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7 recent developments in Crohn's disease
      04/02/15 03:16 PM

7 recent developments in Crohn's disease

Crohn’s disease has been a hot topic recently, with an abundance of data being published in the journals this month. Here is a recap of the most trafficked news on Healio Gastroenterology about Crohn’s disease.

1. Racial disparities exist among children with Crohn’s disease

Jennifer Dotson

Disparities in hospital readmissions, complications and procedures in pediatric Crohn’s disease patients are related to race, according to data from a recent retrospective review.

“We found racial inequalities exist among children and adolescents with Crohn’s disease, likely due to a combination of genetic and environmental differences,” Jennifer Dotson, MD, MPH, a gastroenterologist at Nationwide Children’s Hospital in Columbus, Ohio, and principal investigator in the Center for Innovation and Pediatric Practice, said in a press release. “This is one of the first studies to investigate the rate of various health disparities in the Crohn’s disease population in pediatrics, despite the fact that 25% of the time, Crohn’s disease is diagnosed in childhood.” Read more

2. Experts release international consensus statement on surveillance, management of dysplasia in inflammatory bowel disease

Tonya Kaltenbach

SCENIC, an international multidisciplinary group, has developed unifying consensus recommendations on surveillance and management of dysplasia in IBD.

“We recognized that there was variable practice in the surveillance methods for dysplasia detection in patients with IBD and there were also variable guidelines, both within the US and internationally,” Tonya Kaltenbach, MD, MS, from the Veterans Affairs Palo Alto, who served on the panel, told Healio Gastroenterology. The need for an international consensus statement, she said, came from “an interest to provide a uniform recommendation” — namely on the use of chromoendoscopy for the detection of dysplasia. Read more

3. CRP, calprotectin, excludes IBD in patients with IBS symptoms

William D. Chey

Adding C-reactive protein and fecal calprotectin to symptom-based diagnostic criteria may help to rule out inflammatory bowel disease in patients with symptoms of irritable bowel syndrome, according to new research data.

“Though IBD is uncommon in patients with typical IBS symptoms and no alarming features, patients and providers remain concerned about this possibility,” William D. Chey, MD, AGAF, FACG, FACP, from the University of Michigan Health System, told Healio Gastroenterology.

Adding C-reactive protein and fecal calprotectin to symptom-based diagnostic criteria may help to rule out inflammatory bowel disease in patients with symptoms of irritable bowel syndrome, according to new research data.

“Though IBD is uncommon in patients with typical IBS symptoms and no alarming features, patients and providers remain concerned about this possibility,” William D. Chey, MD, AGAF, FACG, FACP, from the University of Michigan Health System, told Healio Gastroenterology.

William D. Chey

Chey and colleagues performed a systematic review and meta-analysis to assess the utility of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fecal calprotectin and fecal lactoferrin to aid in differentiating between IBS, IBD and healthy patients. After reviewing 1,252 relevant studies, 12 involving 1,059 IBD patients (52.7% male; mean age, 40.7 ± 13.3 years), 595 IBS patients (29.9% male; mean age, 40 ± 18.2 years) and 491 healthy controls (53.5% male; mean age, 38.7 ± 13.8 years) were included in the meta-analysis.

The researchers found that none of the biomarkers could distinguish patients with IBS from healthy controls, but CRP and calprotectin had some value in distinguishing IBD from IBS or healthy controls. High CRP was predictive of IBD, while low CRP indicated the absence of IBD; CRP ≥ 1.7 mg/dl and > 2.7 mg/dl indicated > 52% and > 90% likelihood of IBD, respectively, while CRP ≤ 0.5 indicated that the probability of having IBD was 1% or less.

Likelihood of IBD also increased with calprotectin level, which had a maximal predictive value of 78.7% at 1,000 µg/g. Patients with < 40 µg/g calprotectin had &#8804; 1% chance of having IBD. However, calprotectin level could not rule out IBS entirely; on both sides of the fecal calprotectin range (20 µg/g - 1,000 µg/g) there was an 11.6% and 7.6% predictive probability of IBS, respectively, with a peak predictive probability of 280 µg/g (18.8%).

“Serum CRP and fecal calprotectin provide a noninvasive means by which to exclude IBD in patients with IBS symptoms and no alarming features,” Chey said.

“Based upon these results, it may be reasonable for clinicians to consider ordering CRP or fecal calprotectin to improve their confidence in making a diagnosis of IBS,” the researchers concluded, adding that “prospective studies to evaluate the clinical utility and cost effectiveness of adding CRP or fecal calprotectin to the evaluation of patients with suspected IBS in different populations would be of considerable interest.” – by Adam Leitenberger

4. Slow IBD diagnosis in children leads to more advanced disease
See Also

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Mongersen appears to improve remission in Crohn's disease
What is Crohn's disease?

