chronic inflammatory bowel
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2021 ◽  
Vol 81 (12) ◽  
pp. 1348-1353
Author(s):  
Markus Schmidt ◽  
Maritta Kühnert ◽  
Bettina Kuschel ◽  
Sven Kehl ◽  
Ute Margaretha Schäfer-Graf

AbstractThe incidence of chronic inflammatory bowel disease (chronic IBD) in persons of reproductive age is high. Chronic IBD does not typically lead to impaired fertility. Nevertheless, the percentage of women suffering from chronic IBD who have children is lower than that of the general population, due to self-imposed childlessness. Providing women with open, unbiased information and, if necessary, helping them to overcome baseless fears should therefore be an essential part of preconception counseling. With the exception of methotrexate, most standard drugs can and should be continued during pregnancy. If the pregnancy occurs during an inactive phase of disease, the rate of complications in pregnancy should, in principle, not be higher than normal. Nevertheless, pregnant women with chronic IBD are classed as high-risk pregnancies. Organ screening in accordance with DEGUM II criteria should be carried out in every case, and women must be monitored for the potential development of placental insufficiency. Any flare-ups which occur during pregnancy should be treated in full. Vaginal delivery can be considered if there is no perianal manifestation of disease; however, the individual risk must be carefully weighed up.


Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1220
Author(s):  
Phil-Robin Tepasse ◽  
Richard Vollenberg ◽  
Tobias Max Nowacki

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases (IBDs). Immunosuppressive medication is the main therapeutic approach to reducing inflammation of the gastrointestinal tract. Immunocompromised patients are more vulnerable to severe courses of illness after infection with common pathogens. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the pathogen of the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 leads to acute respiratory distress syndrome (ARDS) following severe pulmonal damage in a significant number of cases. The worldwide circulation of SARS-CoV-2 has led to major concerns about the management of IBD patients during the pandemic, as these patients are expected to be at greater risk of complications because of their underlying altered immunological condition and immunosuppressive therapies. Vaccination against SARS-CoV-2 is considered the main approach in containing the pandemic. Today, several vaccines have been shown to be highly effective in the prevention of SARS-CoV-2 infection and severe disease course in subjects without underlying conditions in respective registration studies. Patients with underlying conditions such as IBD and/or immunosuppressive therapies were not included in the registration studies, so little is known about effectiveness and safety of SARS-CoV-2 vaccination in immunocompromised IBD patients. This review provides an overview of the recent knowledge about vaccine response in IBD patients after vaccination against SARS-CoV-2.


2021 ◽  
Vol 75 (5) ◽  
pp. 438-443
Author(s):  
Karolína Vorčáková ◽  
Anna Ballová ◽  
Matúš Madleňák ◽  
Martin Vorčák ◽  
Juraj Péč

Summary: Introduction: Association between hidradenitis suppurativa (HS) and chronic inflammatory bowel disease (IBD) exists. Prevalence of IBD in patients with HS is not clear. The aim of this paper is to determine the prevalence of IBD in patients with HS, evaluate risk factors and possible phenotype of patients with HS and IBD. Methods: Single center retrospective analysis of 241 patients with HS was carried out and medical files were searched for inflammatory bowel disease accordingly. Epidemiologic data of HS were collected. Results: IBD had a prevalence of 5.8%. Out of this number 13 (92.9%) suffered from Crohn’s disease (CD) and 1 (7.1%) from ulcerative colitis (UC). Eight patients (57.1%) were referred to the dermatologist by gastroenterologist and in six patients (42.9%) history of IBD was detected by dermatologist during routine examination. Special phenotype of the disease associated with IBD was not confirmed. The study points out possible existence of common comorbidities and risk factors such as smoking and obesity. Discussion: Our study confirmed similar data like those available in literature, where strong association between CD and HS is present and weaker with UC and HS. Conclusion: The prevalence of IBD in HS patients (5.8%) however these patients do not have a distinct HS phenotype. Key words: hidradenitis suppurativa – chronic inflammatory bowel disease – Crohn’s disease – ulcerative colitis – comorbidities – association – risk factors


Author(s):  
Rabin Hamal ◽  
◽  
Rahul Pathak ◽  
Brindeswari Kafle Bhandari ◽  
Anurag Jha ◽  
...  

The World Health Organization officially declared infection with severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), leading to coronavirus disease 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and then as a pandemic on March 11, 2020 with reports of infection from most of the countries of the world [1]. COVID-19 has severely disrupted prevention and treatment for noncommunicable diseases. Severe illness can occur in otherwise healthy individuals of any age, but it predominantly occurs in adults with advanced age or certain underlying medical comorbidities [2]. Since the beginning of the health emergency, particular attention has been paid to the management of patients with chronic Inflammatory Bowel Diseases (IBDs) because they frequently are treated with immunosuppressive drugs and therefore potentially are exposed to a greater infectious risk than the general population [3].


