scholarly journals Challenges in Pediatric Inflammatory Bowel Disease

2019 ◽  
Vol 25 (3) ◽  
pp. 132-137
Author(s):  
Mihai Larisia ◽  
Dumitru Eugen ◽  
Pruna Irina ◽  
Chisnoiu Tatiana ◽  
Ungureanu Adina ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Induction Therapy ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Age At Onset ◽  
Favourable Outcome ◽  
Induction Treatment ◽  
Oral Corticosteroids ◽  
Inflammatory Bowel

Abstract Inflammatory bowel disease (IBD) is a chronic condition of the gastrointestinal tract comprising of two entities: Crohn disease (CD) and Ulcerative colitis (UC). Considered rare in children in the past, inflammatory bowel disease is nowadays more frequently found, raising diagnostic and treatment challenges. In our study, we have taken into consideration all children diagnosed with inflammatory bowel disease, in the Department of Pediatrics of the Clinical Emergency County Hospital of Constanta, from 2016 to 2019. 14 children were diagnosed with inflammatory bowel disease during this timeframe, 8 with Crohn disease (57,14%) and 6 with Ulcerative colitis (42,86%). The mean age at onset was 8.2 years for Crohn disease patients, varying between 20 months to 15 years, and 12.8 years for Ulcerative colitis patients, varying between 8 to 14 years. After a positive diagnosis, different types of induction therapy was implemented, depending on the activity and severity of the disease, as well as on the type of inflammatory bowel disease. 12 patients received iv corticosteroids for an average of five days, followed by oral corticosteroids for 4-8 weeks. Aminosalicylates (Mesalazine) was used as a sole induction treatment in children with UC, or in association with corticosteroids in severe cases (4 cases). Immunomodulatory treatment (Azathioprine) was used for maintaining remission in 5 children with Crohn disease for an average period of 6 months. In 3 cases of CD, antibiotics, such as Metronidazole, were used in the initial treatment. Biological therapy, such as Adalimumab (ADA), was administered as an induction therapy in patients with refractory to conventional treatment forms, in 5 cases, with a favourable outcome.

scholarly journals Incidence of Inflammatory Bowel Disease in Kaunas Region, Lithuania

Medicina ◽  
2012 ◽  
Vol 48 (8) ◽  
pp. 64 ◽  
Author(s):  
Gediminas Kiudelis ◽  
Laimas Jonaitis ◽  
Kęstutis Adamonis ◽  
Aida Žvirblienė ◽  
Algimantas Tamelis ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Western Europe ◽  
Age At Onset ◽  
Its Region ◽  
Indeterminate Colitis ◽  
Inflammatory Bowel

Objective. The aim of this study was to evaluate the incidence of inflammatory bowel disease in Kaunas and its region during a 3-year period. Material and Methods. The study was conducted during the 3-year period (2007–2009) and enrolled the patients from Kaunas with its region, which has a population of 381 300 inhabitants. The data were collected from all practices in the area where the diagnosis of inflammatory bowel disease was made by practicing gastroenterologists and consulting pediatricians along with endoscopists. Only new cases of inflammatory bowel disease were included into analysis. The diagnosis of ulcerative colitis and Crohn’s disease was strictly made according to the Copenhagen criteria. Age- and sex-standardized incidence was calculated for each year of the study period. Results. A total of 108 new inflammatory bowel disease cases were diagnosed during the study period: 87 had ulcerative colitis, 16 Crohn’s disease, and 5 indeterminate colitis. The incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis for each study year was 6.85, 5.33, and 7.38 per 100 000; 0.95, 1.11, and 1.57 per 100 000; and 0.47, 0.21, and 0.42 per 100 000, respectively. The average 3-year standardized incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis was 6.52, 1.21, and 0.37 per 100 000, respectively. The mean patients’ age at onset of ulcerative colitis, indeterminate colitis, and Crohn’s disease was 49.95 (SD, 17.03), 49.80 (SD, 17.71), and 34.94 years (SD, 0.37), respectively. Conclusions. The average 3-year incidence of ulcerative colitis in Kaunas region was found to be lower as compared with that in many parts of Central and Western Europe. The incidence of Crohn’s disease was low and very similar to other countries of Eastern Europe. Age at onset of the diseases appeared to be older than that reported in the Western industrialized countries.