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Spotlight on Gut Microbiota
Highlights from DDW 2014

Slow diagnosis of inflammatory bowel disease in pediatric patients was associated with advanced bowel involvement at the time of diagnosis, according to recent data.

“Time from symptom onset to diagnosis for IBD among children and adolescents is too long: an average of 4 to 6 months,” the researchers wrote. “The majority of pediatric IBD patients already have extensive involvement at diagnosis.” Read more

5. FMT induces remission in pediatric patients with Crohn’s disease

David L. Suskind

Children with Crohn’s disease achieved remission after fecal microbiota transplant, recent study data found.

“The fecal microbiome is likely the cause or trigger of the immune response in IBD,” David L. Suskind, MD, from the department of pediatrics, division of gastroenterology at Seattle Children’s Hospital, told Healio Gastroenterology. “Therapies which affect the fecal microbiome such as FMT, have the potential to change our current treatment paradigm by altering the fecal microbiome instead of using medications which suppress the immune response.” Read more

6. Smoking cessation programs for Crohn’s improve outcomes, reduce costs

Stephanie Coward

Gilaad G. Kaplan

The integration of smoking cessation programs targeting patients with Crohn’s disease is cost-effective for health care systems, recent study data found.

“Smoking is known to worsen the course of Crohn’s disease, whereas individuals who quit have a similar prognosis to patients with Crohn’s disease who never smoked,” Stephanie Coward, MSc, and Gilaad G. Kaplan, MD, MPH, both from the University of Calgary in Alberta, Canada, told Healio Gastroenterology. “We conducted a cost-utility analysis to compare different smoking cessation strategies for patients with Crohn’s disease.” Read more

7. Mongersen appears to improve remission in Crohn’s disease

Séverine Vermeire

Patients with Crohn’s disease achieved remission and clinical response in greater proportions with mongersen, a novel oral SMAD7 antisense oligonucleotide, compared with placebo, according to recent study data.

“The impressive clinical effects of mongersen beg for follow-up studies to confirm that we have indeed entered a new phase of Crohn’s disease treatment,” Séverine Vermeire, MD, PhD, from the University Hospitals in Leuven, Belgium, wrote in an accompanying editorial.

Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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Entire thread
Subject Posted by Posted on
* Inflammatory Bowel Disease HeatherAdministrator 07/14/03 01:51 PM
. * Dietary fiber associated with reduced Crohn's disease flares HeatherAdministrator   01/27/16 02:58 PM
. * Probiotics not superior for maintaining ulcerative colitis remission HeatherAdministrator   12/29/15 10:12 AM
. * Fecal transplant induces remission in active ulcerative colitis HeatherAdministrator   07/16/15 04:39 PM
. * 7 recent developments in Crohn's disease HeatherAdministrator   04/02/15 03:16 PM
. * Hormonal contraception improved menstrual-related IBD symptoms HeatherAdministrator   09/15/14 12:43 PM
. * Fecal lactoferrin differentiated IBD from IBS HeatherAdministrator   07/29/14 01:50 PM
. * Vitamin D and Cancer Risk in IBD HeatherAdministrator   07/15/14 02:53 PM
. * Self-assessment scale developed for patients with IBD-fatigue HeatherAdministrator   06/17/14 10:44 AM
. * Stool test distinguishes between IBD and IBS HeatherAdministrator   04/07/14 01:40 PM
. * Breathing exercises, meditation improved inflammatory markers, quality of life in IBD patients HeatherAdministrator   10/23/13 04:20 PM
. * Inflammatory Bowel Disease: Heat Waves Linked to Flares HeatherAdministrator   08/16/13 12:58 PM
. * Dietary changes may reduce effects of IBD HeatherAdministrator   06/27/13 05:43 PM
. * Genetic Clues May Help Unravel Cause of Crohn's HeatherAdministrator   11/02/12 12:59 PM
. * Inflammatory bowel, ulcerative colitis linked to intestinal fungi HeatherAdministrator   06/15/12 01:23 PM
. * Smoking makes Crohn's disease worse HeatherAdministrator   05/09/12 01:33 PM
. * Kids With Crohn’s Disease, Colitis Often Struggle at School HeatherAdministrator   04/23/12 01:22 PM
. * As Nations Develop, So May Bowel Disease HeatherAdministrator   01/09/12 12:01 PM
. * Loneliness Triggers Inflammatory Illnesses HeatherAdministrator   02/10/11 10:05 AM
. * Infants' antibiotic use tied to IBD risk HeatherAdministrator   11/03/10 01:42 PM
. * Olive Oil May Protect Against Ulcerative Colitis HeatherAdministrator   05/05/10 10:32 AM
. * Accutane may cause ulcerative colitis HeatherAdministrator   04/09/10 01:38 PM
. * Red meat may raise odds for ulcerative colitis, but oily fish could be protective HeatherAdministrator   03/11/10 01:22 PM
. * Inflammatory Bowel Disease and Irritable Bowel Syndrome: Separate or Unified? HeatherAdministrator   01/05/10 12:03 PM
. * Novel Compound Targets Mucosal Healing in Crohn's HeatherAdministrator   05/29/06 02:19 PM
. * Viagra May Help Crohn's Disease HeatherAdministrator   03/04/06 12:50 PM
. * Carbon Monoxide Eases Ulcerative Colitis HeatherAdministrator   01/18/06 04:12 PM
. * Colonoscopic Surveillance in Inflammatory Bowel Disease HeatherAdministrator   10/11/05 01:33 PM
. * Oral Contraceptives and HRT a Risk Factor for Inflammatory Bowel Disease HeatherAdministrator   09/13/05 01:22 PM
. * Cannabinoids Show Promise for Inflammatory Bowel Disease HeatherAdministrator   09/01/05 11:23 AM
. * Differentiation of Inflammatory Bowel Disease and Irritable Bowel Syndrome HeatherAdministrator   09/01/05 11:13 AM
. * The Clinical Epidemiology of Inflammatory Bowel Disease HeatherAdministrator   08/22/05 04:45 PM
. * IBD Patients May Benefit From Folic Acid Supplementation HeatherAdministrator   05/22/05 07:02 PM
. * Fish oil, soluble fiber, and antioxidants for corticosteroid sparing in ulcerative colitis HeatherAdministrator   04/24/05 03:33 PM
. * Biotic Therapy Cuts Inflammation in Ulcerative Colitis HeatherAdministrator   02/19/05 05:59 PM
. * Calming Crohn's Disease with Fish Oil and Antioxidants HeatherAdministrator   01/07/05 04:55 PM
. * Probiotics Prove Just As Effective As a Popular Prescription Drug for Ulcerative Colitis HeatherAdministrator   12/20/04 01:37 PM
. * Increased Incidence of Inflammatory Bowel Disease: The Price of the Decline of Infectious Burden? HeatherAdministrator   11/28/04 02:58 PM
. * Diet May Influence Relapse in Ulcerative Colitis HeatherAdministrator   10/24/04 07:50 PM
. * Parasite Therapy for Crohn's and Colitis? HeatherAdministrator   08/08/04 03:00 PM
. * Pipeline Treatments, Novel Procedures Offer New Options for GI Diseases HeatherAdministrator   06/04/04 06:41 PM
. * Faulty Gene for Crohn's Disease Found HeatherAdministrator   04/13/04 03:19 PM
. * Data links Crohn's disease and antibiotics HeatherAdministrator   02/24/04 02:07 PM
. * Elan Reports Successful Results of Antegren Trial for Crohn's Disease HeatherAdministrator   02/10/04 01:30 PM
. * 5-ASA Therapy for Inflammatory Bowel Disease No Bar to Colon Cancer HeatherAdministrator   02/10/04 01:29 PM
. * Once-Daily Probiotic Treatment Maintains Remission in Ulcerative Colitis patients with Pouchitis HeatherAdministrator   01/26/04 03:33 PM
. * Bone Disease and Intestinal Problems May Share a Common Cause HeatherAdministrator   01/07/04 11:47 AM
. * Increased Anal Resting Pressure and Rectal Sensitivity in Crohn's Disease HeatherAdministrator   12/16/03 11:59 AM
. * Environmental Factors May Play a Role in the Pathogenesis of IBD HeatherAdministrator   12/01/03 05:56 PM
. * Colonoscopy Prep HeatherAdministrator   10/17/03 12:05 PM
. * Detection of Pulmonary Involvement in Inflammatory Bowel Disease HeatherAdministrator   09/30/03 01:20 PM
. * Indeterminate Colitis HeatherAdministrator   09/16/03 03:33 PM
. * Familial Occurrence of Inflammatory Bowel Disease in Celiac Disease HeatherAdministrator   09/16/03 03:30 PM
. * Bacteria in Milk Linked to Crohn's Disease and Possibly IBS HeatherAdministrator   08/12/03 11:55 AM
. * Inflammatory Bowel Disease During Pregnancy. HeatherAdministrator   07/15/03 06:20 PM
. * A study of the menopause, smoking, and contraception in women with Crohn's disease. HeatherAdministrator   07/15/03 06:05 PM
. * Hormone replacement therapy prevents bone loss in patients with IBD HeatherAdministrator   07/15/03 06:02 PM
. * Chemo Drug Improves Crohn's Symptoms HeatherAdministrator   07/14/03 04:09 PM

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