2021 ◽  
Vol 25 (3) ◽  
pp. 469-473
Author(s):  
O. V. Bulavenko ◽  
I. V. Oleksiienko ◽  
I. V. Prolygina ◽  
S. V. Balabueva ◽  
S. A. Tarasiuk

Annotation. The aim of the work is to demonstrate the importance of laboratory parameters in pregnant with chronic inflammatory bowel disease. The examined patients were divided into the main group (ulcerative colitis, n=40) and the control group (practically healthy women, n=30). The formation of observation groups was carried out by methods of continuous and selective analysis. The indicators of vasculo-endothelial growth factor (VEGF), serum levels of vitamin D, homocysteine, markers of neutrophilic intestinal inflammation (serum levels of tumor necrosis factor α and interleukin-4 were studied). Database formation and all calculations were performed using the software packages STATISTICA6.1 (№АХХR910F374605FA) and MedCalc (version 17.7.7, MedCalcSoftware). Statistical processing of quantitative data included the calculation of the mean and standard error of the mean (± m) using parametric criteria (in the case of a normal distribution law) or a nonparametric Mann-Whitney test (if the distribution law differs from the normal one). In the analysis of the informativeness of laboratory methods, it was found that women with chronic inflammatory bowel disease were characterized by: increased levels of fecal calprotectin, proinflammatory cytokines TNFα and interleukin-4, homocysteine. The analysis of markers of endothelial dysfunction in pregnant women with COPD was diagnosed with a significant increase in serum levels of vasculo-endothelial growth factor and an increase in microalbuminuria, which allowed to talk about the association of ulcerative colitis with the development of gestational endotheliopathy in such women.


Author(s):  
Boulajaad S ◽  
Haida M ◽  
Errami Ait ◽  
Oubaha S ◽  
Samlani Z ◽  
...  

The extradigestive manifestations of chronic inflammatory bowel disease most often affect the articulations, skin, eyes, liver and bile ducts. Renal involvement is rare, and manifests as kidney stones, glomerulonephritis, tubulointerstitial nephritis, and secondary amyloidosis. In this context of chronic inflammatory bowel disease, in particular ulcerative colitis, renal involvement is very often secondary to nephrotoxicity of the basic treatment of digestive pathology, and very rarely an authentic extradigestive manifestation of intestinal disease. We report a case of IgA nephropathy as an extra-digestive manifestation of ulcerative colitis. The objective of this study is not to neglect the IgA nephtopathy as an extradigestive manifestation of IBD which, even though rare, remains a condition to be looked for by clinicians during the follow-up of IBD.


2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Rabin Hamal ◽  
◽  
Rahul Pathak ◽  
Brindeswari Kafle Bhandari ◽  
Anurag Jha; Arun Gnawali ◽  
...  

The World Health Organization officially declared infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to coronavirus disease 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and then as a pandemic on March 11, 2020 with reports of infection from most of the countries of the world [1]. COVID-19 has severely disrupted prevention and treatment for noncommunicable diseases. Severe illness can occur in otherwise healthy individuals of any age, but it predominantly occurs in adults with advanced age or certain underlying medical comorbidities [2]. Since the beginning of the health emergency, particular attention has been paid to the management of patients with chronic Inflammatory Bowel Diseases (IBDs) because they frequently are treated with immunosuppressive drugs and therefore potentially are exposed to a greater infectious risk than the general population [3].


2021 ◽  
Vol 18 (3) ◽  
pp. 180-184
Author(s):  
Aderemi Oluyemi ◽  
Martins Momoh ◽  
Emuobor Odeghe ◽  
Samuel Keshinro

The term “microscopic colitis” (MC) is used to describe a chronic inflammatory bowel disease that includes two main subtypes based on  histopathologic features: collagenous and lymphocytic. Scientific literature is replete with documentation of the disease from various regions of the world. However, the condition is rarely described in black African patients. We herein present the details of the clinical  aspects and endoscopic findings of 3 Nigerian patients with the lymphocytic variant of MC. A short literature review of the clinical, endoscopic, and pathologic features of this rare condition as well as other relevant aspects of MC is also presented.


2021 ◽  
Vol 25 (2) ◽  
pp. 271-276
Author(s):  
O. V. Bulavenko ◽  
I. V. Oleksiienko ◽  
I. V. Prolygina ◽  
S. A. Tarasiuk ◽  
S. V. Balabueva

