of IBD are still increasing, a demand for surgery remains both for Crohn`s disease and ulcerative colitis throughout all the period of illness. At the same time there is a trend towards the variability of symptoms, mismatch of the clinical symptoms with the real severity of inflammation, increase of a number of patients with extraintestinal manifestations and resistance to induction and maintenance therapies. In addition to this, the observation of this group of patients is complicated due to the difficulty of the early diagnosis and differential analysis of IBD, the need of early induction treatment according to the guidelines and the lack of adherence to the therapy.

scholarly journals Cannabis and Canabidinoids on the Inflammatory Bowel Diseases: Going Beyond Misuse

2020 ◽  
Vol 21 (8) ◽  
pp. 2940
Author(s):  
Antonelly Cassio Alves de Carvalho ◽  
Gabriela Achete de Souza ◽  
Samylla Vaz de Marqui ◽  
Élen Landgraf Guiguer ◽  
Adriano Cressoni Araújo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Diseases ◽  
Literature Search ◽  
Cannabis Sativa ◽  
Antioxidant Properties ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Anti Inflammatory

Inflammatory bowel diseases (IBD) are characterized by a chronic and recurrent gastrointestinal condition, including mainly ulcerative colitis (UC) and Crohn’s disease (CD). Cannabis sativa (CS) is widely used for medicinal, recreational, and religious purposes. The most studied compound of CS is tetrahydrocannabinol (THC) and cannabidiol (CBD). Besides many relevant therapeutic roles such as anti-inflammatory and antioxidant properties, there is still much controversy about the consumption of this plant since the misuse can lead to serious health problems. Because of these reasons, the aim of this review is to investigate the effects of CS on the treatment of UC and CD. The literature search was performed in PubMed/Medline, PMC, EMBASE, and Cochrane databases. The use of CS leads to the improvement of UC and CD scores and quality of life. The medical use of CS is on the rise. Although the literature shows relevant antioxidant and anti-inflammatory effects that could improve UC and CD scores, it is still not possible to establish a treatment criterion since the studies have no standardization regarding the variety and part of the plant that is used, route of administration and doses. Therefore, we suggest caution in the use of CS in the therapeutic approach of IBD until clinical trials with standardization and a relevant number of patients are performed.

scholarly journals Serum Interleukin-6 and -8 as Predictors of Response to Vedolizumab in Inflammatory Bowel Diseases

2020 ◽  
Vol 9 (5) ◽  
pp. 1323 ◽  
Author(s):  
Lorenzo Bertani ◽  
Gian Paolo Caviglia ◽  
Luca Antonioli ◽  
Rinaldo Pellicano ◽  
Sharmila Fagoonee ◽  
...  
Keyword(s):  
Clinical Response ◽  
Inflammatory Bowel Diseases ◽  
Area Under The Curve ◽  
Clinical Role ◽  
Faecal Calprotectin ◽  
Prediction Ability ◽  
Prospective Multicentre Study ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Vedolizumab, a monoclonal antibody directed against integrin α4β7, is an effective treatment for inflammatory bowel diseases. However, a significant number of patients do not achieve steroid-free clinical remission in the first year of treatment. An early identification of these patients is one of the most important challenges for clinicians and offers the possibility of therapeutic optimization in order to personalize biological therapy. The aim of our study was to test the prediction ability of interleukin (IL)-6 and -8 of clinical response after 12 months of therapy with vedolizumab (T2). We performed a prospective, multicentre study in patients affected by inflammatory bowel disease by analysing cytokines level before starting vedolizumab (T0) and after 10 weeks of therapy (T1). In the overall cohort (n = 54), IL-8 decrease > 2.6 pg/mL in the first 10 weeks of therapy was able to predict clinical response (area under the curve (AUC) = 0.70, sensitivity = 66%, specificity = 75%, p = 0.010), negative C-reactive protein (CRP) (AUC = 0.71, sensitivity = 64%, specificity = 80%, p = 0.009) and calprotectin < 250 mg/kg (AUC = 0.69, sensitivity = 64%, specificity = 78%, p = 0.030) after 44 weeks of therapy. In patients with ulcerative colitis (n = 40), baseline IL-8 values > 8.6 pg/mL and a decrease of IL-6 values > 0.4 pg/mL from T0 to T1 were significant and independent predictors of clinical response after 12 months of vedolizumab therapy (odds ratio (OR) = 6.96, 95% CI 1.27–38.22, p = 0.026 and OR = 7.29, 95% CI 1.42–37.50, p = 0.017, respectively). In patients with Crohn’s disease (n = 14), baseline IL-8 values > 8.6 pg/mL and baseline IL-6 values > 1.6 pg/mL allowed the identification of patients achieving negative CRP at T2 (AUC = 0.75, sensitivity = 74%, specificity = 76%, p < 0.001) and patients with faecal calprotectin values < 250 mg/kg at T2 (AUC = 0.71, sensitivity = 78%, specificity = 63%, p = 0.004). In conclusion, our study highlights a potential clinical role of serum cytokine levels for the prediction of clinical and biochemical steroid-free response in patients treated with vedolizumab.

