scholarly journals Ultrasound Elastography in the Assessment of the Intestinal Changes in Inflammatory Bowel Disease—Systematic Review

2021 ◽  
Vol 10 (18) ◽  
pp. 4044
Author(s):  
Dominika Ślósarz ◽  
Elżbieta Poniewierka ◽  
Katarzyna Neubauer ◽  
Radosław Kempiński

Inflammatory bowel disease (IBD) is a chronic condition affecting primarily the gastrointestinal tract and characterized by growing incidence worldwide. Complex diagnostic process of IBD as well as evaluation of disease activity and intestinal complications that are crucial for the therapeutic decisions, require repetitive, invasive, expensive, time-consuming and poorly tolerated tests. In contrast to endoscopy and computed tomography, ultrasound elastography (UE) is non-invasive, non-radiating and non-contrasting dependent tool which might be utilized in IBD patients for the assessment of the intestinal changes. Therefore, we performed the systematic review to evaluate the possible application of the ultrasound elastography for assessment of the intestinal changes in IBD. After the search of three databases: PubMed, World of Knowledge and Scopus, we identified 12 papers which were included in the final analysis. The majority of the studies were focused on the evaluation of the symptomatic ileal/ileocolonic strictures in Crohn’s disease patients that required surgical resection. Only one study concerned ulcerative colitis. The authors evaluated different UE techniques: strain elastography (SE), acoustic radiation force impulse (ARFI) and shear wave elastography (SWE). Results were expressed with semi-quantitative color mapping and strain measurement. Histological scores of inflammation and fibrosis in Crohn’s disease were used as a reference test in the majority of studies. Ultrasound elastography seems to be a promising novel imaging technique supporting evaluation of the intestinal strictures in Crohn’s disease patients in respect to fibrosis detection as well as differentiation between fibrosis and inflammation. However, further research is needed to establish the position of ultrasound elastography in IBD management.

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2657 ◽  
Author(s):  
Jose M. Comeche ◽  
Pablo Caballero ◽  
Ana Gutierrez-Hervas ◽  
Sofia García-Sanjuan ◽  
Iris Comino ◽  
...  

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and is characterized by inflammation of the gastrointestinal tract. One of the possible treatments for this pathology is a change in the type of diet, of which enteral nutrition (EN) is one. This study is to understand how the use of EN can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and a meta-regression. On the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 363 registers with an accuracy of 12% (44 registers). After a full-text review, only 30 research studies were selected for qualitative synthesis and 11 for meta-analysis and meta-regression. The variables used were Crohn’s disease activity index (CDAI), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). EN has been shown to have efficacy for the treatment of Crohn’s disease and is compatible with other medicines. As for the CDAI or rates of remission, there were no differences between enteral and parenteral nutrition. Polymeric formulas have shown better results with respect to the CRP. The long-term treatment could dilute the good CDAI results that are obtained at the start of the EN treatment.


Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2865 ◽  
Author(s):  
Jose M. Comeche ◽  
Iris Comino ◽  
Cesare Altavilla ◽  
Jose Tuells ◽  
Ana Gutierrez-Hervas ◽  
...  

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the inflammation of the gastrointestinal tract. This study is to understand how the use of parenteral nutrition (PN) can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and meta-regression. From the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 119 registers with an accuracy of 16% (19 registers). After a full-text review, only 15 research studies were selected for qualitative synthesis and 10 for meta-analysis and meta-regression. The variables used were Crohn’s Disease Activity Index (CDAI), albumin, body weight (BW), and postoperative complications (COM). PN has shown to have efficacy for the treatment of IBD and is compatible with other medicines. The CDAI and albumin improve, although the effect of PN is greater after a while. However, the effect on the albumin could be less than the observed value in the meta-analysis due to possible publication bias. The BW does not change after intervention. COM utilizing PN has been observed, although the proportion is low. More studies specifically referring to ulcerative colitis (UC) and Crohn’s disease (CD) are needed to develop more concrete clinical results.


2012 ◽  
Vol 107 (S2) ◽  
pp. S240-S252 ◽  
Author(s):  
Eduard Cabré ◽  
Míriam Mañosa ◽  
Miquel A. Gassull

Background & Aim: Despite their well known anti-inflammatory actions, the clinical usefulness of omega-3 PUFA in inflammatory bowel disease is controversial. We aimed to systematically review the available data on the performance of omega-3 PUFA as therapeutic agents in these patients. Methods: Electronic databases were systematically searched for RCT of fish oil or omega-3 PUFA therapy in both active and inactive ulcerative colitis or Crohn's disease, without limitation on either the length of therapy or the form it was given, including nutritional supplements and enteral formula diets. Eligible articles were assessed for methodological quality on the basis of the adequacy of the randomisation process, concealment of allocation, blinding of intervention and outcome, possible biases, and completeness of follow-up. The five-point Oxford quality score was calculated. Results: A total of 19 RCT were finally selected for this review. Overall, available data do not allow to support the use of omega-3 PUFA supplementation for the treatment of both active and inactive inflammatory bowel disease. Negative results are quite consistent in trials assessing the use of omega-3 PUFA to maintain disease remission, particularly ulcerative colitis, and to a lesser extent Crohn's disease. Trials on their use in active disease do not allow to draw firm conclusions mainly because the heterogeneity of design (ulcerative colitis) or their short number (Crohn's disease). In most trials, the appropriateness of the selected placebo is questionable. Conclusion: The present systematic review does not allow to make firm recommendations about the usefulness of omega-3 PUFA in inflammatory bowel disease.


Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 77 ◽  
Author(s):  
Lauritano ◽  
Boccalari ◽  
Stasio ◽  
Vella ◽  
Carinci ◽  
...  

Background: Extra-intestinal manifestations of inflammatory bowel disease (IBD) are widely studied. Oral manifestations are manifold, miscellaneous, and hardly detected by general practitioners and gastroenterologists. Objectives: The main purpose of this systematic review is to find all the possible correlations between inflammatory bowel disease and the oral cavity in order to underline the importance of multidisciplinary cooperation with dental care providers, and to secure better treatments for patients. Materials and methods: Articles were searched up to June 2019 through Ebsco’s, Google Scholar, and PubMed databases. The search terms included IBD, oral manifestations of inflammatory bowel disease, oral manifestations of Crohn’s disease or Ulcerative colitis, an extra-intestinal manifestation of IBD, oral Crohn’s disease, and paediatric inflammatory bowel disease. Discussion: The prevalence of the oral manifestation of IBD ranges from 0.7% to 37% in adults and from about 7% to 23% in children. They can be divided into specific manifestations (cobblestoning mucosa, mucosal tags, cheilitis granulomatosa, pyostomatitis vegetans) and nonspecific manifestations (halitosis, dysphagia, aphthous ulcerations, deep oral fissuring, cheilitis angularis, taste changes, lichen planus). Moreover, the link between IBD and the higher prevalence of dental caries and periodontitis have also been studied. Conclusions: The presence of oral manifestations that precede or follow intestinal symptoms of IBD, must be taken into serious consideration from both gastroenterologists and dentists in order to allow for early diagnosis and improve patients’ quality of life.


Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 52
Author(s):  
José M. M. Comeche ◽  
Ana Gutierrez-Hervás ◽  
José Tuells ◽  
Cesare Altavilla ◽  
Pablo Caballero

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the importance of diet in pathological development. This study aims to understand how the use of predefined diets can affect the adult population diagnosed with IBD. We conducted a systematic review and meta-analysis. From the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, and WOS), we found 4195 registers. After a review process, only 31 research studies were selected for qualitative synthesis and 10 were selected for meta-analysis. The variables used were Crohn’s Disease Activity Index (CDAI) for patients with Crohn’s Disease (CD) and fecal calprotectin (FC), C-Reactive Protein (CRP), and albumin (ALB) for patients with IBD. Predefined diets have been shown to have partial efficacy for the treatment of IBD and are compatible with other medical treatments. CDAI improved but with reasonable doubts due to the high heterogeneity of the data, while no differences were observed for ALB, FC, and CRP. More studies that evaluate the influence of predefined diets on IBD patients are needed due to the great variability in diets and the tools used to measure their effects.


2017 ◽  
Vol 1 (2) ◽  
pp. 127
Author(s):  
María Isabel Mangas Borrego

Abstract Introduction: There are currently many studies that discuss possible relationships among the diet, the etiology of Crohn's disease and the possible improvement or worsening of its symptoms. Most of them are based on surveys that describe the dietary patterns adopted by these patients. Objectives: The present review will address quantitative studies comparing the consumption of certain foods (milk and fruits) by subjects diagnosed with Crohn's disease and healthy subjects. On the other hand, it will also address studies of patients who exclude these foods from their diets because they associate them with worsening symptoms of the disease. Methodology: This systematic review was elaborated following the PRISMA guidelines. Six studies that analyze the selected subject matter were selected. Results: The two foods selected for study are very often present in articles that relate diet and Crohn's disease, and both are considered by patients to be influential in the evolution of their pathology. Conclusions: Each study presents different results; thus, to date, there is no consensus on the best diet to follow in inflammatory bowel disease. Of course, it has not been sufficiently demonstrated that the consumption of certain foods causes or worsens the development of this disease. Therefore, further investigations are necessary.


1988 ◽  
Vol 27 (03) ◽  
pp. 83-86 ◽  
Author(s):  
B. Briele ◽  
F. Wolf ◽  
H. J. Biersack ◽  
F. F. Knapp ◽  
A. Hotze

A prospective study was initiated to compare the clinically proven results concerning localization/extent and activity of inflammatory bowel diseases with those of 111ln-oxine leukocyte imaging. All patients studied were completely examined with barium enema x-ray, clinical and laboratory investigations, and endoscopy with histopathology. A total of 31 leukocyte scans were performed in 15 patients (12 with Crohn’s disease, 3 with ulcerative colitis). The scans were graded by comparing the cell uptake of a lesion (when present) and a bone marrow area providing a count ratio (CR). The inflammatory lesions were correctly localized on 26 leukocyte scans, and in 21 scans the scintigraphically estimated extent of disease was identical to endoscopy. In 5 cases the disease extent was underestimated, 4 scans in patients with relapse of Crohn’s disease were falsely negative, and in one patient with remission truly negative. The scintigraphically assessed disease activity was also in a good agreement with clinical disease activity based on histopathology in all cases. We conclude that leukocyte imaging provides valuable information about localization and activity of inflammatory bowel disease.


Sign in / Sign up

Export Citation Format

Share Document