Psychiatric Presentation of Crohn's Disease

1994 ◽  
Vol 164 (2) ◽  
pp. 256-261 ◽  
Author(s):  
H. Rickards ◽  
M. Prendergast ◽  
I. W. Booth
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Psychiatric Symptoms ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Physical Status ◽  
Significant Delay ◽  
Child Psychiatric ◽  
Serial Assessments

Four children presented to child psychiatric clinics with a variety of symptoms. They were all later recognised as having Crohn's disease. There was a significant delay between the onset of symptoms and diagnosis, compared with a control group of patients with Crohn's disease whose presentation was with predominantly gastrointestinal symptoms, which was associated with evidence of increased morbidity. Children with abdominal and psychiatric symptoms occurring in combination need serial assessments of physical status, including height and weight, and measurements of inflammatory and nutritional status.

scholarly journals P455 Adherence to enteral nutrition therapy by adults with active Crohn’s disease is associated with conscientiousness personality trait

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S406-S407
Author(s):  
C Wall ◽  
A McCombie ◽  
R Mulder ◽  
A Day ◽  
R Gearry
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Personality Trait ◽  
Gastrointestinal Symptoms ◽  
Nutrition Therapy ◽  
Control Group ◽  
Healthy Controls ◽  
Eating Behaviours ◽  
Exclusive Enteral Nutrition

Abstract Background Conscientiousness is a personality trait characterised by the ability to control impulses, delay gratification, set and reach goals, and plan in advance. Conscientious people are more likely to be non-smokers, do physical activity and practice healthy eating behaviours. They are also more likely to be adherent to medication. The aim of this study was to assess whether people with Crohn’s disease who score high on conscientiousness are more likely to be adherent to enteral nutrition (EN) therapy than low scorers. Methods Adults aged 16 to 40 years with newly diagnosed Crohn’s disease or having a flare of disease were invited by their gastroenterologist to use nutrition therapy to induce disease remission. Nutrition therapy was either eight weeks of exclusive enteral nutrition (EN) or two weeks of exclusive EN followed by six weeks of partial EN and one meal per day. A convenience control group of healthy participants with no history of gastrointestinal symptoms was also recruited to use exclusive EN for two weeks. Adherence to EN was self-reported fortnightly using a standardised questionnaire. Non-adherence was defined as patients who repeatedly ate foods while using EN or ate more than one meal per day on partial EN. Patients who could not initiate or did not tolerate the EN formula were included in the non-adherent group. Prior to starting nutrition therapy, conscientiousness was measured using the well-validated conscientiousness subset of the Big Five Inventory. Results Twenty-three (59%) of the 39 patients recruited with Crohn’s disease completed and adhered to the eight-week treatment. Reasons for non-adherence by the 14 patients who did not complete treatment included: could not initiate EN (n = 4), non-response at week 4 (n = 2), intolerance of EN (n = 7) or repeated eating of food or started eating food again prior to the end of treatment (n = 2). Seventeen (81%) of the 21 healthy controls completed and adhered to 2 weeks of exclusive EN. Reasons for non-adherence were could not initiate EN (n = 3) or intolerance of the formula (n = 1). Adherence and completion of EN therapy were associated with a greater mean conscientiousness score 35.57 (95% CI: 32.88, 38.25) compared with the non-adherence group mean 30.13 (95% CI: 26.53, 33.73), p = 0.014. Mean conscientiousness score of the healthy controls who completed exclusive EN was similar to the Crohn’s disease group (36.65 (95% CI: 33.53, 39.77), p > 0.05). Conclusion Conscientiousness was associated with adherence to EN therapy. EN therapy can be a cognitively and emotionally demanding treatment and this personality trait should ideally be considered when determining suitable candidates for EN therapy.

scholarly journals VISCERAL FAT IS INCREASED IN INDIVIDUALS WITH CROHN’S DISEASE: A COMPARATIVE ANALYSIS WITH HEALTHY CONTROLS