scholarly journals Surgical strategy in massive colorectal bleeding

2004 ◽  
Vol 51 (2) ◽  
pp. 91-92
Author(s):  
I. Bartha ◽  
T. Danya ◽  
A. Nemeth
Keyword(s):  
Gastrointestinal Bleeding ◽  
Inflammatory Bowel Diseases ◽  
Diagnostic Methods ◽  
Surgical Strategy ◽  
Selective Angiography ◽  
Surgical Method ◽  
Common Experience ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Several pathologic disorders can become a sou-rce of severe gastrointestinal bleeding. The most frequently observed entities responsible for massi-ve colorectal bleeding are diverticulae, intestinal angiodysplasias, inflammatory bowel diseases and cancers. In order to choose the best - surgical - method to stop the hemorrhage and cure the disease; it is mandatory to properly identify the origin and location of the bleeding. It is a common experience that the usually advised diagnostic methods often yield disappointing results in urgent cases. The presented case shows that selective angiography can lead to the fastest diagnosis in angiodysplasia and with surgery a definitive result can be obtained.

scholarly journals Omega Fatty Acids and Inflammatory Bowel Diseases: An Overview

2019 ◽  
Vol 20 (19) ◽  
pp. 4851 ◽  
Author(s):  
Ledyane Taynara Marton ◽  
Ricardo de Alvares Goulart ◽  
Antonelly Cassio Alves de Carvalho ◽  
Sandra Maria Barbalho
Keyword(s):  
Fatty Acids ◽  
Inflammatory Bowel Diseases ◽  
Intestinal Inflammation ◽  
Omega 3 ◽  
Beneficial Effects ◽  
Ω3 Fatty Acids ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Processes ◽  
Inflammatory Bowel

Inflammatory bowel diseases (IBD) are chronic, inflammatory processes that affect the gastrointestinal tract and are mainly represented by ulcerative colitis (UC) and Crohn’s disease (CD). Omega 3 (ω3) fatty acids (eicosapentanoic acid and docosahexaenoic acid) show an indispensable role in the inflammatory processes and, for these reasons, we aimed to review the effects of these acids on UC and CD. Databases such as PUMED and EMBASE were searched, and the final selection included fifteen studies that fulfilled the inclusion criteria. The results showed that ω3 fatty acids reduce intestinal inflammation, induce and maintain clinical remission in UC patients, and are related with the reduction of proinflammatory cytokines, decrease disease activity and increase the quality of life of CD patients. Furthermore, the consumption of these fatty acids may be related to a reduced risk of developing IBD. Many studies have shown the beneficial effects of ω3 as adjunctive in the treatment or prevention of UC or CD. Nevertheless, most were performed with a small number of patients and there are many variations in the mode of consumption, the type of food or the type of formulation used. All these factors substantially interfere with the results and do not allow reliable comparisons.

scholarly journals IMPORTANCE OF MEASURING LEVELS OF INFLIXIMAB IN PATIENTS TREATING INFLAMMATORY BOWEL DISEASE IN A BRAZILIAN COHORT

