scholarly journals Experiences of Adolescents Who Are Living with Inflammatory Bowel Disease

2021 ◽  
Vol 13 (4) ◽  
pp. 49
Author(s):  
E. Ann Holmes ◽  
Cathy Banwell ◽  
Robyn M Lucas ◽  
Joanna Hawkes ◽  
David Moore ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Bowel Disease ◽  
South Australia ◽  
Physical Symptoms ◽  
Face To Face ◽  
Gender Balance ◽  
The Future ◽  
Inflammatory Bowel ◽  
Study Participants

BACKGROUND: Inflammatory bowel disease (IBD) is an incurable, chronic, gastrointestinal condition characterised by recurrent bouts of debilitating abdominal pain and diarrhoea. There is little information on how adolescents with paediatric IBD (PIBD) face the challenges of living with the disease and their perceptions of their journeys towards adulthood. This paper reports the findings of a qualitative study on these issues in adolescents living with PIBD in South Australia. METHODS: Potential study participants, aged between 12 and 17 years were selected by a treating clinician from the PIBD clinic of a major referral hospital, to achieve gender balance and some diversity in the PIBD stage and severity. In-depth face-to-face interviews focused on participants’ perceptions about living with IBD during adolescence and for the future. Interviews were recorded, transcribed and analyzed thematically. RESULTS: Nine adolescents aged 15-17 years consented to participate in the study. Using an overarching theme of ‘the journey’, three major temporal themes were apparent, namely, ‘Reactions at time of diagnosis’, ‘Learning to cope with IBD’ and ‘Acceptance and the future with IBD’. This study demonstrates that, even with optimum support, the pathways towards adulthood were often turbulent and challenging for these young people due to the unpredictability of painful and/or embarrassing physical symptoms. They nevertheless developed strategies which enabled them to accept and cope with a new ‘normality’ with positivity and determination. More research is warranted to investigate the skills required to navigate this path successfully.

scholarly journals Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 643
Author(s):  
Angela Saviano ◽  
Mattia Brigida ◽  
Alessio Migneco ◽  
Gayani Gunawardena ◽  
Christian Zanza ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Human Health ◽  
Bowel Disease ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Inflammatory Bowel

Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

Chronic Nonspecific Inflammatory Bowel Disease of the Cecum and Proximal Colon in Children With Grossly Normal-Appearing Colonic Mucosa: Diagnosis by Colonoscopic Biopsies

PEDIATRICS ◽  
1987 ◽  
Vol 80 (2) ◽  
pp. 255-261
Author(s):  
Melvin B. Heyman ◽  
Jay A. Perman ◽  
Linda D. Ferrell ◽  
M. Michael Thaler
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Bowel Disease ◽  
Colonic Mucosa ◽  
Disease Process ◽  
Proximal Colon ◽  
Chronic Abdominal Pain ◽  
Medical Attention ◽  
Inflammatory Bowel ◽  
Inflammatory Changes

The diagnosis of inflammatory bowel disease rests on radiologic, endoscopic, and histologic creteria. Five patients, 2 to 17 years of age, sought medical attention because of chronic abdominal pain, diarrhea, and heme-positive stools. Rectal biopsies, visual inspection of colonic mucosa through the colonoscope, and contrast radiographs of the large and small intestine yielded nonspecific results. Serial endoscopic biopsies demonstrated a gradient of inflammatory changes diminishing in severity distally from the ileocecal valve and cecum. The disease process was most evident in specimens from the cecum, whereas biopsies distal to the transverse colon had a normal histologic appearance in all five patients. Biopsies from the proximal colon may provide evidence of inflammatory bowel disease not detectable using standard techniques. The combination of chronic abdominal pain, diarrhea, and heme-positive stools associated with inflammatory changes in biopsy specimens obtained from the proximal colon, but normal findings on radiologic, colonoscopic, and rectal biopsy examinations, may represent an early stage in the evolution of chronic nonspecific inflammatory bowel disease, including ulcerative colitis or regional enteritis (Crohn disease).

scholarly journals P136 Management of patients with Inflammatory Bowel Disease and their outcome during the first wave of Covid-19 pandemics

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S223-S224
Author(s):  
A Viola ◽  
F Giambò ◽  
M F Chiappetta ◽  
G Costantino ◽  
S Pallio ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Secondary Outcome ◽  
Reference Period ◽  
Disease Flare ◽  
Face To Face ◽  
Risk Of Disease ◽  
Inflammatory Bowel ◽  
Group 2 ◽  
The Impact