2018 ◽  
Vol 55 (2) ◽  
pp. 142-147
Author(s):  
Daniéla Oliveira MAGRO ◽  
Maria Rita Lazzarini BARRETO ◽  
Everton CAZZO ◽  
Michel Gardere CAMARGO ◽  
Paulo Gustavo KOTZE ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Visceral Fat ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Control Group ◽  
Healthy Controls ◽  
Fat Percentage ◽  
Cross Sectional

ABSTRACT BACKGROUND: It is known that obesity is associated with a chronic inflammatory state, but few studies have evaluated visceral fat (VF) content and its role in individuals with Crohn’s disease (CD). OBJETIVE: To compare the nutritional status, body composition and proportion of VF between CD individuals and healthy volunteers. METHODS: Cross-sectional study that enrolled individuals with Crohn’s disease and healthy controls. The stratification according to nutritional status was carried out by means of BMI. The percentage of body fat percentage (%BF) and VF were estimated by means of DEXA. VF proportion was evaluated by means of the VF/BMI and VF/%BF ratios. RESULTS: A total of 78 individuals were included. The control group was comprised of 28 healthy subjects aged 35.39±10 years old (60.7% women); mean BMI=23.94±3.34 kg/m2; mean VF=511.82±448.68 g; mean CRP=0.81±1.78 ng/mL. The CD group was comprised of 50 patients; 11 (22%) were underweight (BMI=18.20±1.97 kg/ m2; %BF=24.46±10.01; VF=217.18±218.95 g; CRP=4.12±4.84 ng/mL); 18 (36%) presented normal weight (BMI=22.43±1.48 kg/m2; %BF=30.92±6.63; VF=542.00±425.47 g and CRP=4.40±1.78 ng/mL); 21 (42%) were overweight or obese (BMI=29.48±3.78 kg/m2; %BF=39.91±7.33; VF=1525.23±672.7 g and CRP=1.33±2.06 ng/mL). The VF/BMI ratio was higher in the CD group when compared to controls (32.41±24.63 vs 20.01±16.23 g per BMI point; P=0.02). Likewise, the VF/%BF was also higher in the CD group (35.21±23.33 vs 15.60±12.55 g per percentage point; P<0.001). CONCLUSION: Among individuals with Crohn’s disease, BMI presents a direct correlation with visceral fat content. These results indicate the presence of an adiposopathy in Crohn’s disease subjects, which is evidenced by a higher visceral fat.

scholarly journals Analysis of Crohn’s Disease-Related CARD15 Polymorphisms in Spanish Patients with Idiopathic Uveitis

2008 ◽  
Vol 24 (2) ◽  
pp. 111-117 ◽  
Author(s):  
N. Rodríguez-Pérez ◽  
A. Aguinaga-Barrilero ◽  
Marina B. Gorroño-Echebarría ◽  
Mercedes Pérez-Blas ◽  
J. M. Martín-Villa
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Dna Sequencing ◽  
Healthy Subjects ◽  
Gene Frequency ◽  
Spanish Population ◽  
Control Group ◽  
Accession Number ◽  
Direct Dna Sequencing ◽  
Exon 11

We wished to analyse the frequency of Crohn’s disease-linked CARD15 polymorphisms (P268S, R702W, G908R and 1007fs) in a group of Spanish patients with idiopathic uveitis. To this aim, DNA samples were obtained from 111 unrelated patients. P268S, R702W and G908R polymorphisms were detected using TaqMan Genotyping kits (Applied Biosystems), and the 1007fs variation by direct DNA sequencing. Control group consisted of 105 healthy subjects.None of the polymorphisms studied revealed a significant increase in the groups of patients, when compared to the control group. Thus, P268S is found in 50% of patients (gene frequency 0.284) vs 44% of control individuals (gene frequency 0.245); R702W in 7% of patients (0.036) vs 7% (0.033); G908R in 2% of patients (0.009) vs 4% (0.019) and, finally, 1007fsin 2% of uveitis patients (0.008) vs 4% (0.021). Moreover, DNA sequencing has allowed us to define two new intronic polymorphisms in phase, in the 5' and 3' boundaries of the exon 11 (GenBank accession number #DQ 869189).Altogether, our results suggest that the Crohn’s disease-linked CARD15 polymorphisms do not seem to predispose to idiopathic uveitis in the Spanish population.

