Fecal Calprotectin Is Not Affected by Pregnancy: Clinical Implications for the Management of Pregnant Patients with Inflammatory Bowel Disease
Background: Noninvasive biomarkers of inflammation for monitoring inflammatory bowel disease (IBD) are important in pregnancy. Clinical and laboratory markers are often affected by the physiological adaption that occurs during pregnancy, although, few, if any, data exist on fecal calprotectin (FC). We investigated FC concentrations in pregnant controls and IBD women, and whether FC correlated with physician global assessment (PGA), C-reactive protein (CRP), and Harvey–Bradshaw Index (HBI)/Simple Clinical Colitis Activity Index (SCCAI) before and after pregnancy, as well as during each trimester.
Methods: The study is a ...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Distance to Specialist Care and Disease Outcomes in Inflammatory Bowel Disease
Conclusions: Greater distance to referral health care center was associated with increased risk for needing IBD-related surgery in patients with Crohn's disease or ulcerative colitis. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Inadequate Gestational Weight Gain, the Hidden Link Between Maternal IBD and Adverse Pregnancy Outcomes: Results from the Norwegian Mother and Child Cohort Study
Conclusions: Inadequate GWG should be considered as a risk factor for adverse pregnancy outcomes or as a marker of disease activity. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Pouch-Related Symptoms and Quality of Life in Patients with Ileal Pouch–Anal Anastomosis
Background: Restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA) has become the standard surgical treatment for the majority of patients with inflammatory bowel disease (IBD) who require colectomy. We evaluated the prevalence of pouch-related symptoms among the Crohn's and Colitis Foundation of America Partners cohort and the effect of pouch-related symptoms on Patient-Reported Outcome Measurement Information System measures.
Methods: We performed analyses nested in the Crohn's and Colitis Foundation of America Partners cohort. We used bivariate analyses to compare demographics and medication use among p...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Outcomes After Primary Infliximab Treatment Failure in Inflammatory Bowel Disease
This study assessed the prognosis, defined as surgery-free survival, in patients with primary infliximab treatment failure as compared to patients without primary failure (initial responders). Furthermore, this study assessed the specter of medical therapies used after primary infliximab treatment failure along with treatment outcomes.
Methods: Retrospective, observational, cohort study of patients with inflammatory bowel disease treated with infliximab as first-line anti–tumor necrosis factor treatment at a tertiary center. Primary infliximab treatment failure was defined as no clinical improvement during infliximab in...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Therapeutic Drug Monitoring to Guide Infliximab Dose Adjustment is Associated with Better Endoscopic Outcomes than Clinical Decision Making Alone in Active Inflammatory Bowel Disease
Background: Adequate infliximab (IFX) levels are associated with favorable outcomes in inflammatory bowel disease. Using therapeutic drug monitoring (TDM) to guide dosing is cost effective and associated with clinical improvement, but effect on endoscopic outcomes remains unclear.
Methods: Primary responders to IFX who underwent dose escalation (2008–2014) were reviewed. Patients with active endoscopic disease were included. Two cohorts were examined: TDM-based decision to escalate (TDM) and clinical decision (non-TDM). Outcomes recorded at median 6 months after adjustment included endoscopic remission (Mayo (Source: In...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Preoperative Clostridium difficile Infection Does Not Affect Pouch Outcomes in Patients with Ulcerative Colitis Who Undergo Ileal Pouch-anal Anastomosis
Background: The operation of choice for patients with chronic ulcerative colitis (CUC) is restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Pouchitis is the most common complication after IPAA. The incidence of Clostridium difficile infection (CDI) is higher in CUC patients than the general population and can lead to significant disease flares and higher rates of colectomy. We sought to determine the risk of pouchitis in patients with precolectomy CDI and 90-day postoperative IPAA complications.
Methods: A retrospective case–control study was conducted on patients with CUC who underwent an IPAA betwe...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset
Background: As the American population is aging, the number of older people with inflammatory bowel disease is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults.
Methods: We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate, and multivariate analyses. “Older-onset” patients were diagnosed after age 60, “younger-onset” patients were diagnosed before age 60 but are older than 60 years, and the remainder were “...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Sarcopenia Is Common in Overweight Patients with Inflammatory Bowel Disease and May Predict Need for Surgery
Background: Inflammatory bowel disease (IBD) is associated with altered body composition, such as low muscle mass, which affects clinical outcomes. Body composition changes in overweight patients with IBD are less understood. The study aim was to determine the prevalence of sarcopenic overweight and obese patients in a cohort of patients with IBD starting new anti-tumor necrosis factor-α therapy and examine differences in response.
Methods: This is a retrospective review of patients with IBD starting a new anti-tumor necrosis factor-α medication that had computed tomography within 3 months of initiation. L3 vertebral sl...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study
Background: Extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) are frequently observed. Little is known about the efficacy of anti–tumor necrosis factor (TNF) in EIM management. We assessed the effect of 3 anti-TNF agents (infliximab, adalimumab, and certolizumab pegol) on EIM evolution.
Methods: Data on 1249 patients from the Swiss IBD Cohort Study (SIBDCS) were analyzed. All EIMs were diagnosed by relevant specialists. Response was classified into improvement, stable disease, and clinical worsening based on the physician's interpretation.
Results: Of the 366 patients with at least...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Measuring Severity of Anxiety and Depression in Patients with Inflammatory Bowel Disease: Low Concordance Between Patients and Male Gastroenterologists
Conclusions: Agreement between gastroenterologists and IBD patients regarding the presence of clinically significant anxiety or depression was low, with no further action taken after consultation for 50% of patients who were identified by gastroenterologists as being anxious or depressed. This study highlights the need for educating gastroenterologists to improve their ability to identify IBD patient distress. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Clinical Course of Ulcerative Colitis After Liver Transplantation in Patients with Concomitant Primary Sclerosing Cholangitis and Ulcerative Colitis
Conclusions: Although the clinical course of UC remains unchanged or even improves in the majority of patients after LT, some may experience an aggressive course. The type of immunosuppression after transplantation can affect UC activity after LT. Cyclosporine may have some protective effects post-LT. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
One-Year Clinical Outcomes in an IBD Cohort Who Have Previously Had Anti-TNFa Trough and Antibody Levels Assessed
Background: Loss of response (LOR) is a big concern for anti-TNFa therapies in inflammatory bowel disease. Immunomonitoring may be useful to optimize response rates and overcome secondary LOR.
Methods: This was an observational retrospective cohort study of a group of patients with inflammatory bowel disease on infliximab (IFX) and adalimumab (ADA) who had anti-TNFa trough and antibody levels measured, during maintenance phase of treatment. Anti-TNFa trough and antibody levels were measured using standard enzyme-linked immunosorbent assay techniques. Baseline patient characteristics were determined and patients were revie...
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Evaluation of the Quality of Semen and Sexual Function in Men with Inflammatory Bowel Disease
Conclusions: Men with Crohn's disease showed a trend toward poorer semen quality than those with ulcerative colitis. Treatment with anti–tumor necrosis factor drugs does not seem to be associated with poor sperm quality. In patients in clinical remission, male sexual function is not affected by IBD. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Supplementation of Low- and High-fat Diets with Fermentable Fiber Exacerbates Severity of DSS-induced Acute Colitis
Conclusions: While inulin, and perhaps other fermentable fibers, can ameliorate low-grade inflammation and associated metabolic disease, it also has the potential to exacerbate disease severity in response to inducers of acute colitis. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - June 19, 2017 Category: Gastroenterology Tags: Original Basic Science Articles Source Type: research