Abstract Background The restrictions adopted in Italy during the phase I COVID-19 pandemics with a nationwide lockdown period, represented a challenge in the management of Patients with Inflammatory Bowel Disease (IBD) patients. The aim of the present study was to assess if, and how, a limited course of telemedicine did influence the clinical outcome in patients with Crohn’s disease (CD) and Ulcerative Colitis (UC). Methods IBD patients followed before March 8th, 2020 were included and divided into 3 groups (Fig.1): group 1, patients on endovenous biologics (EV); group 2, patients on biologics administered subcutaneously (SC); and group 3, patients on conventional treatments (CT) at the start of lockdown. The primary outcome was to assess the occurrence of disease flare in the three groups since only the EV group received face-to-face visits during lockdown. As secondary outcome we assessed the number of control endoscopies performed and the start of new biologic therapies, compared with a reference period in 2019. Results A total of 689 patients (CD: 369, UC 320) were included in the study (247 IV, 217 SC and 225 CT, respectively). Telemedicine was more frequently adopted in SC and CS, (p<0.001) both. Treatment delays or transitory stops were more frequent in EV (p<0.001), whereas there was a significantly greater need to change therapy (p= 0.038) and need for steroids (p = 0.008) in the SC group compared with EV (Tab.1). Concerning endoscopies, compared with the reference period in 2019 only 25% of scheduled endoscopies were performed. The only risk factor for disease flare during or shortly after lockdown was belonging to the patient groups subjected to telemedicine (SC and CT groups) (p < 0.001). Conclusion Patients followed with a face-to-face approach instead of telemedicine, had a lower risk of disease flare during lockdown period. The impact of the important reduction of endoscopic assessments still needs to be assessed.

scholarly journals Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea: calgranulin-C versus calprotectin stool tests

2018 ◽  
Vol 103 (6) ◽  
pp. 565-571 ◽  
Author(s):  
Anke Heida ◽  
Els Van de Vijver ◽  
Don van Ravenzwaaij ◽  
Stephanie Van Biervliet ◽  
Thalia Z Hummel ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Bowel Disease ◽  
Secondary Outcome ◽  
Test Accuracy ◽  
Diagnostic Study ◽  
Operating Characteristics ◽  
Reference Test ◽  
Cross Sectional ◽  
Inflammatory Bowel

ObjectiveCalgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for inflammatory bowel disease (IBD) than calprotectin, since it is only released by activated granulocytes. We compared calgranulin-C and calprotectin to see which of the two tests best predicted IBD in children with chronic abdominal pain and diarrhoea.DesignDelayed-type cross-sectional diagnostic study.Setting and patientsPreviously undiagnosed patients aged 6–17 years, who were seen in paediatric clinics in the Netherlands and Belgium, sent in a stool sample for analysis. Patients with a high likelihood of IBD underwent upper and lower endoscopy (ie, preferred reference test), while those with a low likelihood were followed for 6 months for latent IBD to become visible (ie, alternative reference test). We used Bayesian modelling to correct for differential verification bias.Main outcome measuresPrimary outcome was the specificity for IBD using predefined test thresholds (calgranulin-C: 0.75 µg/g, calprotectin: 50 µg/g). Secondary outcome was the test accuracy with thresholds based on receiver operating characteristics (ROC) analysis.ResultsIBD was diagnosed in 93 of 337 patients. Calgranulin-C had significantly better specificity than calprotectin when predefined thresholds were used (97% (95% credible interval (CI) 94% to 99%) vs 71% (95% CI 63% to 79%), respectively). When ROC-based thresholds were used (calgranulin-C: 0.75 µg/g, calprotectin: 400 µg/g), both tests performed equally well (specificity: 97% (95% CI 94% to 99%) vs 98% (95% CI 95% to 100%)).ConclusionsBoth calgranulin-C and calprotectin have excellent test characteristics to predict IBD and justify endoscopy.Trial registration numberNCT02197780.

scholarly journals The Microbiome in Inflammatory Bowel Disease: Current Status and the Future Ahead

2014 ◽  
Vol 146 (6) ◽  
pp. 1489-1499 ◽  
Author(s):  
Aleksandar D. Kostic ◽  
Ramnik J. Xavier ◽  
Dirk Gevers
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Current Status ◽  
The Future ◽  
Inflammatory Bowel

scholarly journals Characterizing Clinical Features and Creating a Gene Expression Profile Associated With Pain Burden in Children With Inflammatory Bowel Disease