Profuse Diarrhea after Misoprostol Use in a Patient with a History of Crohn's Disease

1992 ◽  
Vol 26 (9) ◽  
pp. 1092-1093 ◽  
Author(s):  
Julie S. Johnson ◽  
James A. Karboski ◽  
Glenys O. Williams
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Case Reports ◽  
Data Extraction ◽  
Gastrointestinal Symptoms ◽  
Personal Communication ◽  
Watery Diarrhea ◽  
Synthetic Analog ◽  
Ulcer Disease ◽  
History Of

OBJECTIVE: To report a case of profuse diarrhea after misoprostol use in a patient with a history of Crohn's disease and to discuss the role of eicosanoids in Crohn's disease. DATA SOURCES: Patient medical records, case reports, review articles identified by MEDLINE, and personal communication with the physician, patient, and manufacturer. DATA EXTRACTION: From interviews, the manufacturer, and pertinent published sources by one author and reviewed by the others. DATA SYNTHESIS: A 55-year-old woman presented to clinic complaining of multiple joint pains. Her medical history was significant for peptic ulcer disease, hypertension, and Crohn's disease in remission since May 1989. Her joint pains were treated with ibuprofen 600 mg po qid and misoprostol 200 μg po qid (after meals and at bedtime). Following the administration of three doses of ibuprofen and misoprostol, the patient experienced abdominal cramps, pain, and voluminous, watery diarrhea for two days. Upon discontinuation of the ibuprofen and misoprostol, all of her gastrointestinal symptoms resolved within 12 hours. Rechallenge with ibuprofen alone failed to produce a recurrence of symptoms. Enhanced synthesis of intestinal eicosanoids has been demonstrated in Crohn's disease. Misoprostol, a synthetic analog of one of the eicosanoids, could induce a flare-up of Crohn's disease as suggested in this patient. CONCLUSIONS: Misoprostol should be used with caution in patients with known inflammatory bowel disease.

P.2 Influence of localisation of crohn's disease on nutritional status and intestinal absorption

1983 ◽  
Vol 2 ◽  
pp. 57
Author(s):  
H. Lochs ◽  
R. Pötzi ◽  
P. Ferenci ◽  
M. Egger-Schöld ◽  
H. Pamperl
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Intestinal Absorption

P054 The impact of intestinal stenosis on the expression of Crohn’s disease in young mice with genetic predisposition

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
I Georgopoulos ◽  
E Mavrigiannaki ◽  
S Stasinopoulou ◽  
G Renieris ◽  
G NIkolakis ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Suture Technique ◽  
Intraluminal Pressure ◽  
Control Group ◽  
Intestinal Stenosis ◽  
The Creation ◽  
And Control ◽  
The Impact

