scholarly journals The role of mindfulness in promoting subjective wellbeing and mood homeostasis in patients with Crohn’s disease

2021 ◽  
Vol 4 ◽  
pp. 1-12
Author(s):  
Kimina Lyall
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Stress Reduction ◽  
Subjective Wellbeing ◽  
Physiological Stress ◽  
Control Measures ◽  
Randomised Control Trial ◽  
Wait List ◽  
Reactive Protein ◽  
Intervention Measures

Objective: The relationship between stress, symptoms of inflammatory bowel disease (IBD), and depression has not previously been considered using the theory of subjective wellbeing (SWB) homeostasis as a conceptual framework. It is proposed that mindfulness, as a mechanism of down-regulating challenging emotion, can aid in the restoration of mood homeostasis and reduce symptoms of both psychological and physiological stress. The study aims to identify whether individuals with Crohn’s disease (CD) and co-occurring psychological depression or stress are experiencing the defeat of SWB homeostasis. Further, the study aims to test whether a Mindfulness Based Stress Reduction (MBSR) intervention can restore homeostasis. The study would also identify whether this restoration of homeostasis is associated with a reduction in disease symptomatology. Methods: An exploratory randomised control trial with 40 participants recruited from public health gastroenterology patients and randomly allocated to an 8-week MBSR program or wait-list control. Measures of SWB, depression, stress, and C-reactive protein (CRP) levels will be collected prior to and after the intervention. Individual HPMood set points will be determined from affect data collected over 7 days through momentary sampling techniques prior to the commencement of the intervention. Measures will be repeated at 6-month follow-up. Following this, the wait-list group will be offered the same 8-week MBSR. Hypotheses will be tested using mixed ANOVA and clinical significance tests. Conclusions: This study will be an important contributor to knowledge about psychological vulnerability and resilience for people with CD and will provide initial evidence that could contribute to the development of a larger future trial. Trial Registration: The trial has been prospectively registered in the Australian New Zealand trial registry - ACTRN12618002009291  

The Correlation between Vitamin D Levels and the Risk of Postoperative Recurrence in Crohn’s Disease

Digestion ◽  
2021 ◽  
pp. 1-9
Author(s):  
Akihiro Yamada ◽  
Yuga Komaki ◽  
Fukiko Komaki ◽  
Haider Haider ◽  
Dejan Micic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Reactive Protein ◽  
Endoscopic Recurrence ◽  
Vitamin D Levels ◽  
Endoscopic Remission ◽  
The University

<b><i>Background and Aims:</i></b> Vitamin D deficiency has been associated with disease activity in Crohn’s disease (CD). We assessed whether there is a correlation between vitamin D levels and the risk of postoperative recurrence in CD. <b><i>Methods:</i></b> CD patients who underwent surgery were identified from a prospectively maintained database at the University of Chicago. The primary endpoint was the correlation of serum 25-hydroxy vitamin D levels measured at 6–12 months after surgery and the proportion of patients in endoscopic remission, defined as a simple endoscopic score for CD of 0. Clinical, biological (C-reactive protein), and histologic recurrences were also studied. <b><i>Results:</i></b> Among a total of 89 patients, 17, 46, and 26 patients had vitamin D levels of &#x3c;15, 15–30, and &#x3e;30 ng/mL, respectively. Patients with higher vitamin D levels were significantly more likely to be in endoscopic remission compared to those with lower levels (23, 42, and 67% in ascending tertile order; <i>p</i> = 0.028). On multivariate analysis, vitamin D &#x3e;30 ng/mL (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.07–0.66, <i>p</i> = 0.006) and anti-tumor necrosis factor agent treatment (OR 0.25, 95% CI 0.08–0.83, <i>p</i> = 0.01) were associated with reduced risk of endoscopic recurrence. Rates of clinical, biological, and histologic remission trended to be higher in patients with higher vitamin D levels (<i>p</i> = 0.17, 0.55, 0.062, respectively). <b><i>Conclusion:</i></b> In the present study, higher vitamin D level was associated with lower risk of postoperative endoscopic CD recurrence. Further, studies are warranted to assess the role of vitamin D in postoperative CD recurrence.

