scholarly journals The Correlation Between Endotoxin, D-Lactate and Diamine Oxidase With Endoscopic Activity in Inflammatory Bowel Disease

2020 ◽  
Author(s):  
Qi Zhang ◽  
Xi Chen ◽  
Min Chen
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Predictive Value ◽  
Diamine Oxidase ◽  
Intestinal Barrier Function ◽  
Characteristic Analysis ◽  
Endoscopic Remission ◽  
Inflammatory Bowel

Abstract Background & Objective: The disease activity monitoring of inflammatory bowel disease (IBD) plays a crucial role for making therapeutic strategies. Endoscopy has been recognized as a gold standard for evaluating disease activity of IBD. However, this method is invasive. Currently, a noninvasive biomarker that could replace endoscope is needed in clinical practice. In this study, we examined whether the diamine oxidase (DAO), D-lactate and endotoxin (ETX) could monitor the disease activity and predict endoscopic remission in patient with IBD. Methods: A total of 149 eligible IBD patients (82CD and67UC) who had received both endoscopic examination and intestinal barrier function detection in our hospital were enrolled in this study. Endoscopic activity was estimated by the Simple Endoscopic Score (SES-CD) for Crohn’s disease, and the ulcerative colitis endoscopic index of severity (UCEIS) for ulcerative colitis. The predictive value and optimal predictive thresholds for those biomarkers were determined by Receiver operating characteristic analysis.Results: For UC patients, DAO, D-lactate and ETX showed better correlation with UCEIS than ESR and CRP, and exhibited satisfactory predictive value in predicting remission. Among patients with CD, DAO and ETX not only showed a better correlation than ESR and CRP with SES-CD, but also capacity to identify more severe patients.Conclusion: DAO and ETX could be used to distinguish different endoscopic activity of CD. DAO, D-lactate and ETX could predict UC endoscopic remission.

Validation of the “German Inflammatory Bowel Disease Activity Index (GIBDI)”: An Instrument for Patient-Based Disease Activity Assessment in Crohn’s Disease and Ulcerative Colitis

2018 ◽  
Vol 56 (10) ◽  
pp. 1267-1275 ◽  
Author(s):  
Angelika Hüppe ◽  
Jana Langbrandtner ◽  
Winfried Häuser ◽  
Heiner Raspe ◽  
Bernd Bokemeyer
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Activity Index ◽  
Disease Activity Index ◽  
Inflammatory Bowel ◽  
Activity Indices

Abstract Introduction Assessment of disease activity in Crohn’s disease (CD) and ulcerative colitis (UC) is usually based on the physician’s evaluation of clinical symptoms, endoscopic findings, and biomarker analysis. The German Inflammatory Bowel Disease Activity Index for CD (GIBDICD) and UC (GIBDIUC) uses data from patient-reported questionnaires. It is unclear to what extent the GIBDI agrees with the physicians’ documented activity indices. Methods Data from 2 studies were reanalyzed. In both, gastroenterologists had documented disease activity in UC with the partial Mayo Score (pMS) and in CD with the Harvey Bradshaw Index (HBI). Patient-completed GIBDI questionnaires had also been assessed. The analysis sample consisted of 151 UC and 150 CD patients. Kappa coefficients were determined as agreement measurements. Results Rank correlations were 0.56 (pMS, GIBDIUC) and 0.57 (HBI, GIBDICD), with p < 0.001. The absolute agreement for 2 categories of disease activity (remission yes/no) was 74.2 % (UC) and 76.6 % (CD), and for 4 categories (none/mild/moderate/severe) 60.3 % (UC) and 61.9 % (CD). The kappa values ranged between 0.47 for UC (2 categories) and 0.58 for CD (4 categories). Discussion There is satisfactory agreement of GIBDI with the physician-documented disease activity indices. GIBDI can be used in health care research without access to assessments of medical practitioners. In clinical practice, the index offers a supplementary source of information.

scholarly journals The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Carlijn R. Lamers ◽  
Nicole M. de Roos ◽  
Ben J. M. Witteman
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Activity Index ◽  
Statistical Significance ◽  
Inflammatory Bowel ◽  
Anti Inflammatory

