Tags: Ulcerative Colitis
Gastro-Hep News
Esophageal DNA Test Granted US Food and Drug Administration Breakthrough Device Status The US Food and Drug Administration (FDA) has granted Breakthrough Device status to […]
A Comprehensive Review of Topical Therapies for Distal Ulcerative Colitis
Abstract: Patients with ulcerative colitis (UC) limited to distal segments of the colon and rectum are often poorly represented in large clinical therapeutic trials, yet […]
The Expanding Role of Anti–IL-12 and/or Anti–IL-23 Antibodies in the Treatment of Inflammatory Bowel Disease
Abstract: The interleukin (IL)-12/IL-23 pathway is one of many proposed mechanistic pathways of intestinal inflammation. Earlier studies introduced IL-12 as a major cytokine in the […]
Implementing Dietary Modifications and Assessing Nutritional Adequacy of Diets for Inflammatory Bowel Disease
Abstract: Guidelines for dietary recommendations and nutritional therapy for patients with inflammatory bowel disease (IBD) are lacking, and patients are moving toward popular defined diets […]
Complications Related to J-Pouch Surgery
Abstract: Restorative proctocolectomy with ileal pouch–anal anastomosis is the gold-standard surgical procedure for familial adenomatous polyposis, refractory ulcerative colitis, and colitis–associated dysplasia requiring colectomy. Numerous […]
Use of Medical Cannabis in Patients With Inflammatory Bowel Disease
G&H What is the current legal status of cannabis? JK As of March 2018, 9 US states have legalized cannabis (also known as marijuana) for […]
Gastro-Hep News
US Food and Drug Administration Approves Lenvatinib for Hepatocellular Carcinoma On August 16, 2018, the US Food and Drug Administration (FDA) approved the kinase inhibitor lenvatinib […]
The Use of Complementary and Alternative Medicine in Patients With Inflammatory Bowel Disease
Abstract: Complementary and alternative medicine (CAM) includes products or medical practices that encompass herbal and dietary supplements, probiotics, traditional Chinese medicines, and a variety of […]
Gastro-Hep News
Pancreatic Cancer Associated With Recent-Onset Diabetes Recent-onset diabetes is associated with a significantly higher risk of pancreatic cancer among African American and Latino individuals, according to […]
Update on Fecal Microbiota Transplantation in Patients With Inflammatory Bowel Disease
G&H What is the rationale for using fecal microbiota transplantation to try to treat disease, particularly inflammatory bowel disease? PM The concept of using fecal […]
When Not to Pouch: Important Considerations for Patient Selection for Ileal Pouch–Anal Anastomosis
Abstract: Ileal pouch–anal anastomosis (IPAA) is the preferred surgical treatment for patients who undergo colectomy and wish to avoid a permanent ileostomy. The overall outcomes […]
Gastro-Hep News
US Food and Drug Administration Approves Treatment for Chronic Hepatitis C Virus Genotypes 1 Through 6 On July 18, 2017, the US Food and Drug Administration […]
Advances in the Diagnosis and Management of Colonic Dysplasia in Patients With Inflammatory Bowel Disease
Abstract: The prevalence of colorectal cancer (CRC) in inflammatory bowel disease (IBD) is estimated at 3.7%. Risk factors for CRC include more severe disease (as […]
Gastro-Hep News
Higher Risk of Interval Colorectal Cancer Found Among Older Black Patients Older black patients have a higher risk for interval colorectal cancer (CRC), particularly cancer of […]
Management of Hospitalized Patients With Ulcerative Colitis
G&H What are the indications for hospitalization of patients with ulcerative colitis? LB Patients with ulcerative colitis (UC) who have failed or have not responded […]
Assessing Disease Activity in Patients with Ulcerative Colitis
G&H What factors should clinicians consider when assessing disease activity in patients with ulcerative colitis? AW/ST Clinicians need to consider 4 different factors when assessing ulcerative […]
Chilaiditi Syndrome: A Rare Entity with Important Differential Diagnoses
Chilaiditi Syndrome Complicated by a Closed-Loop Small Bowel Obstruction David A. Mateo de Acosta Andino, MD1 Corinne M. Aberle, MD1 Laura Ragauskaite, MD1 Gaith Khair, MD1 […]
Predictors of Aggressive Inflammatory Bowel Disease
Abstract: Inflammatory bowel disease comprises a group of conditions characterized by idiopathic inflammation of the gastrointestinal tract. The natural course of disease can range from an indolent course with prolonged periods of remission to aggressive, incapacitating disease. Predicting which patients are more susceptible to developing severe disease is important, especially when choosing therapeutic agents and treatment strategies. This paper reviews current evidence on the main demographic, clinical, endoscopic, histologic, serologic, and genetic markers that predict aggressive inflammatory bowel disease. In ulcerative colitis, we considered disease to be aggressive when patients had a high relapse rate, need for admission and/or surgery, development of colon cancer, or extraintestinal manifestations. We defined aggressive Crohn’s disease as having a high relapse rate, development of penetrating disease, need for repeat surgery, or multiple admissions for flares. In Crohn’s disease, involvement of the upper gastrointestinal tract and ileum, penetrating disease, early age at diagnosis, smoking, extensive ulceration of the mucosa, high titers of serum antibodies, and mutations of the NOD2 gene are markers of aggressive disease. In ulcerative colitis, patients with more extensive involvement of the colon (pancolitis) have more symptomatology and are at higher risk for needing a colectomy and developing colon cancer. Also, plasmocytic infiltration of the colonic mucosa and crypt atrophy predict treatment failure. As with diagnosis, no single method can predict disease aggressiveness. Multiple serologic and genetic tests are being developed to refine the accuracy of prediction. Endoscopic findings can also predict the future course of disease. At present, clinical manifestations are the most useful way to make therapeutic decisions.