scholarly journals A Case Report on Korean Medical Treatment for Induced Remission of Pediatric Crohn’s Disease

2021 ◽  
Vol 42 (5) ◽  
pp. 853-862
Author(s):  
Hyun-Jin Lee ◽  
Hanul Lee ◽  
Hae In Jeong ◽  
Yun-jae Cho ◽  
Chang-Yul Keum ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Treatment ◽  
Activity Index ◽  
Disease Activity Index ◽  
Nausea And Vomiting ◽  
Abdominal Ct ◽  
Activity Index Score

Objectives: This case study examined the effectiveness of Korean medical treatment for pediatric Crohn’s disease.Methods: A 15-year-old female Korean patient with Crohn’s disease received acupuncture, electroacupuncture, herbal medicine, moxibustion, and aromatherapy treatment for 1 month in a hospital.Results: Decreases in the Pediatric Crohn’s Disease Activity Index score (from 22.5 to 7.5) and the size of two abscesses (from 39.97 mm to 33.36 mm, and from 28.14 mm to 18.71 mm) according to an abdominal CT were observed following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment.Conclusion: It would be worth examining the long-term effectiveness of Korean medical treatment for pediatric Crohn’s disease.

scholarly journals Bovine lactoferrin and Crohn’s disease: a case study

2017 ◽  
Vol 95 (1) ◽  
pp. 133-141 ◽  
Author(s):  
David B. Alexander ◽  
Masaaki Iigo ◽  
Mohamed Abdelgied ◽  
Keiji Ozeki ◽  
Satoshi Tanida ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Activity Index ◽  
Disease Activity Index ◽  
Disease Recurrence ◽  
Mucosal Healing ◽  
University Hospital ◽  
Bovine Lactoferrin ◽  
Colonoscopic Examination

A 22-year-old male suffering from abdominal pain, repeated diarrhea, and weight loss visited the Digestive Disease Department of Nagoya City University Hospital on 19 December 2011. He was hospitalized and diagnosed with Crohn’s colitis. His Crohn’s Disease Activity Index (CDAI) was 415. Treatment by granulocyte apheresis, mesalazine, and adalimumab was started. His CDAI was 314 on 30 December and 215 on 5 January. A colonoscopic examination on 19 January showed almost complete remission in the transverse colon and marked remission in the rectum. Mesalazine therapy was stopped on 28 February, and the patient was instructed to self-inject 40 mg of adalimumab every other week. His CDAI was 50 on 10 April, indicating clinical remission. His last self-injection of adalimumab was on 24 April 2012, and he started taking 1 g of bovine lactoferrin (bLF) daily. His CDAI was 35 on 8 January 2013. He continued taking 1 g of bLF daily without any other treatment for Crohn’s disease. Laboratory blood tests on 7 September 2015 showed no sign of disease recurrence, and a colonoscopic examination on 23 October 2015 showed almost complete mucosal healing. This case indicates that ingestion of bLF to maintain Crohn’s disease in a remissive state should be further explored.

scholarly journals Use of Exclusive Enteral Formula Diet as Adjunctive Therapy for Treatment of a Crohn’s Disease Flare

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Levi M Teigen ◽  
Abigail J Johnson ◽  
Eugenia Shmidt ◽  
Byron P Vaughn
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Activity Index ◽  
Disease Activity Index ◽  
Formula Diet ◽  
Disease Flare ◽  
Exclusive Enteral Nutrition ◽  
Activity Index Score ◽  
Enteral Formula

Abstract Introduction We report the case of an adult patient who achieved remission of a Crohn’s disease flare after treatment with exclusive enteral nutrition as adjunctive therapy to medication. Case Report A 46-year-old man with severe, stricturing Crohn’s presented for severe abdominal pain and weight loss; estimated Crohn’s Disease Activity Index score greater than 300. Antibiotics, vedolizumab, budesonide, and exclusive enteral nutrition diet were instituted. Approximately 30 days later, his Crohn’s Disease Activity Index score improved to 170. Discussion This case illustrates the possible utility of an exclusive enteral formula diet as an adjunct to medication to induce remission of a Crohn’s disease flare.

scholarly journals Penyakit Crohn: Laporan Kasus

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Paul V. Siwy ◽  
Fandy Gosal
Keyword(s):  
Crohn’S Disease ◽  
Los Angeles ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Histopathological Examination ◽  
Activity Index ◽  
Disease Activity Index ◽  
Endoscopic Examination ◽  
Mild Disease ◽  
Activity Index Score