2017 ◽  
Vol 54 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Katia Cristina KAMPA ◽  
Daphne Benatti Gonçalves MORSOLETTO ◽  
Marcela Rocha LOURES ◽  
Alcindo PISSAIA JUNIOR ◽  
Rodrigo Bremer NONES ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Clinical Symptoms ◽  
Serum Levels ◽  
Induction Phase ◽  
Tnf Α ◽  
Measurement Results ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Necrosis Factor ◽  
Chronic Inflammatory Bowel

ABSTRACT BACKGROUND: Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases. In such pathologies, there is an increased production of alpha tumor necrosis factor (TNF-α). Patients, in whom the conventional immunosuppressant treatment fails, require the use of immunobiological therapy, such as anti-TNF-α, a monoclonal antibody. Infliximab is an anti-TNF-α drug, a chimerical immunoglobulin, with a murine component, which is responsible for the generation of immunogenicity against the drug and formation of anti-TNF-α antibodies. The presence of anti-drug antibodies may be responsible for adverse events and reduction of the drug’s effectiveness. Patients with inflammatory bowel diseases undergoing therapy with biological medication, such as infliximab, can relapse overtime and this may not be translated into clinical symptoms. Thus, there is a need for a method to evaluate the efficacy of the drug, through the measurement of serum infliximab levels, as well as antibodies research. OBJECTIVE: This study aimed to measure serum infliximab levels and anti-infliximab antibodies in patients with inflammatory bowel diseases post-induction phase and during maintenance therapy, and describe the therapeutic modifications that took place based on the serum levels results. METHODS: It was a retrospective study, that included forty-five patients, with a total of 63 samples of infliximab measurement. RESULTS: Twenty-one patients had an adequate infliximab serum level, 31 had subtherapeutic levels and 11 had supratherapeutic levels. Seven patients had their medication suspended due to therapeutic failure or high levels of antibodies to infliximab. CONCLUSION: In conclusion, only a third of the patients had adequate infliximab levels and 36% presented with subtherapeutic levels at the end of the induction phase. Therapy optimization occurred based in about 46% of the samples results, demonstrating the importance of having this tool to help the clinical handling of patients with inflammatory bowel diseases ongoing biologic therapy.

scholarly journals The prevalence of bacterial overgrowth syndrome and its associated factors in patients with inflammatory bowel diseases (according to the data of the Novosibirsk registry)

2017 ◽  
Vol 89 (2) ◽  
pp. 15-19
Author(s):  
Yu A Kulygina ◽  
M F Osipenko ◽  
M I Skalinskaya ◽  
K D Palchunova
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Associated Factors ◽  
Clinical Symptoms ◽  
Bacterial Overgrowth ◽  
Hydrogen Breath Test ◽  
Abdominal Bloating ◽  
Overgrowth Syndrome ◽  
Bowel Diseases ◽  
Patient Groups ◽  
Inflammatory Bowel

Aim. To assess the prevalence of bacterial overgrowth syndrome (BOS) and its risk factors in patients with inflammatory bowel diseases (IBD). Subjects and methods. The patients from the Novosibirsk IBD registry, who had undergone a hydrogen breath test (HBT) using a Gastro+ device, were examined. Results. In 93 IBD patients who had undergone a HBD, the prevalence of BOS was 48% (46.2% for ulcerative colitis and 51.2% for Crohn’s disease). There was a strong correlation between abdominal bloating, abdominal rumbling, and positive HBT results in both patient groups. During the HBT, the patients with BOS frequently complained of diarrhea, borborygmi, belching, and anxiety. Conclusion. The findings suggest that BOS is highly prevalent among patients with IBD. BOS is associated with clinical symptoms, such as abdominal bloating, abdominal rumbling, tearfulness, and irritability.

scholarly journals Guidance for Restarting Inflammatory Bowel Disease Therapy in Patients Who Withheld Immunosuppressant Medications During COVID-19

