Tailored Medical Management of the Complex Postoperative Crohn's Disease Patient

Clinics in Colon and Rectal Surgery 2019; 32: 225-230 DOI: 10.1055/s-0039-1683853Despite advancements in medical therapy, many patients with Crohn's disease continue to require surgery for intestinal resection and/or management of perianal disease at some point in their disease course. Unfortunately, in this complex group of patients, postoperative disease recurrence rates are high. Medical prophylaxis can be used to prevent Crohn's disease recurrence or manage residual disease after surgery, but the ideal timing to start medications after surgery varies based on patient risk factors and patient preference for medication use. Currently, the largest medical treatment effects are seen with thiopurines and antitumor necrosis factor antibodies, but there are continually expanding options as new medical therapies are developed. A proposed algorithm stratified based on patient risk factors is provided. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Clinics in Colon and Rectal Surgery - Category: Surgery Authors: Tags: Review Article Source Type: research

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Conclusions: Anorectal function is impaired in IBD patients with perianal disease. Fecal incontinence correlates with poorer quality of life. Anorectal manometry and ultrasonography are useful tools for evaluating IBD patients. PMID: 31625422 [PubMed - as supplied by publisher]
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Objective: The aim of this study was to assess recurrence risk factors following ileocolonic resection (ICR) for Crohn disease (CD) in a nationwide cohort study Summary Background Data: Recurrence rate after ICR for CD can be up to 60%, but its predictive factors have never been evaluated in large prospective cohort studies. Methods: From 2013 to 2015, 346 consecutive patients undergoing ICR for CD and a postoperative ileocoloscopy within 6 to 12 months after surgery at 19 academic French centers were included prospectively. Results: Twelve-month postoperative endoscopic (Rutgeerts score ≥i2) and clinical rec...
Source: Annals of Surgery - Category: Surgery Tags: ESA PAPERS Source Type: research
Conditions:   Crohn's Disease;   IBD Interventions:   Drug: Infliximab;   Drug: Adalimumab Sponsors:   Children's Hospital Medical Center, Cincinnati;   The Leona M. and Harry B. Helmsley Charitable Trust Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
This study mainly investigated altered functional connectivity (FC) of the amygdala in CD patients during resting-state. Magnetic resonance imaging scans were acquired from 42 CD patients and 35 healthy controls (HCs). Whole amygdala bilaterally were selected as regions o f interest (ROIs). Voxel-based morphometry and FC methods were applied to investigate the differences of structure or intrinsic connectivity of the amygdala between the two groups, separately. Pearson correlations were performed to explore relationships between the clinical characteristics and neuro imaging findings in CD patients. Based on the whole...
Source: Brain Imaging and Behavior - Category: Neurology Source Type: research
Abstract Pediatric Crohn's disease (CD) is characterized by an aggressive course that commonly requires more intensive pharmacological and surgical treatments. In spite of the therapeutic advances in monitoring and management, including the widespread use of biologic therapy, the cumulative incidence of surgery in children with CD is still high. However, surgery is usually not curative and disease recurrence after small bowel resection is common. Gastrointestinal endoscopy is currently the gold standard to evaluate disease progression after surgery, but other non-invasive methods have been suggested. Although the ...
Source: Paediatric Drugs - Category: Pediatrics Authors: Tags: Paediatr Drugs Source Type: research
Authors: Sonoda A, Wada Y, Togo K, Mizukami K, Fuyuno Y, Umeno J, Fujioka S, Fukuda K, Okamoto K, Ogawa R, Okimoto T, Murakami K Abstract Patients with chronic enteropathy associated with SLCO2A1 (CEAS) develop multiple circular, longitudinal, or eccentric ulcers in the ileum. It is sometimes difficult to distinguish CEAS from Crohn's disease. CEAS and primary hypertrophic osteoarthropathy (PHO) are together known to be caused by a mutation of SLCO2A1 gene. The case of a 65-year-old man whose characteristic appearance due to pachydermia of the forehead folds led to the diagnosis of CEAS with PHO is presented. P...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Tim G.J. de Meij Endoscopic evaluation is mandatory in establishing the diagnosis of pediatric inflammatory bowel disease (IBD), but unfortunately carries a high burden on patients. Volatile organic compounds (VOC) have been proposed as alternative, noninvasive diagnostic biomarkers for IBD. The current study aimed to assess and compare the potential of fecal and urinary VOC as diagnostic biomarkers for pediatric IBD in an intention-to-diagnose cohort. In this cohort study, patients aged 4–17 years, referred to the outpatient clinic of a tertiary referral center under suspicion of IBD, were eligible to par...
Source: Sensors - Category: Biotechnology Authors: Tags: Article Source Type: research
Authors: Mahamid M, Bar-Gil Shitrit A, Amara H, Koslowsky B, Ghantous R, Safadi R Abstract BACKGROUND: Crohn's disease and ulcerative colitis are the two major classic presentations of inflammatory bowel diseases (IBD). Studies have shown a wide variation in the incidence and prevalence attributed to different geographic and ethnic populations. OBJECTIVES: To assess the clinical characteristics of IBD among Arabs in Israel and to compare them to characteristics of IBD among Ashkenazi Jews. METHODS: This retrospective, comparative study compared the clinical characteristics of IBD among 150 Arabs from the Ho...
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Purpose of review Recent knowledge teaches us that food is one of the most important environmental factors affecting our health from disease prevention to cause. Food is one of the key players in the normal gut microenvironment, affecting microbial composition, function, gut barrier and host immunity. This review aims to summarize the current data on food components as regulators of intestinal inflammation, with particular focus on the inflammatory bowel diseases (IBDs). Recent findings We summarize our current understanding on nutrition as possible cause and treatment for IBD and concentrate on several food component...
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Alan C. Moss Source Type: research
Researchers have found that blood vessels likely contribute to the development of inflammatory bowel diseases. The finding also suggests novel treatments.
Source: Health News from Medical News Today - Category: Consumer Health News Tags: Crohn's / IBD Source Type: news
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