Abstract Background In the majority of patients, the areas of the intestine affected in Crohn’s disease (CD) are the terminal ileum and less commonly the rectum. The terminal ileum is affected in the majority of genetic animal models of CD as well. Additionally, CD recurs at sites of tight anastomosis or strictures postoperatively. These observations lead to the assumption that increased intraluminal pressure related to the presence of a valve, sphincter or stenosis is associated with CD pathogenesis. We investigated the hypothesis that the creation of a partial intestinal stenosis could have an impact on disease severity, in a genetic animal model of CD (TNFΔare/+). TNFΔare/+ mice overexpress TNFα leading to a Crohn-like colitis in the terminal ileum. Methods Twenty-nine TNFΔare/+ mice, 6 weeks old, were divided into three intervention groups: stenosis, sham and control. In the stenosis group (n = 11), a partial small bowel obstruction was created via a novel triple suture technique, approximately 3 cm from the ileocecal valve. In the control group (n = 9), a loose single suture was placed at the aforementioned site to test the direct effect of the foreign material on the intestinal wall. The sham group (n = 9) received a sham operation. The triple suture stenosis was also performed on wild-type (WT) C57BL/6 mice (group WT, n = 9). 6 weeks post-surgery all animals were sacrificed and samples from the ileum 3 cm proximal and 3 cm distal to the intervention site were collected for histopathological evaluation. The Crohn-like changes were assessed using a modified colitis histological scoring system (based on Katakura et al., JCI 2005; 115: 695–702). Results Proximal to the intervention, the mean colitis score of stenosis group (10.18 ± 0.87) was significantly higher compared with sham (6.33 ± 0.97, p: 0.009) and control group (5.00 ± 0.91, p: 0.001). There was no difference between sham and control group (p: 0.332). No significant differences between the groups were reported distal to the intervention. The triple suture technique led to Crohn-like inflammatory lesions only in the TNFΔare/+ mice, as shown from the significantly increased score compared with WT mice proximal and distal to the stenosis (10.18 ± 0.87 vs. 0.67 ± 0.37, p &lt; 0.001 and 9.20 ± 1.09 vs. 0.33 ± 0.24, p &lt; 0.001). Conclusion The creation of a stenotic segment in the intestine of TNFΔare/+ mice, led to higher colitis score than expected. The probable mechanism is the increased intraluminal pressure proximal to the stenosis. This suggests that mechanical forces contribute as important co-factors in the pathophysiology of CD, in genetically predisposed populations.

scholarly journals P649 Dietary habits in patients with inactive Crohn’s disease: Results of a controlled study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S535-S535
Author(s):  
N Ben Mustapha ◽  
H Ben Youssef ◽  
A Labidi ◽  
M Hafi ◽  
M Fekih ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Dietary Habits ◽  
Controlled Study ◽  
Control Group ◽  
Cross Sectional ◽  
Dietary History ◽  
Dietary Restrictions ◽  
Digestive Disorders ◽  
Vegetables And Fruits

Abstract Background The purpose of this study was to compare the dietary habits of patients with Crohn’s disease in remission with a control group. Methods This is a comparative cross-sectional descriptive study that took place over a period of one month including 45 patients already managed for Crohn’s disease (CD), who had been in stable clinical remission for at least 6 months at the time of the survey and had the same treatment for at least 6 months compared with a group of 40 healthy volunteers adjusted for age, sex and body mass index (BMI) recruited among health personnel. Questionnaires about dietary habits, patients’ attitudes and beliefs about diet and its impact on their illness, and a dietary history-type food survey were asked and completed for all subjects. Results Total energy and macronutrient intakes were comparable in both groups and adapted to the guidelines. Fibre and micronutrient intakes were significantly lower in CD group, as was the consumption of dairy products, legumes, vegetables and fruits, oleaginous fruit. There were multiple dietary restrictions among CD patients including milk and its derivatives, fruits, vegetables, and legumes. In fact, 11% of them continued to strictly follow the same residue-free diet prescribed at the time of flares and others had barely expanded their diet. The reasons were mainly represented by the fear of triggering digestive disorders in 77% of cases. Fifty-six per cent of patients believed that fibre and milk negatively affect their disease and could trigger digestive disorders. Forty-four per cent said that the avoided foods gave them digestive disorders. By stratifying patients by age, sex or disease characteristics (location, treatment, history of surgery), we found no predictive factor for these dietary restrictions. Moreover, in 23% of patients, the diet was totally obscured by the doctor during consultations. In addition, and despite the discussion with the doctor about food, 46% turned to other sources such as the entourage, other patients, media and internet to find information on their diet. Conclusion Our study shows that patients with Crohn’s disease in remission suffer from several deficiencies due to multiple dietary exclusions. The results suggest that an unbalanced diet should be identified to avoid the micronutrient deficiency observed and highlights the importance of communication about diet between Doctors and patients.

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