Abstract Background Diet may play a role in disease status in patients with inflammatory bowel disease. We tested whether the inflammatory potential of diet, based on a summation of pro- and anti-inflammatory nutrients, is associated with disease activity in patients with Crohn’s disease and ulcerative colitis. Methods Participants completed a disease activity questionnaire (short Crohn’s Disease Activity (sCDAI) or Patient Simple Clinical Colitis Activity Index (P-SCCAI)) and a Food Frequency Questionnaire (FFQ). FFQ data were used to calculate the Dietary Inflammatory Index (DII) which enables categorization of individuals’ diets according to their inflammatory potential on a continuum from pro- to anti-inflammatory. Associations with disease activity were investigated by multiple linear regression. Results The analysis included 329 participants; 168 with Crohn’s disease (median sCDAI score 93 [IQR 47–156]), and 161 with ulcerative colitis (median P-SCCAI score 1 [IQR 1–3]). Mean DII was 0.71 ± 1.33, suggesting a slightly pro-inflammatory diet. In Crohn’s disease, the DII was positively associated with disease activity, even after adjustment for confounders (p = 0.008). The mean DII was significantly different between participants in remission and with mild and moderately active disease (0.64, 0.97 and 1.52 respectively, p = 0.027). In ulcerative colitis, the association was not significant. Conclusions Disease activity was higher in IBD participants with a more pro-inflammatory diet with statistical significance in Crohn’s disease. Although the direction of causality is not clear, this association strengthens the role for diet in medical treatment, which should be tested in an intervention study.

scholarly journals P253 The prevalence of type 6 herpes with polyps in patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S276-S276
Author(s):  
G Babayeva-Sadigova ◽  
Z Babayev ◽  
U Mahmudov ◽  
G Asadova ◽  
F Quliyev ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Disease Activity ◽  
Pyruvate Kinase ◽  
Bowel Disease ◽  
Herpes Viruses ◽  
Intestinal Polyps ◽  
Inflammatory Bowel

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 infections are a serious problem, especially for individuals with prolonged immunosuppression. The aim of this study was t o assess the frequency of detection of herpes-6 type with polyps in patients with IBD. Methods 189 patients with IBD, 102 with ulcerative colitis and 87 with Crohn’s disease were examined. Of the number of patients: 98women, 91man. The age of the patients is from 16 to 63 years (mean age 41.4 ± 4.8), out of 189 patients intestinal polyps were identified in 61 patients with a colonoscopy. In addition to standard clinical and endoscopic examinations, disease activity was assessed by indicators of highly sensitive C-reactive protein, homocysteine, vitamin D in blood serum, albumin in urine, calprotectin, lactoferrin and pyruvate kinase in faeces. All patients underwent a serological blood test by ELISA for specific antibodies to herpesvirus type 1–6 IgG/IgM antibodies, as well as avidity, determination of DNA to herpes viruses of types 1–6 species by PCR in blood and mucosal biopsy. Results Among patients with IBD (n = 189), active herpes viruses in the blood were found in 65 patients (34.4%); of them, 39 patients (20.6% (n = 189) and 60%(n = 65),respectively) were diagnosed with monoherpesvirus infections, and 26 (13.7%(n = 189) and 40%(n = 65), respectively) of myxedvirus infections. PCR of the biopsy material was positive in isolation for type 6 herpes virus in 22 cases (11.6% (n = 189) and 33.8% (n = 65)) and in 34 cases (17.9% (n = 189) and 52.3% (n = 65)) a myxedvirus lesion was detected in the tissue (HV6 + EPB, HV6 + CMV), these indicators were detected in patients with intestinal polyps. Although clinical and endoscopic and laboratory indicators of disease activity were significantly higher in patients with mixed tissue lesions (p˂0.05), the level of faecal pyruvate kinase was higher in patients with polyps, indicating a negative effect of herpes type 6 on the course of inflammatory bowel diseases. At the same time, no significant differences were found between patients with ulcerative colitis and Crohn’s disease. Conclusion The frequency of occurrence of herpes type 6 on PCR biopsy in patients with polyps with IBD is more than 91.8% (36.5% in isolation and 55.7% of mixed lesions) and is accompanied by higher rates of faecal pyruvate kinase, which is already an indicator of emerging malignancy. The authors propose the determination of polyps in patients with IBD HV6 by PCR biopsy of intestinal tissue.

scholarly journals Intestinal Ultrasound in Inflammatory Bowel Disease: A Valuable and Increasingly Important Tool

2021 ◽  
pp. 1-17
Author(s):  
Catarina Frias-Gomes ◽  
Joana Torres ◽  
Carolina Palmela
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Response To Therapy ◽  
Inflammatory Bowel