2019 ◽  
Vol 26 (8) ◽  
pp. 1283-1290 ◽  
Author(s):  
Victoria Grossi ◽  
Jeffrey S Hyams ◽  
Nicole C Glidden ◽  
Brittany E Knight ◽  
Erin E Young
Keyword(s):  
Gene Expression ◽  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Bowel Disease ◽  
Newly Diagnosed ◽  
Pain Experience ◽  
Factors Affecting ◽  
Cq Method ◽  
Inflammatory Bowel ◽  
Rectal Biopsies

Abstract Background There is often dissociation between inflammatory activity and abdominal pain in children with inflammatory bowel disease (IBD), suggesting other factors may play a role in the pain experience. Methods Patients (8 to 17 years) newly diagnosed with IBD were enrolled in the ALLAY Study: Assessing Risk Factors for Abdominal Pain in Children with Inflammatory Bowel Disease (NCT02984059). At diagnostic colonoscopy, 3 rectal biopsies were collected, and gene expression analysis was performed using Qiagen RT2 Profiler Neuropathic and Inflammatory Pain PCR Array. Relative fold difference in gene expression for 84 pain-associated genes was calculated using the 2-ΔΔ Cq method compared with pain-free controls. Factors affecting pain burden (Pain Burden Interview; PBI) were analyzed, including age, sex, rectal inflammation, and gene expression. Data were analyzed using multiple stepwise linear regression and 2-tailed t tests (P ≤ 0.05). Results Thirty-nine newly diagnosed IBD patients were included (65% male, mean age 12.75 years [SD 2.63], 23 Crohn’s disease, 16 ulcerative colitis), along with 3 controls. Mean PBI score was 7.73 (SD 6.4, range 0 to 23) for all patients. Age and sex were not predictive of pain burden, but disease activity score was (P = 0.03). Expression of TRPV3, OPRM1, P2X3, SCN9A, PTGS2, and MAPK14 were associated with PBI score. Subsequent 2-tailed t tests comparing patients with no pain (PBI score ≦ 2, N = 11) to those with pain (PBI > 2, N = 28) confirmed differential expression of TRPV3, PTGS2, and MAPK14 was in patients with pain (all P < 0.05). Conclusion Pain burden in newly diagnosed IBD patients may be linked to TRPV3, PTGS2, and MAPK14 expression, suggesting potential therapeutic targets for managing pain in IBD.

scholarly journals Ileocecal Burkitt’s Lymphoma Presenting as Acute Abdominal Pain

2020 ◽  
Vol 13 (2) ◽  
pp. 968-972
Author(s):  
Mostafa Mosbeh Abdelmaksoud ◽  
Maram Kheder Alshareef ◽  
Alaa Osama Jamjoom ◽  
Mohamed Tarek Hafez
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Renal Transplantation ◽  
Gastrointestinal Tract ◽  
Bowel Disease ◽  
Acute Abdominal Pain ◽  
Emergency Laparotomy ◽  
Ileocecal Region ◽  
Inflammatory Bowel ◽  
Hodgkin's Lymphomas

Primary gastrointestinal non-Hodgkin’s lymphomas are rare tumors which account for about 0.9% of all gastrointestinal tract tumors. They are usually associated with inflammatory bowel disease, previous radiotherapy, and renal transplantation. We report a case of non-Hodgkin’s lymphoma involving the ileocecal region in a 46-year-old gentleman who presented with acute abdominal pain that mandated emergency laparotomy.

scholarly journals Sulphasalazine-Induced Pseudomembranous Colitis

1991 ◽  
Vol 5 (5) ◽  
pp. 167-170 ◽  
Author(s):  
Hugh J Freeman ◽  
Urs P Steinbrecher ◽  
WC Peter Kwan ◽  
Stephanie Ensworth
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Ankylosing Spondylitis ◽  
Clostridium Difficile ◽  
Bowel Disease ◽  
Pseudomembranous Colitis ◽  
Flexible Sigmoidoscopy ◽  
Frequent Use ◽  
Toxin Assay ◽  
Inflammatory Bowel

An 18-year-old female with ankylosing spondylitis developed fever, abdominal pain and diarrhea on two occasions after starting sulphasalazine therapy. Flexible sigmoidoscopy revealed pseudomembranous colitis; fecal cultures were positive forClostridium difficile; andC difficiletoxin assay was positive. Despite the frequent use of sulphasalazine in the management of inflammatory bowel disease, this complication has been apparently rare. Clinicians should be wary of the onset of diarrhea in patients receiving sulphasalazine, whether for inflammatory bowel disease or other conditions.

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