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Basic scienceUnderstanding the pathogenesis of pouchitis Morgan XC, Kabakchiev B, Waldron L, et al. Associations between host gene expression, the mucosal microbiome, and clinical outcome in the pelvic pouch of patients with inflammatory bowel disease. Genome Biol 2015:16:67. doi:10.1186/s13059-015-0637-x Approximately 10%–35% of patients with UC will require colectomy with pouch reconstruction, and half of these patients will develop pouchitis. In addition, one-fifth will ultimately suffer pouch failure. Therefore, defining the basis of pouchitis is clearly of utmost importance. Similar to IBD, both host genetics and the microbiota are implicated in the pathogenesis of pouchitis. However, how these factors interact in this condition is not well understood. Interestingly, pouch construction is also performed for patients with familial adenomatous polyposis, although pouchitis is rare in this group. To investigate the basis of potential host–microbe interactions, this study by Morgan and colleagues collected paired host transcriptome and microbial metagenome...
Source: Gut - Category: Gastroenterology Authors: Tags: JournalScan Source Type: research

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ConclusionsBandemia and low serum albumin are independent predictors of failure of infliximab rescue therapy in acute severe ulcerative colitis. Serum albumin  ≤ 2.5 g/dl and band neutrophil count ≥ 13% had a 100% positive predictive value for 90-day colectomy.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
CONCLUSIONS: Long-term ostomy-free survival can be achieved in the majority of patients who undergo restoration of intestinal continuity after total abdominal colectomy for Crohn’s colitis. A positive distal microscopic margin was independently associated with long-term anastomotic failure, and it should be accounted for when risk stratifying patients for postoperative prophylactic medical therapy. See Video Abstract at http://links.lww.com/DCR/B111. ¿QUÉ FACTORES ESTÁN ASOCIADOS CON LA EVENTUAL NECESIDAD DE UNA ILEOSTOMÍA DESPUÉS DE UNA COLECTOMÍA ABDOMINAL TOTAL Y UNA AN...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Inflammatory Bowel Disease Source Type: research
AbstractBackgroundCytomegalovirus (CMV) infection may complicate ulcerative colitis (UC) or Crohn ’s disease (CD) hospitalizations. Studies examining this relationship are often single-center examining short time periods.AimsTo quantify the prevalence of CMV and its impact on outcomes among UC and CD hospitalizations over time using nationwide administrative databases.MethodsThe National Inpatient Sample and Nationwide Readmissions Database were analyzed to calculate CMV prevalence per 1000 UC and CD hospitalizations between 1998 and 2014. Univariable and multivariable logistic and linear regression were used to asse...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Clinical outcomes in pediatric ulcerative colitis (UC) in the era of biologic agents are poorly defined. We aimed to describe risk factors for colectomy in pediatric UC in the era of infliximab therapy.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
We present a review of modern surgical practices in ulcerative colitis, addressing some current controversies and diversities.
Source: Updates in Surgery - Category: Surgery Source Type: research
In this study, we present the evidence-based management for patients hospitalized for ulcerative colitis (UC) with a special focus on the synergic approach of the two key actors of the inflammatory bowel disease multidisciplinary team (IBD-MDT): gastroenterologist and surgeon.Recent FindingsFocused treatment by a specialized IBD-MDT and early involvement of the colorectal surgeon in the management of hospitalized UC patients is advocated. The colectomy rate has not changed over the years. Moreover, delayed surgery after admission is burden by increase complication and mortality rates. Thus, it is pivotal to identify the pa...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
The rate of colectomy within the first year after hospital admission for ulcerative colitis has declined in the modern era of biologics, suggesting the advent of biologic therapy has changed the natural history of the disease, researchers report.Reuters Health Information
Source: Medscape General Surgery Headlines - Category: Surgery Tags: Gastroenterology News Source Type: news
Hospital readmissions are frequent and expensive. Thirty-day readmission rates for adult patients undergoing colectomy are as high as 25%, with inflammatory bowel disease (IBD) being a major risk factor for readmission. We sought to 1) determine the 30-day readmission rate for pediatric patients with ulcerative colitis (UC) undergoing total abdominal colectomy (TAC) between 2012 and 2017 using a national pediatric surgical database and 2) identify risk factors for unplanned readmission in this population.
Source: Gastroenterology - Category: Gastroenterology Authors: Tags: Epidemiology Source Type: research
A 20 year old female with a history of Ulcerative colitis status post total colectomy and end ileostomy was admitted to the intensive care unit with septic shock. She had initially been diagnosed with fulminant ulcerative pancolitis three months prior, and after failing to respond to dual therapy with high dose infliximab and azathioprine, she underwent total colectomy and end ileostomy as the first part of a staged ileal pouch-anal anastomosis procedure.
Source: Gastroenterology - Category: Gastroenterology Authors: Tags: Disease Complications Source Type: research
Despite reducing mortality, the use of intravenous (IV) corticosteroids has not significantly reduced inpatient colectomy rates among hospitalized patients with ulcerative colitis (UC). Whether the occurrence of colectomy, estimated at 20-30% in this population in the prebiologic era, remains elevated is unknown.
Source: Gastroenterology - Category: Gastroenterology Authors: Tags: Natural History and Outcomes Source Type: research
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