Crohn's Disease in Children

1981 ◽  
Vol 2 (8) ◽  
pp. 239-244
Author(s):  
Joyce D. Gryboski
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Alimentary Tract ◽  
Unknown Origin ◽  
Clear Cut ◽  
Presenting Symptoms ◽  
Perianal Tissue ◽  
Inflammatory Bowel

Once considered rare in children, Crohn's disease (CD) is being recognized with increasing frequency.1-3 This is due not only to physical awareness but to an alarming increase in the incidence of the disease in young people. Although early descriptions of CD localized the site of involvement to the terminal ileum, it is now recognized that all organs of the alimentary tract may be affected, and in some unfortunate patients involvement extends proximally as far as the stomach, esophagus, or oropharynx and distally, to involve even perianal tissue. Unlike ulcerative colitis which is rather clear-cut in its presentation, CD is often insidious with solitary symptoms of anorexia, weight loss, short stature, or fever of unknown origin being its only manifestation. The presenting symptoms and longterm course vary with the site of disease, and although each patient must be evaluated and treated individually, some overall predictions may be offered as to the victim's future quality of life.4-6 Significant advances have been made during the last decade in understanding the pathophysiology of the disease and in methods of its treatment, although as yet the etiology remains to be defined. Although CD has many features in common with ulcerative colitis and the two are often combined in the terminology, "inflammatory bowel disease," the pathologic findings, course, and complications are distinctive enough that they should be considered as two distinct diseases.

Quality of Life Considering Patients with Chronic Inflammatory Bowel Diseases - Natural and Parenteral Nutrition

2014 ◽  
Vol 86 (9) ◽  
Author(s):  
Aneta Raczkowska ◽  
Michał Ławiński ◽  
Aleksandra Gradowska ◽  
Urszula Zielińska-Borkowska
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Parenteral Nutrition ◽  
Inflammatory Bowel Diseases ◽  
Nutritional Therapy ◽  
Bowel Diseases ◽  
Inflammatory Bowel

AbstractOne of the elements of treatment considering inflammatory bowel diseases is nutritional therapy. The duration of the above-mentioned depends on the prevalence of such symptoms as fever, bowel move-ments, length of the functioning gastrointestinal tract, stoma and intestinal fistula presence. Nutritional therapy is an essential element of successful treatment alongside pharmacological, surgical, and biological therapy, as well as other methods. Crohn's disease and ulcerative colitis considered as chronic diseases, lead towards physical and biopsychosocial disability, being responsible for the reduction in the quality of life.was to determine the quality of life after surgical procedures in case of patients diagnosed with Crohn's disease and ulcerative colitis, subjected to natural and parenteral nutrition.The study group comprised 52 patients from the Department of Gastroen-terology, Military Medical Institute, and Department of Surgery and Clinical Nutrition, Clinical Hospital in Warsaw. The study was performed between October, 2011 and April, 2012. The World Health Organization Quality of Life Instrument - Bref (WHOQOL-BREF) questionnaire was used to deter-mine the patients’ quality of life.A lower quality of life was observed in case of patients subjected to parenteral nutrition, poor education, disease symptoms exacerbation, in the majority-rural inhabitants. The quality of life does not depend on gender, type of disease, family status, and additional medical care.