Combined evaluation of fecal calprotectin and C-reactive protein as a therapeutic target in the management of patients with Crohn's disease

2021 ◽  
Vol 44 (2) ◽  
pp. 87-95
Author(s):  
Francisco Guilherme Cancela Penna ◽  
Rodrigo Macedo Rosa ◽  
Fernando H. Pereira ◽  
Pedro Ferrari Sales Cunha ◽  
Stella Cristina S. Sousa ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Therapeutic Target ◽  
Fecal Calprotectin ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Combined Evaluation

Correlation between levels of C-reactive protein and clinical activity in Crohn's disease

2007 ◽  
Vol 39 (11) ◽  
pp. 1006-1010 ◽  
Author(s):  
S. Karoui ◽  
S. Ouerdiane ◽  
M. Serghini ◽  
T. Jomni ◽  
L. Kallel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Activity ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals P532 Delay of maintenance infliximab increases the risk of relapse in Crohn’s disease during the COVID-19 pandemic

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S507-S507
Author(s):  
H Guo ◽  
J Tang ◽  
Z Huang ◽  
B Li ◽  
Q Yang ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Delay Interval ◽  
Cumulative Effect ◽  
Disease Recurrence ◽  
Delay Group ◽  
Disease Relapse ◽  
Reactive Protein ◽  
Real World Evidence ◽  
Unusual Situation

Abstract Background Scheduled maintenance infliximab (IFX) therapies were frequently delayed during the COVID-19 pandemic. The unusual situation allowed us to study the influence of decreased treatment adherence on Crohn’s disease (CD). This retrospective study aimed to evaluate the effect of IFX delay on relapse in Crohn’s disease (CD) patients. Methods 166 CD patients with maintenance IFX between January 25, 2020, and April 25, 2020, were retrospectively enrolled. Demographic and clinical characteristics were recorded. Relapse was defined as clinical disease relapse or biochemical disease relapse (C-reactive protein (CRP) level ≥5 mg/L without other, non-IBD related explanation). Associations between relapse and IFX delay were analyzed. Results A retrospective cohort study was conducted, including 166 CD patients receiving maintenance IFX infusion during the COVID-19 pandemic. Of all, 135 (81.3%) had delayed their IFX infusion. Only 31 (18.7%) followed the schedule infusion during the COVID-19 pandemic. The median time of the IFX delay was 18.6±17.1 days. The relapse rate in the IFX-delay group was significantly higher than the group without delay (25.9% versus 5.5%, P＜0.02). During a median IFX delay interval of 46 days (95% CI 20.9–71.1), the ratio of relapse increased with the increase of IFX delay intervals. Delay interval had a cumulative effect on disease recurrence. We proposed interval prolongation resulted in a significant IFX trough concentration reduction. Conclusion Our study provided real-world evidence of influence on relapse of IFX delay in CD patients undergone maintenance therapy. It might help the IBD specialists arrange reasonable IFX treatment intervals for patients.

Plasma Arachidonic Acid-Rich Phospholipids in Crohn's Disease: Response to Treatment

1996 ◽  
Vol 91 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Stephen P. Pereira ◽  
Theresa B. Cassell ◽  
Jeffrey L Engelman ◽  
Gordon E. Sladen ◽  
Gerard M. Murphy ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Polyunsaturated Fatty Acids ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Polyunsaturated Phosphatidylcholine

1. Increased concentrations of plasma polyunsaturated fatty acids have been implicated in the pathogenesis of Crohn's disease. However, it is not known whether there are corresponding changes in circulating phospholipids - the major source of fatty acids in the plasma. 2. Fasting plasma samples were obtained from 17 control subjects and 13 patients with active Crohn's disease [Simple Index of Crohn's Disease Activity (SICDA) >6] before, and 2 and 8 weeks after, treatment with either a peptide diet or oral prednisolone. 3. Before treatment, the Crohn's disease patients had mildly active disease (SICDA 9.9 ± 0.8, erythrocyte sedimentation rate 26.4 ± 6.5 mm/h, serum C-reactive protein 2.8 ± 0.4 mg/l). The proportions of the polyunsaturated phosphatidylcholine species, 16:0–20:4 (10.0 ± 0.7%) and 16:0–22:6 (7.1 ± 0.8%), were both significantly higher than those in healthy controls (7.6 ± 0.5%, P < 0.01 and 5.3 ± 0.5%, P < 0.05 respectively). 4. After 2 weeks treatment, the SICDA in the Crohn's disease patients decreased to 3.2 ± 0.6 (P < 0.0001 compared with the pretreatment value), and there were corresponding falls in the erythrocyte sedimentation rate (to 12.6 ± 2.7 mm/h, P < 0.05) and C-reactive protein concentration (to 1.7 ± 0.3 mg/l, P < 0.05)—these improvements being maintained at 8 weeks. There was also a fall to normal values in 16:0–20:4 (to 7.7 ± 0.6%, P < 0.01 compared with the pretreatment value) and in 16:0–22:6 (to 5.7 ± 0.5%, P not significant), by week 8. 5. The proportions of polyunsaturated phosphatidylcholine molecular species were increased in the plasma of patients with active Crohn's disease, but fell to normal levels during disease remission. These observations are consistent with the theory that, in active Crohn's disease, the mucosal phospholipids containing polyunsaturated fatty acids are increased, contribute to eicosanoid synthesis and ‘spill’ into the plasma.

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