scholarly journals Ulcerative Colitis: the Role of Elective and Emergency Surgery

2021 ◽  
Vol 5 (1) ◽  
pp. 829-833
Author(s):  
Francesk Mulita ◽  
Fotios Iliopoulos ◽  
Elias Liolis ◽  
Levan Tchabashvili ◽  
Nikolas Drakos ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Alimentary Tract ◽  
Colon Adenocarcinoma ◽  
General Surgeon ◽  
Major Contributor ◽  
Inflammatory Conditions ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) is a group of auto-inflammatory conditions characterized by chronic, remitting, and relapsing inflammation of the alimentary tract. It is comprised of two phenotypically different entities: Crohn’s disease, and ulcerative colitis (UC). The aim of this article is to explore the role of the general surgeon regarding the treatment of patients suffering from UC while presenting a case of a 55-year-old woman with low-differentiated colon adenocarcinoma associated with ulcerative colitis. Patients with UC have a high-risk of developing colorectal cancer. While medical treatment is commonly the initial approach to UC, surgery constitutes a major contributor in dealing with UC.  Inflammatory bowel disease (IBD) is a group of auto-inflammatory conditions characterized by chronic, remitting, and relapsing inflammation of the alimentary tract. It is comprised of two phenotypically different entities: Crohn’s disease, and ulcerative colitis (UC). The aim of this article is to explore the role of the general surgeon regarding the treatment of patients suffering from UC while presenting a case of a 55-year-old woman with low-differentiated colon adenocarcinoma associated with ulcerative colitis. Patients with UC have a high-risk of developing colorectal cancer. While medical treatment is commonly the initial approach to UC, surgery constitutes a major contributor in dealing with UC.  Case report. A 55-year-old female with hypertension and iron deficiency anemia presented to our emergency department with fever, diarrhea, and epigastric pain for 24 hours which was not associated with heartburn, vomiting, melena, or hematemesis. On examination, the patient’s temperature was 39oC, heart rate was 104 beats per minute, blood pressure was 108/65 and the respiratory rate was 20 breaths per minute. Her abdomen was soft, without distension, and with no evidence of palpable mass...

scholarly journals Clinical assessment of inflammatory bowel disease activity: a critical overview

2015 ◽  
Vol 84 (2) ◽  
pp. 113-125
Author(s):  
Adam Fabisiak ◽  
Natalia Murawska ◽  
Anna Mokrowiecka ◽  
Ewa Małecka-Panas ◽  
Jakub Fichna
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Clinical Aspects ◽  
Gi Tract ◽  
Inflammatory Conditions ◽  
Symptom Recognition ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Critical Overview ◽  
Future Concepts

Crohn’s disease (CD) and ulcerative colitis (UC), which belong to the group of inflammatory bowel diseases (IBD), are chronic inflammatory conditions of the gastrointestinal (GI) tract. Over the last eighty years the overview of IBD has evolved, along with disease symptom recognition, hypotheses on etiology and recommendations for clinical treatment. This review focuses on the clinical aspects of IBD throughout the years and discusses the most recent and future concepts in IBD diagnosis.

N04 Knowledge, attitude and perception of inflammatory bowel disease patients towards colorectal cancer risk, its management and the role of healthcare providers: a cross-sectional study in the UK

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S659-S659
Author(s):  
F Khan ◽  
W Czuber-Dochan ◽  
C Norton
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Risk Management ◽  
Cancer Risk ◽  
Bowel Disease ◽  
Initiation Time ◽  
Cross Sectional ◽  
Early Cancer Diagnosis ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) increases the risk of colorectal cancer (CRC) and requires specialised cancer risk management. Although literature exists on general disease-related knowledge in IBD patients, limited studies have assessed IBD patients’ knowledge of CRC risk and its management. Consequently, patient perception of the role of a healthcare provider (HCP) in patient education of CRC risk and their attitude towards recommended risk management has not been assessed in UK IBD patients. Methods We conducted a cross-sectional online survey with IBD patients recruited via charity sources from April-July 2019. Adult patients (>18 years) with a confirmed diagnosis of IBD for 2 years and adequate command of English language were included. A self-designed and piloted questionnaire with open and closed-ended questions was used. Closed-ended data were analysed using descriptive statistics and open-ended responses were analysed using content analysis. Fischer’s exact test and bivariate logistic regression were used to test for association between knowledge and patient demographics. Results 92 participants, including 52.5% CD and 67.5% females, responded. 88% knew that IBD increases CRC risk. The mean fear of CRC risk (0–10 visual analogue scale) was 6.37 (SD ± 2.8). One-fifth were aware of colonoscopy as the best screening tool; 88% were unaware of screening initiation time. 90% would agree to their doctor’s recommendation of colonoscopy to ensure early cancer diagnosis and treatment. For dysplasia with 10% risk of CRC, 46.7% would not agree to colectomy mainly due to 10% risk of CRC not being high enough to undergo surgery. Forty-eight per cent of participants said that they never had a discussion about increased CRC risk in IBD with their doctor. Almost two-thirds were not informed about the role of screening/surveillance in cancer. Two-thirds were satisfied with the information provided by their HCP. Overall, patients desired more information about their individualised cancer risk and services available for managing the increased risk. Conclusion IBD patients are well informed about IBD-associated CRC risk, feared this risk greatly but were poorly aware of screening initiation time. HCP’s role in cancer knowledge dissemination was sub-optimal and patients desired more knowledge. We need deeper understanding of patients’ educational needs related to CRC.