scholarly journals News and controversy in inflammatory bowel disease treatment

2013 ◽  
pp. 179-186
Author(s):  
Giulia Straforini ◽  
Ramona Brugnera ◽  
Rosy Tambasco ◽  
Fernando Rizzello ◽  
Paolo Gionchetti ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Topical Treatment ◽  
Preventive Treatment ◽  
High Dose ◽  
First Choice ◽  
Oral Steroids ◽  
Inflammatory Bowel

Background: The treatment of Inflammatory bowel disease comes from many years of esperience, clinical trials and mistakes. Discussion: In patients with active Crohn disease steroids are considerated the first choice, but recently, the introduction of anti-TNF alfa agents (infliximab and adalimumab) has changed the protocols. Anti-TNF are also used for closing fistula after surgical curettage. An efficently preventive treatment of Crohn disease still has not been found but hight dose of oral salicylates, azatioprine or 6-MP and antibiotics might be useful. In severe attacks of ulcerative colitis, high dose iv treatment of steroids are required for a few days. Later on, a further treatment with anti- TNF might delay the need of surgery. In patients with mild to moderate attacks of ulcerative colitis, topical treatment is preferred, it consists of enemas, suppositories or foams containing 5-aminosalycilic acid, traditional steroids, topical active steroids. Topical treatment can be associated with oral steroids or oral salicylates. Oral salicylates or azatioprine are used for prevention of relaps.

scholarly journals FREQUENCY OF OPHTHALMOLOGICAL POSTERIOR SEGMENT FINDINGS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2018 ◽  
Vol 55 (2) ◽  
pp. 188-191 ◽  
Author(s):  
Luis Filipe NAKAYAMA ◽  
Vinicius Campos BERGAMO ◽  
Marina Lourenço de CONTI ◽  
Lívia BUENO ◽  
Nilva Simeren Bueno de MORAES ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Posterior Segment ◽  
Oct Angiography ◽  
Ophthalmological Examination ◽  
Study Objective ◽  
Systemic Inflammatory Disease ◽  
Inflammatory Bowel

ABSTRACT BACKGROUND: Inflammatory bowel disease is a systemic inflammatory disease classified as Crohn disease or ulcerative colitis. It could present extra intestinal findings, such as fever, weight loss, arthralgia, mucocutaneous lesions, hepatic, renal and ophthalmological involvement. Among ophthalmological findings, posterior segment findings are present in less than 1% of patients with inflammatory bowel disease, however, these findings could bring definitive visual impairment. OBJECTIVE: Our study objective was to evaluate ocular posterior segment findings is patients with inflammatory bowel disease, through retinal mapping, color fundus retinography, optical coherence tomography (OCT) and OCT angiography, and compare our results to literature. METHODS: We evaluated eighty patients with inflammatory bowel disease through complete ophthalmological examination and posterior segment assessment. Color fundus retinography, OCT and OCT angiography was performed with Topcon Triton (Topcon ® , Tokyo, Japan). Macula and posterior pole were evaluated with binocular indirect ophthalmoscopy and fundus biomicroscopy. RESULTS: Participants mean age was 44.16 years (18.08-68.58), 28 (35%) male patients and 52 (65%) female patients. Thirty-five (44%) with diagnosis of Crohn disease, 41 (52%) patients with diagnosis of ulcerative colitis and 3 (4%) had non-conclusive Crohn disease or ulcerative colitis classification. We found abnormal exams in 21 (26.25%) patients. CONCLUSION: Our study found similar prevalence of ophthalmological posterior segment commitment compared to previous literature prevalence. The findings were predominantly unrelated to inflammatory bowel disease, rather than primarily related to it. The most prevalent, and non-previous reported, finding was increased arteriolar tortuosity, probably occurs due to systemic vascular impairment in inflammatory bowel disease.