Annotation. “Voluntary childlessness” as a consequence of fear of infertility, doubts about the ability to cope with pregnancy in the presence of the disease, the hereditary nature of the disease and adverse effects on the fetus; improper medication; self-modification or discontinuation of therapy in patients with CIBD (chronic inflammatory bowel disease) are significant not only medical but also social problems that currently remain unresolved. The aim of this work is to provide up-to-date evidence for the optimal diagnosis and treatment of chronic inflammatory bowel disease before conception, during pregnancy and in the postpartum period. A detailed analysis of the social, somatic, gynecological and obstetric history of women with inflammatory bowel disease was performed. The examined patients were divided into the main group (ulcerative colitis) (n=40) and control groups (almost healthy women) (n=30). The first main clinical group underwent prophylactic therapy using a drug containing active folate of the 4th generation "Quatrefolic" (equivalent to 400 μg of folic acid), potassium iodide 1 table. per day and vitamin D 1000 IU per day, starting from the planning stage of pregnancy). The second major clinical group received, in addition to Quatrefolic and potassium iodide, vitamin D 4,000 IU per day during the pre-pregnancy phase and 2,000 IU per day during pregnancy and 1,000 IU per day in cases of placental dysfunction and anemia. The formation of observation groups was carried out by methods of continuous and selective analysis. Statistical processing of research results was performed using the software package Statistica 6.0. The obtained indicators were processed statistically with the determination of the arithmetic mean (M) and the error of the standard deviation (±m), at p<0,05. Risk ratio (RR) and confidence interval (CI) were determined with a given reliable probability p=95%. Comparison of groups by case frequency was performed using the exact Fisher test (two-way criterion). Pregnant women with ulcerative colitis have a better clinical efficacy of preventive therapy using the 4th generation active folate “Quatrefolic” (equivalent to 400 mcg of folic acid) and vitamin D 4000 IU at the pre-pregnancy stage and 2000 IU after pregnancy verification compared with active folate 4th generation “Quatrefolic” (equivalent to 400 mcg of folic acid) and vitamin D 1000 IU.


2021 ◽  
Vol 55 (2) ◽  
pp. 98-103
Author(s):  
M.V. Stoykevich ◽  
N.S. Fedorova ◽  
N.V. Nedzvetskaya ◽  
I.A. Klenina ◽  
O.M. Tatarchuk

Background. The pathogenesis of chronic inflammatory bowel disease (IBD) is still not fully clarified. It is known that disorders of the intestinal microbiota lead to an increased intestinal permeability, activation of mucous and adaptive immunity, impaired production and intestinal absorption of short-chain fatty acids (SCFA). The ratio of acetic, propionic, butyric acids is an important indicator of the integrity of the intestinal microbial community. Thus, the study of the composition of the intestinal microbiota and the concentrations of fecal SCFA is a very promi­sing approach to broadening the understanding of IBD pathoge­nesis. The purpose of our study was to determine the features of the production of fecal SCFA and the composition of colon microbiota in patients with IBD. Materials and methods. The study, which was carried out at the Department of Intestinal Diseases of the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine, involved 74 patients with IBD with an average age of (43.2 ± 1.8) years, who according to nosology were divided into 2 groups: group I — those with ulcerative colitis (UC) (n = 66), group II — individuals with Crohn’s disease (CD) (n = 8). The diagnoses of CD and UC were established accor­ding to generally accepted diagnostic standards in gastroenterology. Determination of fecal SCFA was carried out by chromatographic method with the use of hardware-software complex for medical researches on the basis of the gas chromatographer Chromateс Crystal 5000. The intestinal microflora was evaluated using a microbiological study of the colon content. Results. Patients with IBD had significant changes in the spectrum of SCFA, which were similar in both UC and CD: a decrease in acetic acid in the UC group by 5.7 times, in the CD group by 10.5 times (p < 0.05), butyric acid in the UC group by 1.6 times, in the CD group by 1.5 times (p < 0.05), and an increase in propionic acid in the UC group by 4 times and in the CD group by 3.3 times (p < 0.05) compared with the control group. There was also a significant increase in the anaerobic index in patients with IBD. Microbiological study of feces showed a significant decrease in Lactobacillus, which was observed in all patients with IBD, as well as a decrease in Bifidobacterium in 19.7 % of those with UC and in 37.5 % with CD. There was a decrease of other representatives of the normal microflora: Enterococci (in 15.2 % in the UC group and 25 % in the CD group) and Escherichia coli (in 15.2 % in the UC group and 12.5 % in the CD group). Excessive growth of opportunistic flora was also detected: hemolytic Escherichia coli was increased in 19.7 % of patients with UC and in 12.5 % of those with CD; Proteus was detected in 12.1 % of people with UC and in 37.5 % with CD. The excessive growth of Candida was found in 43.9 % of patients in the UC group and in 87.5 % of indivi­duals with CD. Conclusions. Quantitative and qualitative deviations of the intestinal microbiota, such as a decrease in the number of major symbionts and an increase in the number of opportunistic pathogens, were observed in all examined patients with IBD. The obtained results showed that changes in SCFA concentrations in both nosologies of IBD differed significantly from those in the control group, which in combination with primary genetic defects of the barrier function of the epithelium and its regenerative abi­lity can lead to deterioration in the course and prognosis of IBD. Evalua­tion of the ratio of SCFA fractions with the calculation of the anaerobic index may be useful for the diagnosis of intestinal dysbiosis in patients with IBD.


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