Abstract: Crohn’s disease is an inflammatory transmural bowel disease with unspecific clinical characteritics. It could involve all parts of the digestive system. The exact cause of this disease remains unknown. Its manifestation depends on the location of involved intestinal mucosa, however, it could also occur extra intestinal. We reported a case of Crohn’s disease in a 54-year-old male. In this patient there was defecation with blood in stool, abdominal pain, nausea, and weight loss. Diagnosis was based on history, physical examination, endoscopic examination and colonoscopy, as well as histopathological examination. Colonoscopy EGD examination and tissue biopsy were performed on this patient and revealed esophagitis EGD classification of Los Angeles grade A and erosive gastritis. The results of colonoscopy suggested Crohn’s disease, and internal and external hemorrhoids. Pathology examination showed non-specific chronic gastritis, nonspecific chronic ileitis with datia cells, nonspecific pancolitis, and specific chronic proctitis. Disease activity measured by using CDAI (Crohn Disease Activity Index) score was 170 (mild disease). Moreover, based on the Montreal classification it was classified as A3 L3 B1 and SES-CD (Simple Endoscopic Scoring System in Crohn’s Disease) with value of 0 (not active). This patient was planned to be treated with 500 mg of mesalazine three times daily.Keywords: Crohn’s disease Abstrak: Penyakit Crohn adalah bagian dari penyakit inflamasi saluran cerna dengan karakteristik klinis yang tidak jelas, transmural, dan dapat mengenai semua bagian saluran cerna. Sampai saat ini etiologinya belum diketahui pasti. Manifestasi penyakit ini bervariasi tergantung kerusakan dari lokasi mukosa intestinal yang terkena. Manifestasi ini dapat juga terjadi di luar sistem saluran cerna. Kami melaporkan suatu kasus penyakit Crohn pada seorang laki-laki berusia 54 tahun. Pada pasien ini didapatkan buang air besar disertai darah, nyeri perut, mual dan penurunan berat badan. Diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, pemeriksaan endoskopi dan kolonoskopi serta pemeriksaan histopatologik. Pemeriksaan EGD-kolonoskopi dan biopsi jarring-an dengan hasil EGD esofagitis klasifikasi Los Angeles grade A dan gastritis erosiva. Hasil kolonoskopi ialah kesan suspek penyakit Crohn dengan hemoroid interna dan eksterna. Hasil histopatologi mendapatkan gastritis kronik non spesifik, ileitis kronik non spesifik dengan sel datia, pankolitis non spesifik dan proktitis kronik non spesifik. Aktivitas penyakit diukur dengan skor CDAI sebesar 170 (aktivitas ringan) dan berdasarkan klasifikasi Montreal diklasifikasikan sebagai A3 L3 B1 dan SES-CD sebesar 0 (tidak aktif). Pasien ini direncanakan untuk diterapi dengan pemberian mesalasin 500mg tiga kali sehari.Kata kunci: penyakit Crohn

Outcomes of Passable and Non-passable Strictures in Clinical Trials of Crohn’s Disease: A Post-hoc Analysis

2021 ◽  
Author(s):  
Neeraj Narula ◽  
Emily C L Wong ◽  
Parambir S Dulai ◽  
John K Marshall ◽  
Jean-Frederic Colombel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Activity Index ◽  
Disease Activity Index ◽  
Symptom Improvement ◽  
Logistic Regression Models ◽  
Post Hoc Analysis ◽  
Endoscopic Remission ◽  
Post Hoc ◽  
The Impact

Abstract Background and Aims There is paucity of evidence on the reversibility of Crohn’s disease [CD]-related strictures treated with therapies. We aimed to describe the clinical and endoscopic outcomes of CD patients with non-passable strictures. Methods This was a post-hoc analysis of three large CD clinical trial programmes examining outcomes with infliximab, ustekinumab, and azathioprine, which included data on 576 patients including 105 with non-passable strictures and 45 with passable strictures, as measured using the Simple Endoscopic Score for Crohn’s Disease [SES-CD]. The impact of non-passable strictures on achieving clinical remission [CR] and endoscopic remission [ER] was assessed using multivariate logistic regression models. CR was defined as a Crohn’s Disease Activity Index [CDAI] <150, clinical response as a CDAI reduction of ≥100 points, and ER as SES-CD score <3. Results After 1 year of treatment, patients with non-passable strictures demonstrated the ability to achieve passable or no strictures in 62.5% of cases, with 52.4% and 37.5% attaining CR and ER, respectively. However, patients with non-passable strictures at baseline were less likely to demonstrate symptom improvement compared with those with passable or no strictures, with reduced odds of 1-year CR (adjusted odds ratio [aOR] 0.17, 95% CI 0.03–0.99, p = 0.048). No significant differences were observed between patients with non-passable strictures at baseline and those with passable or no strictures in rates of ER [aOR 0.82, 95% CI 0.23–2.85, p = 0.751] at 1 year. Conclusions Patients with non-passable strictures can achieve symptomatic and endoscopic remission when receiving therapies used to treat CD, although they are less likely to obtain CR compared with patients without non-passable strictures. These findings support the importance of balancing the presence of non-passable strictures in trial arms.

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.

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