Ulcerative Colitis and Crohn Disease in Children

1987 ◽  
Vol 9 (4) ◽  
pp. 109-120
Author(s):  
Kathleen J. Motil ◽  
Richard J. Grand
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Correct Diagnosis ◽  
Age Groups ◽  
Growth Failure ◽  
Clinical Findings ◽  
Chronic Inflammatory Bowel Disease ◽  
Inflammatory Bowel

Once considered rare in pediatric practice, chronic inflammatory bowel disease is now recognized with increasing frequency in children. Ulceractive colitis and Crohn disease constitute the two major entities, and it is still not clear whether these are two separate entities or different portions of the spectrum of one disease. Abdominal pain, diarrhea, rectal bleeding, weight loss, and anemia are prominent findings in both ulcerative colitis and Crohn disease; however, extraintestinal manifestations may dominate the clinical findings, masquerading as juvenile rheumatoid arthritis, idiopathic growth failure, or even anorexia nervosa. Often, it is not until intestinal manifestations are recognized that a correct diagnosis is made.1 EPIDEMIOLOGY OF INFLAMMATORY BOWEL DISEASE Since 1950, there has been an increase, in the incidence of Crohn disease, ranging from 100% to 400% in all age groups.2 In contrast, the incidence of ulcerative colitis has not changed significantly. Ulcerative colitis is diagnosed in 15% of patients before the age of 20 years, usually in adolescence. Although ulcerative colitis may occur in infancy, inflammatory disease of the colon during the first year of life is more often due to food allergy3 or infectious disease. Certain groups of children are at greater risk for the development of inflammatory bowel disease. Ulcerative colitis and Crohn disease occur more commonly among Northern European, Anglo-Saxon races, in urban rather than rural dwellers, and in Jewish individuals living in Europe and North America.

Monocytosis Is a Biomarker of Severity in Inflammatory Bowel Disease: Analysis of a 6-Year Prospective Natural History Registry

2021 ◽  
Author(s):  
Alyce Anderson ◽  
Cynthia Cherfane ◽  
Benjamin Click ◽  
Claudia Ramos-Rivers ◽  
Ioannis E Koutroubakis ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Natural History ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Disease Type ◽  
Care Utilization ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) is associated with alterations of the innate and adaptive immune systems. Monocytes respond to inflammation and infection, yet the relationship between monocytosis and IBD severity is not fully understood. We aimed to characterize the prevalence of monocytosis in IBD and the association between monocytosis and disease severity and IBD-related health care utilization. Methods We used a multiyear, prospectively collected natural history registry to compare patients with IBD with monocytosis to those without monocytosis, among all patients and by disease type. Results A total of 1290 patients with IBD (64.1% with Crohn disease; 35.9% with ulcerative colitis) were included (mean age 46.4 years; 52.6% female). Monocytosis was found in 399 (30.9%) of patients with IBD (29.3% with Crohn disease; 33.9% with ulcerative colitis). Monocytosis was significantly associated with abnormal C-reactive protein level and erythrocyte sedimentation rate, anemia, worse quality of life, active disease, and increased exposure to biologics (all P < 0.001). Compared with patients without monocytosis, patients with monocytosis had a 3-fold increase in annual financial health care charges (median: $127,013 vs. $32,925, P < 0.001) and an increased likelihood of hospitalization (adjusted odds ratio [AOR], 4.5; P < 0.001), IBD-related surgery (AOR, 1.9; P = 0.002), and emergency department (ED) use (AOR, 2.8; P < 0.001). Patients with monocytosis had a shorter time to surgery, hospitalization, and ED visit after stratifying by disease activity (all P < 0.05). Conclusions Patients with IBD with monocytosis, regardless of disease type, are at increased risk for worse clinical outcomes, hospitalization, surgery, and ED use. Peripheral monocytosis may represent a routinely available biomarker of a distinct subgroup with severe disease.

Colonic Disorders

2016 ◽  
pp. 217-228
Author(s):  
Conor G. Loftus
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Chronic Inflammation ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Key Factor ◽  
Inflammatory Bowel

Inflammatory bowel disease refers to 2 disorders of unknown cause: ulcerative colitis and Crohn disease. Other possible causes of inflammation, especially infection, should be excluded before making the diagnosis of inflammatory bowel disease. The presence of chronic inflammation on biopsy is the key factor for making a diagnosis of inflammatory bowel disease.

Sign in / Sign up

Export Citation Format

Share Document