<b><i>Background:</i></b> Intestinal ultrasound is emerging as a non-invasive tool for monitoring disease activity in inflammatory bowel disease patients due to its low cost, excellent safety profile, and availability. Herein, we comprehensively review the role of intestinal ultrasound in the management of these patients. <b><i>Summary:</i></b> Intestinal ultrasound has a good accuracy in the diagnosis of Crohn’s disease, as well as in the assessment of disease activity, extent, and evaluating disease-related complications, namely strictures, fistulae, and abscesses. Even though not fully validated, several scores have been developed to assess disease activity using ultrasound. Importantly, intestinal ultrasound can also be used to assess response to treatment. Changes in ultrasonographic parameters are observed as early as 4 weeks after treatment initiation and persist during short- and long-term follow-up. Additionally, Crohn’s disease patients with no ultrasound improvement seem to be at a higher risk of therapy intensification, need for steroids, hospitalisation, or even surgery. Similarly to Crohn’s disease, intestinal ultrasound has a good performance in the diagnosis, activity, and disease extent assessment in ulcerative colitis patients. In fact, in patients with severe acute colitis, higher bowel wall thickness at admission is associated with the need for salvage therapy and the absence of a significant decrease in this parameter may predict the need for colectomy. Short-term data also evidence the role of intestinal ultrasound in evaluating therapy response, with ultrasound changes observed after 2 weeks of treatment and significant improvement after 12 weeks of follow-up in ulcerative colitis. <b><i>Key Messages:</i></b> Intestinal ultrasound is a valuable tool to assess disease activity and complications, and to monitor response to therapy. Even though longer prospective data are warranted, intestinal ultrasound may lead to a change in the paradigm of inflammatory bowel disease management as it can be used in a point-of-care setting, enabling earlier intervention if needed.

scholarly journals P371 Self-medication with analgesics in ulcerative colitis: Results of a patient survey

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S349-S350
Author(s):  
I Rodríguez-Lago ◽  
F Mesonero Gismeno ◽  
M Cañas ◽  
C Savini ◽  
R Saldaña ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Emergency Room ◽  
Disease Activity ◽  
Bowel Disease ◽  
Working Group ◽  
Online Survey ◽  
Hospital Admissions ◽  
Self Medication ◽  
Inflammatory Bowel

Abstract Background Ulcerative colitis (UC) is a debilitating chronic condition that affects the large intestine and courses with episodes of flare and remission, being steroid-free remission the main treatment goal. Our aim was to assess the prevalence of self-medication with analgesics, and its associated factors in a Spanish cohort of UC patients. Methods An anonymous cross-sectional survey was developed by 3 IBD experts from the Spanish working group on Crohn’s disease (CD) and Ulcerative Colitis (GETECCU), one nurse of the Spanish nursing working group on inflammatory bowel disease (GETEII) and two patients from the Spanish confederation of associations of patients with CD and UC (ACCU). A link to the online survey was distributed to the ACCU affiliates and to other adult patients with UC through 50 inflammatory bowel disease (IBD) units from Spain. Participants voluntarily answered to the survey based on their own experiences during the last year. Results We collected data from 546 patients, 61% women, mean age 40 years old. Of these, 51% patients were followed-up by IBD specialists and 47% by a general gastroenterologist. Patients’ self-reported disease activity during the last year was: 125 (23%) inactive, 188 (34%) mild, 170 (31%) moderate and 63 (12%) severe. Visits to the emergency room (24%), urgent telephone calls (43%) and hospital admissions (10%) were reported by patients during the last year. A total of 320 (59%) patients declared to have self-medicated with analgesics during the past year, mostly with paracetamol [n = 247 (45%)] and metamizole [118 (22%)], followed by ibuprofen [26 (5%)] and codeine [23 (4%)]. The frequency of self-medication was higher in those patients who declared having a moderate (57%) to severe (65%) disease activity, compared with those who felt their disease was mild (45%) or inactive (39%), (p &lt; 0.001). In addition, patients who needed urgent telephone assistance showed a higher frequency of self-medication (n = 139, 59%) [OR 2 (95% CI:1–3), p &lt; 0.001]. Multivariate analysis revealed that self-medication with analgesics was associated to female gender [OR 2 (95% CI: 1–3), p &lt; 0.001], intravenous (IV) biological therapy [OR 3 (95% CI: 2–5), p &lt; 0.001] and visits to the emergency room [OR 3 (95% CI: 2–4), p &lt; 0.001]. Conclusion Self-medication with analgesics is a common practice in patients with UC from Spain. Factors like being a woman, treatment with IV biological drugs, needing urgent telephone assistance and attending to the emergency room, were associated with self-medication with analgesics. This project was endorsed by GETECCU, GETEII, ACCU and funded by MSD Spain.

scholarly journals Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables

2014 ◽  
Vol 132 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Rodrigo Andrade Alves ◽  
Sender Jankiel Miszputen ◽  
Maria Stella Figueiredo
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Iron Deficiency ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Activity Index ◽  
Deficiency Anemia ◽  
Inflammatory Bowel

CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.

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