scholarly journals The Social Toll of Inflammatory Bowel Disease

1994 ◽  
Vol 8 (7) ◽  
pp. 433-437 ◽  
Author(s):  
Richard G Farmer
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Cleveland Clinic ◽  
The Social ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) – ulcerative colitis and Crohn’s disease – has become one the most important chronic digestive disorders found in the younger population. As a result of the nature of the illness, with remission and exacerbation of the inflammatory process, there has been increasing concern regarding the costs, both financial and social, of IBD. There have been attempts to quantify disease activity and to assess the results of treatment and the ability of the patient to function in society. As a result, there has been an increased interest in the ‘social toll’ of IBD. Begi1ming in 1988, and using a direct interview technique, ambulatory patients with IBD were evaluated for quality of life at the Cleveland Clinic Foundation. Included were patients whose disease had been present for about 10 years, and both surgical and nonsurgical patients. The interview questionnaire consisted of 47 items in four categories: functional/economic, social/recreational, affect/life in general and medical/symptoms. Patients with ulcerative colitis had better quality of life than those with Crohn’s disease and patients without surgery had better quality of life than those who had undergone surgery. Over the ensuing five-year period, it was shown that quality of life measures are of value in assessing the results of medical and surgical therapy, and the measures frequently give information not usually obtained by physicians and have implications for quality assurance and outcome measurement.

Specific quality of life factors in patients with inflammatory bowel disease

2012 ◽  
Vol 153 (38) ◽  
pp. 1511-1519 ◽  
Author(s):  
Beáta Nagy ◽  
Réka Laczkóné Majer
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Content Analysis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Control Group ◽  
Inflammatory Bowel

Introduction: Inflammatory bowel disease is a chronic disease with a fluctuating course and unknown origin. Its two major forms are Crohn’s disease and ulcerative colitis. Objective: The authors attempted to analyse the quality of life of patients with inflammatory bowel disease as compared to healthy persons and patients with asthma in order to identify specific factors which most significantly affect the quality of life of these patients. Method: 269 subjects participated in the study (control group, 115 subjects; Crohn’s disease, 67 patients; ulcerative colitis, 25 patients; asthma, 62 patients). The following methods were used: WHO-5, IIRS, SIBDQ and AQLQ(S) questionnaires and content analysis. Results: Patients with inflammatory bowel disease had the worst quality of life with respect to both subjective well-being and burden of disease. The results obtained from questionnaires developed for the analysis of quality of life indicated that extraintestinal symptoms and emotional problems are the major factors which interfere with the quality of life of patients with inflammatory bowel disease. These findings were confirmed by content analysis of interviews with patients. Conclusions: The authors recommend that more attention should be paid to improving the quality of life of patients with inflammatory bowel disease and helping them to live with the illness, especially at the level of interpersonal relations. Orv. Hetil., 2012, 153, 1511–1519.

scholarly journals Quality assessment of the inflammatory bowel disease biopsy diagnosis using digital images

2021 ◽  
Vol 10 (3) ◽  
pp. 21-28
Author(s):  
Kh.M. Akhrieva ◽  
◽  
E.A. Kogan ◽  
A.S. Tertychniy ◽  
O.V. Zayratyants ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Biopsy Diagnosis ◽  
Morphological Diagnosis ◽  
Internet Platform ◽  
Inflammatory Bowel

Introduction. Morphological diagnosis of inflammatory bowel diseases (IBDs) based on endoscopic biopsies remains a rather challenging task and does not always allow the pathologist to make the final conclusion. Difficulties arise due to the absence of a classical morphological picture in biopsy specimens as well as the lack of clinical and laboratory data. These issues may lead to an incorrect interpretation of the detected pathological changes and an erroneous conclusion. The aim of the study was to assess the quality of biopsy diagnosis of IBDs using Internet diagnostic tools, namely, the digitalized histological slides. Materials and methods. We created an Internet platform, which contained 100 scanned images of histologi-cal slides from 70 patients with suspected IBD. Based on our own practical experience and guidelines of international European and British societies of pathology, we arranged a survey. The diagnosis was made on the combined clinical and morphological approach, considering also a complex of clinical, laboratory, endoscopic, and morphological data. The first stage of the survey was anonymous and included a list of 25 questions. Ten pathologists, who agreed to take part in the study, completed the questionnaire. After statistical processing, the results were assessed using a Fleiss' kappa criterion. Results. The comparative analysis of morphological study showed that the participants were able to diagnose accurately only 71% of ulcerative colitis cases and 63% of Crohn’s disease cases. At the same time, the agreement coefficient demonstrated satisfactory values: the Fleiss' kappa was 0.34 and 0.25, respectively. In some cases, the participants found it difficult to perform a differential diagnosis between IBD and other forms of colitis and were not always capable of distinguishing ulcerative colitis from Crohn’s disease. A few of the individual criteria, on which the diagnosis is based, rarely reached agreement above a kappa of 0.5. The participants’ agreement was considered more often as “weak” and “satisfactory”. This is largely due to the fact that we did not discuss the exact criteria for the proposed parameters and that these parameters were divided into four degrees of severity from 0 to 3. Conclusion. The results showed the current discrepancies in the assessment of biopsies in patients with suspected IBD. The developed Internet platform provides additional significant opportunities to improve the quality of morphological diagnosis in ileal and colon biopsies by means of refining the criteria and their assessment in the final diagnosis statement. Keywords: inflammatory bowel disease, colitis, digital pathology