Inflammatory bowel disease and colonic disorders

2021 ◽  
pp. 150-208
Author(s):  
Thomas Marjot
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Core Curriculum ◽  
Therapeutic Drug ◽  
Biologic Therapies ◽  
Inflammatory Bowel ◽  
Prevention Of Cancer ◽  
Curriculum Topics

This chapter covers core curriculum topics relating to inflammatory bowel disease (IBD) and colonic disorders. A diagnostic approach to IBD is covered including the role of imaging, endoscopy, histopathology and clinical features. Pathophysiology and epidemiology of IBD is detailed. Management of Ulcerative colitis and Crohn’s disease includes assessment of disease severity, imaging modalities and therapeutic management. Particular focus is given to therapeutic drug monitoring and indications for biologic therapies. Surgical management of IBD is broadly covered including indications, timing and approach. Coverage is also given to the diagnosis and management of extra-intestinal manifestations of IBD, IBD in special situations (pregnancy, elderly, transition) and the prevention of cancer in IBD. Colorectal cancer and benign conditions including constipation, functional gut disorders and other colitides are also featured.

The Multifaceted Role of Natural Agents in Colitis-Associated Cancer Prevention and Therapy

2021 ◽  
pp. 220-239
Author(s):  
Ashok Kumar Kumar Pandurangan ◽  
Suresh Kumar Anandasadagopan ◽  
Neesar Ahmed
Keyword(s):  
Oxidative Stress ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Colon Cancer ◽  
The Other ◽  
Preclinical Model ◽  
Natural Agents ◽  
Inflammatory Bowel ◽  
Prevention And Therapy

Inflammatory bowel disease (IBD) is comprised of ulcerative colitis (UC) and Crohn's disease (CD) that was recognized by the inflammation in the colon. There are no proper medications are available to control the IBD in patients. NASIDs such as Aspirin, diclofenac, and ibuprofen are widely used to control the inflammation. On the other hand, the untreated prolonged inflammation leads to the development of cancer in the colon termed as colitis-associated cancer or inflammation-driven colon cancer. Oxidative stress and inflammation play key roles in the pathogenesis of colitis-associated cancer. Single dose of azozymethane (AOM) and three cycles of 2% dextran sodium sulfate (DSS) induces colitis-associated cancer (CAC) in mouse. Hence, many natural products were tested in the preclinical model of colitis-associated cancer. Each of these natural agents modulate important signaling pathway to control the colitis-associated cancer (CAC). In this review, the authors tabulated all the natural agents that culminate the colitis-associated cancer in the preclinical models.

Case-control Study on Dactylitis, Enthesitis, and Anterior Uveitis in Spondyloarthritis Associated with Inflammatory Bowel Diseases: Role of Coexistent Psoriasis

2017 ◽  
Vol 44 (9) ◽  
pp. 1341-1346 ◽  
Author(s):  
Fabrizio Cantini ◽  
Laura Niccoli ◽  
Carlotta Nannini ◽  
Emanuele Cassarà ◽  
Olga Kaloudi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Anterior Uveitis ◽  
Skin Disease ◽  
Case Control Study ◽  
Case Control ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Control Study

