Inflammatory Bowel
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2021 ◽  
Vol 51 (4) ◽  
Author(s):  
Alba Santiago Badenas ◽  
Elena F Verdu

nflammatory bowel disease is an immune mediated condition that includes Crohn’s disease and ulcerative colitis and causes chronic inflammation of the gastrointestinal tract. Although the exact cause for inflammatory bowel disease is unknown, there is consensus that a combination of genetic, environmental, and immune factors participate in its pathogenesis. To date, all the studies have been focused on alterations that occur once IBD has developed, however, the causes triggering the onset of the disease are still unclear. There is an evident genetic basis in which multiple genes involved in intestinal homeostasis are affected, such as NOD2, ATG16L1 and XBP1. However, these genetic factors are not sufficient for disease onset and additional environmental factors such as those related to dysregulation of gut microbiota and the immune system are required. A lower microbial diversity and a decrease in the relative abundance of Firmicutes, as well as an increase in Proteobacteria, have been described in patients with inflammatory bowel disease, but are not found in all studies. In addition to variations in microbial composition, functional changes have also been observed in cross-sectional studies. Longitudinal cohorts in patients at risk for inflammatory bowel disease have recently been conducted allowing us to interrogate whether specific microbial communities and functions could be influencing the onset of the disease. Indeed, a translational study performed in a cohort of at-risk individuals for inflammatory bowel disease (GEM cohort) showed an increased fecal proteolytic activity, associated with microbial composition changes, before the onset of ulcerative colitis. These findings may help develop new non-invasive diagnostic techniques, as well as new therapeutical approaches for inflammatory bowel disease.


Author(s):  
Christine Beran ◽  
Nathaniel A. Sowa ◽  
Millie D. Long ◽  
Hans H. Herfarth ◽  
Spencer D. Dorn

Background Individuals with inflammatory bowel disease (IBD) are up to twice as likely to suffer from anxiety and/or depression. Collaborative care management (CoCM) is an evidenced-based approach to treating behavioral health disorders that has proven effective for a range of conditions in primary care and some specialty settings. This model involves a team-based approach, with care delivered by a care manager (case reviews and behavioral therapy), psychiatrist (case reviews and psychopharmacological recommendations), and medical provider (ongoing care including psychopharmacological prescriptions). We assessed the feasibility and effectiveness of CoCM in reducing anxiety and depressive symptoms in patients with IBD. Methods Patients with psychological distress identified by clinical impression and/or the results of the Patient Health Questionaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were referred to the CoCM program. Data from our 9-month CoCM pilot were collected to assess depression and anxiety response and remission rates. We obtained provider surveys to assess provider acceptability with delivering care in this model. Results Though the coronavirus SARS-CoV2 (COVID-19) pandemic interrupted screening, 39 patients enrolled and 19 active participants completed the program. Overall, 47.4% had either a response or remission in depression, while 36.8% had response or remission in anxiety. The gastroenterologists highly agreed that the program was a beneficial resource for their patients and felt comfortable implementing the recommendations. Discussion CoCM is a potentially feasible and well accepted care delivery model for treatment of depression and anxiety in patients with IBD in a specialty gastroenterology clinic setting


2021 ◽  
Vol 116 (1) ◽  
pp. S7-S7
Author(s):  
Dadlani Apaar ◽  
Gala Khushboo ◽  
Rai Jayesh ◽  
Rai Shesh ◽  
Dryden Gerald

2021 ◽  
Vol 116 (1) ◽  
pp. S16-S16
Author(s):  
Trujillo de la Fuente Korely ◽  
López Goméz Jesús ◽  
Cortes Espinosa Tomas ◽  
Perez-CabezadeVaca Rebeca ◽  
Paredes Amenabar Carlos ◽  
...  

2021 ◽  
Vol 46 ◽  
pp. S757-S758
Author(s):  
D. Kofinova ◽  
R. Shentova ◽  
P. Hadzhiyski ◽  
H. Naydenov ◽  
P. Yaneva ◽  
...  

Author(s):  
Gerard Serrano-Gómez ◽  
Luis Mayorga ◽  
Iñigo Oyarzun ◽  
Joaquim Roca ◽  
Natalia Borruel ◽  
...  

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