2020 ◽  
Vol 14 (Supplement_3) ◽  
pp. S769-S773
Author(s):  
Corey A Siegel ◽  
Britt Christensen ◽  
Asher Kornbluth ◽  
Joel R Rosh ◽  
Michael D Kappelman ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Clinical Symptoms ◽  
Molecular Testing ◽  
Disease Therapy ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Immunosuppressant Medications

Abstract Patients with inflammatory bowel diseases [IBD] are frequently treated with immunosuppressant medications. During the coronavirus disease 2019 [COVID-19] pandemic, recommendations for IBD management have included that patients should stay on their immunosuppressant medications if they are not infected with the severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], but to temporarily hold these medications if symptomatic with COVID-19 or asymptomatic but have tested positive for SARS-CoV-2. As more IBD patients are infected globally, it is important to also understand how to manage IBD medications during convalescence while an individual with IBD is recovering from COVID-19. In this review, we address the differences between a test-based versus a symptoms-based strategy as related to COVID-19, and offer recommendations on when it is appropriate to consider restarting IBD therapy in patients testing positive for SARS-CoV-2 or with clinical symptoms consistent with COVID-19. In general, we recommend a symptoms-based approach, due to the current lack of confidence in the accuracy of available testing and the clinical significance of prolonged detection of virus via molecular testing.

scholarly journals P234 Frequency detectiveness of some viral infections in patients with inflammatory bowel diseases

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S259-S260
Author(s):  
G Babayeva-Sadigova ◽  
Z Babayev ◽  
G Asadova ◽  
U Mahmudov ◽  
F Quliyev ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Viral Infections ◽  
Herpes Simplex Viruses ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Endoscopic Picture

Abstract Background The prevalence of opportunistic infections in individuals with inflammatory bowel disease (IBD) remains relevant. Viral infections are a common cause of systemic inflammation of the digestive tract. Clinically expressed herpes and parvovirus infections are a serious problem, especially for people with prolonged immunosuppression. The aim of the study was t o assess the incidence of certain herpes and parvovirus infections in patients with IBD. Methods In total, 189 patients with IBD, 102 with ulcerative colitis and 87 with Crohn’s disease were examined. Of the number of patients: 98 women, 91man. The age of patients is from 16 to 63 years (mean age 41.4 ± 4.8). In addition to a standard examination, disease activity was assessed by indicators of highly sensitive C-reactive protein, homocysteine, vitamin D in blood serum, albumin in urine, calprotectin and lactoferrin in faeces. All patients underwent serological blood tests by ELISA for specific antibodies to herpes viruses and IgG/IgM antibodies to parvovirus B19, determination of DNA to herpes simplex viruses of types 1-2,6(HSV1-2?HSV6), Epstein–Barr (EBV}, cytomegalovirus (CMV), herpes zoster (HZV) by PCR in blood and mucosal biopsy, and also avidity. Results Among patients with IBD, active infections (herpes and parvoviruses) in the blood occurred in 81 patients (42.8%); of them, 39 patients (20.6%) were diagnosed with monoherpesvirus infections, in 16 patients parvovirus (8.4%), and in 26 (13.8%) cases, active mixed viral infections were detected. In 79 cases (41.7%) of PCR biopsy material was positive for isolated infection: 36 cases (19%) of CMV, 21 cases (11.1%) of EBV, 22 cases (11.6%) of HSV6. Tissue viral infection was found in 34 patients (17.9%). Clinical endoscopic and laboratory indicators of activity in IBD were significantly higher in patients with active viral infections (p ˂ 0.05), which indicates the negative effect of chronic active herpes and parvovirus infections on the course of inflammatory bowel diseases. However, significant differences between patients with ulcerative colitis and Crohn’s disease were not detected. Conclusion The frequency of occurrence of herpes and parvovirus lesions in patients with IBD in the blood is more than 42.8%, isolated infection in the tissue in 41.7%, and mixed infection in 17.9% of the number of patients. The clinical endoscopic picture, as well as laboratory data indicate a more severe course of diseases in the presence of these infections.

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