Objective.To evaluate the frequency of dactylitis, enthesitis, and anterior uveitis (AU) in spondyloarthritis (SpA) associated with inflammatory bowel disease (IBD-SpA) compared with other SpA, and to assess the role of associated psoriasis in the occurrence of dactylitis and enthesitis.Methods.In a 12-month case-control study, the frequency of dactylitis and enthesitis in 29 patients with ulcerative colitis (UC) and 59 with Crohn disease (CD) who satisfied the Spondyloarthritis international Society criteria for axial or peripheral SpA was compared with 176 controls, including 97 (55.1%) with psoriatic arthritis (PsA), 47 (26.7%) with ankylosing spondylitis (AS), and 32 (18.2%) with nonradiographic axial SpA (nr-axSpA). The occurrence of these features in IBD-SpA with and without psoriasis was also evaluated.Results.Axial, peripheral, or mixed involvement was observed in 46 (52%), 29 (33%), and 13 (15%) patients, respectively; and 14/88 (16%) had psoriasis. Dactylitis was recorded in 4/88 patients (4.5%) with IBD-SpA and in 30 controls (17.4%; p = 0.008), enthesitis in 16 cases (18.1%) and in 78/176 controls (44.3%; p < 0.001), and AU in 3 patients (3.4%) with IBD-SpA and in 26 controls (14.7%; p = 0.01). No significant differences were found between patients with UC-SpA and those with CD-SpA. Dactylitis and enthesitis were significantly more common in patients with IBD-SpA who also had psoriasis compared to those without skin disease (p = 0.009 and 0.003, respectively).Conclusion.Dactylitis, enthesitis, and AU are significantly less frequent in IBD-SpA compared with other types of SpA. Given the frequent association of psoriasis and IBD, overlooking coexistent skin disease may lead to overestimating the frequency of these features.

scholarly journals Going Beyond Bacteria: Uncovering the Role of Archaeome and Mycobiome in Inflammatory Bowel Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Yashar Houshyar ◽  
Luca Massimino ◽  
Luigi Antonio Lamparelli ◽  
Silvio Danese ◽  
Federica Ungaro
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
The Body ◽  
Inflammatory Conditions ◽  
Relapsing Remitting ◽  
Health And Disease ◽  
Inflammatory Bowel ◽  
Chronic Intestinal Inflammation

Inflammatory Bowel Disease (IBD) is a multifaceted class of relapsing-remitting chronic inflammatory conditions where microbiota dysbiosis plays a key role during its onset and progression. The human microbiota is a rich community of bacteria, viruses, fungi, protists, and archaea, and is an integral part of the body influencing its overall homeostasis. Emerging evidence highlights dysbiosis of the archaeome and mycobiome to influence the overall intestinal microbiota composition in health and disease, including IBD, although they remain some of the least understood components of the gut microbiota. Nonetheless, their ability to directly impact the other commensals, or the host, reasonably makes them important contributors to either the maintenance of the mucosal tissue physiology or to chronic intestinal inflammation development. Therefore, the full understanding of the archaeome and mycobiome dysbiosis during IBD pathogenesis may pave the way to the discovery of novel mechanisms, finally providing innovative therapeutic targets that can soon implement the currently available treatments for IBD patients.

scholarly journals DIAGNOSTIC AND MANAGEMENT APPROACH TO POUCHITIS IN INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 57 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Rocío SEDANO ◽  
Paulina NUÑEZ ◽  
Rodrigo QUERA
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Sclerosing Cholangitis ◽  
Biological Therapy ◽  
Response To Therapy ◽  
Management Approach ◽  
Total Proctocolectomy ◽  
Inflammatory Bowel

ABSTRACT In patients with ulcerative colitis refractory to medical therapy, total proctocolectomy and posterior ileal-anal pouch anastomosis is the standard surgical therapy. One of the possible complications is pouchitis. Depending on the duration of the symptoms, it can be classified as acute, recurrent, or chronic. The latter, according to the response to therapy, can be defined as antibiotic-dependent or refractory. The treatment of pouchitis is based on the use of antibiotics and probiotics. Thiopurine and biological therapy have been suggested in patients with refractory pouchitis. Special care should be taken in the endoscopic surveillance of these patients, especially if they present risk factors such as dysplasia or previous colorectal cancer, primary sclerosing cholangitis or ulcerative colitis for more than 10 years.

scholarly journals Sparring partners in inflammatory bowel disease: Resident microbiota and the gastrointestinal mucosal immune system

2011 ◽  
Vol 33 (4) ◽  
pp. 26-31
Author(s):  
Mona Bajaj-Elliott
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Immune System ◽  
Bowel Disease ◽  
Mucosal Immune System ◽  
Inflammatory Conditions ◽  
Cellular Events ◽  
Inflammatory Bowel ◽  
Molecular Nature

Intestinal homoeostasis is a complex affair. We are just beginning to appreciate the molecular nature of the crosstalk that allows happy coexistence between the commensal resident microbiota and the gastrointestinal (GI) mucosal immune system. Both microbial and host components involved in this interplay are being increasingly identified and studied. A better understanding of these multifaceted interactions holds the key for unlocking the cellular events responsible for gut inflammatory conditions such as Crohn's disease and ulcerative colitis.

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