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Inflammatory Bowel Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Manifestations of CD in pregnancy are similar to those in the non-pregnant state. Typical symptoms include chronic or intermittent diarrhea, abdominal pain often in the right lower quadrant and worse postprandially, weight loss, fever, and rectal bleeding. Acute ileitis may mimic appendicitis. Additional clinical features include anemia, pallor, anorexia, palpable abdominal mass/tenderness, perianal fissures, fistula, or abscess. Perianal manifestations are unique to CD and perianal fistulizing CD is seen in up to 25% of patients [3].
Questions 1–20
Published in Anna Kowalewski, SBAs and EMQs in Surgery for Medical Students, 2021
This is a classic presentation of ulcerative colitis. Remember this is a relapsing and remitting disease that always involves the rectum and spreads proximally. It can also involve the terminal ileum via backwash ileitis. There is an association with non- smokers. Fifteen per cent develop extensive disease and 20% develop pancolitis.
Gastrointestinal disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Cases with involvement of the colon may present with any of the earlier mentioned features, although bleeding is more common in UC than in CD. Cases with ileitis present with: Cramping mid-abdominal painDiarrhoeaWeight loss
Relationship between faecal calprotectin and inflammation in peripheral joints and entheses in axial spondyloarthritis
Published in Scandinavian Journal of Rheumatology, 2020
We found it interesting that the level of faecal calprotectin in patients with axSpA was associated with peripheral symptoms rather than with axial symptoms. Both peripheral arthritis and enthesitis were more common in patients with elevated faecal calprotectin than in those without. Faecal calprotectin correlated significantly with the tender joint and swollen joint counts. Klingberg et al reported a correlation between the tender joint count (using the 68-joint examination) and faecal calprotectin levels in AS (11). The prevalence of macroscopic and microscopic ileitis is higher in reactive arthritis and AS with peripheral involvement, but less so in pure axial AS and psoriatic arthritis (31). Our multivariate analysis showed that elevated faecal calprotectin levels are independently associated with peripheral symptoms. These findings suggest that subclinical gut inflammation may be more related to peripheral inflammation in those with axSpA.
Metagenomic analysis of intestinal mucosa revealed a specific eukaryotic gut virome signature in early-diagnosed inflammatory bowel disease
Published in Gut Microbes, 2019
Federica Ungaro, Luca Massimino, Federica Furfaro, Valeria Rimoldi, Laurent Peyrin-Biroulet, Silvia D’Alessio, Silvio Danese
The National Center for Biotechnology Information Gene Expression Omnibus (NCBI GEO) database (www.ncbi.nlm.nih.gov/geo/) was interrogated to search for high-throughput sequencing data performed on endoscopic biopsies collected from IBD patients and healthy controls satisfying the following criteria: (1) all subjects had to be not older than 20 years; (2) IBD patients enrolled had to be at their first diagnosis (with clinical symptoms for less than 5 years) and treatment-naïve. One RNA-Seq experiment (GEO accession number GSE5794513) displaying these patients’ characteristics was performed on total RNA isolated from ileal biopsies obtained during diagnostic colonoscopy of early-diagnosed CD, UC, and non-IBD (Ctrl) patients, with an age comprised between 2 up to 17 years and belonging to the RISK study, an ongoing, prospective observational inflammatory bowel disease (IBD) inception cohort sponsored by the Crohn’s and Colitis Foundation of America (CCFA) (www.crohnscolitisfoundation.org). Confirmation of active colitis/ileitis was done by histology prior to diagnosis and treatment, in a standardized fashion. Information about diagnosis and biopsy collection is available in Haberman et al., 201413 and at http://www.crohnscolitisfoundation.org/science-and-professionals/research/current-research-studies/pediatric-risk-successes.html?referrer=https://www.google.it/#.
The use of single balloon enteroscopy in Crohn’s disease and its impact on clinical outcome
Published in Scandinavian Journal of Gastroenterology, 2018
Grainne Holleran, Giorgio Valerii, Annalisa Tortora, Franco Scaldaferri, Silvia Conti, Arianna Amato, Antonio Gasbarrini, Guido Costamagna, Maria Elena Riccioni
Of the 55 completed procedures, positive findings were reported in 35 procedures (64%) including active ileitis (n = 12, 22%), anastomotic stricture (n = 10, 18%), ileal stricture (n = 16, 29%), jejunal stricture (n = 2, 4%), colonic stricture (n = 2, 4%) and fistulae (n = 2, 4%) (Table 1). In seven procedures (13%) more than one positive finding was detected, whereas none of the patients with suspected CD had multiple positive findings. Based on underlying diagnosis, the diagnostic yield (DY) was significantly higher for patients with known CD at 77% (n = 30) versus 39% (n = 5) for suspected CD (p < .01, 95% confidence interval 0.10–0.67). Based on specific indication, the DY was 67% (20/30) for abnormal imaging (including MRI in 13, CT in 13, intestinal ultrasonography in 4 and capsule endoscopy in 2), 91% (10/11) for obstructive symptoms, 57% (4/7) for surveillance of known small bowel disease, and 20% (1/5) for non-specific symptoms. In the patients with false positives detected by imaging, all were due to the detection of ileitis on imaging which was not then seen at SBE, and there were no false positives for the detection of strictures.