scholarly journals Assessment of quality of life of patients with inflammatory bowel disease residing in Southern Brazil

2010 ◽  
Vol 47 (3) ◽  
pp. 285-289 ◽  
Author(s):  
Danielle Cohen ◽  
Ceres Maltz Bin ◽  
Ana Paula Trussardi Fayh
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Significant Difference ◽  
Inflammatory Bowel

CONTEXT: Chronic diseases have an impact on the quality of life of the individuals. OBJECTIVE: To evaluate the quality of life of adults with inflammatory bowel disease by the inflammatory bowel disease questionnaire certified for Portuguese language. METHODS: We interviewed 50 individuals from both genders aged from 18 to 60 years old, with Crohn's disease and ulcerative colitis, regardless of disease activity. RESULTS: The average age of the sample was 42.2 ± 13.6 years old, the disease length was 98.8 ± 74.3 months, and 72% of patients had Crohn's disease and 14% presented disease activity. There was no significant difference in questionnaire scores of patients with different inflammatory bowel disease when they are in the remission phase (172.0 ± 42.4 and 173.6 ± 28.2 for ulcerative colitis and Crohn's disease, respectively, P = 0.886). When compared to scores of patients who were in crisis, it was found that they have a lower quality of life that patients in remission (123.8 ± 44.5 and 173.3 ± 31.5 for patients in crisis and remission, respectively, P = 0.001). CONCLUSION: It was noticed that the quality of life of patients with inflammatory bowel disease did not differ among patients with Crohn's disease or ulcerative colitis, when patients are in remission. The main aspect which determines the loss of quality of life would be being at the stage of disease activity.

scholarly journals Nutritional Assessment and Disease Activity for Patients with Inflammatory Bowel Disease

1995 ◽  
Vol 9 (3) ◽  
pp. 131-136
Author(s):  
Thomas E Wasser ◽  
James F Reed ◽  
Kathleen Moser ◽  
Pamela Robson ◽  
Linda Faust ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Age Group ◽  
Inflammatory Bowel

Using the Harvard/Willett Semi-Quantitative Food Frequency Questionnaire (H/WSQFFQ), nutritional information was gathered on patients enrolled in an inflammatory bowel disease (IBD) registry. The registry lists 320 patients positive for either ulcerative colitis (n=124) or Crohn’s disease (n=196). The sample was limited to those 19 to 84 years old (mean ± SD 48.57±14.98), and comprised 136 males and 184 females. Using a battery of indices, quality of life, disease activity and general well-being were also assessed. Nutritional intake values from the Harvard-Willett data were compared with recommended dietary allowances (RDA) tables by sex and age group (19 to 24 years, 25 to 50, 51 and older) to discover any intake deficiencies. Results showed that IBD patients were below RDA guidelines for vitamin E, calcium, magnesium, zinc, iodine and selenium. Females were below RDA guidelines for iron while men were below for vitamin B6. There were also some deficiencies according to age in males and two nutrient deficiencies were seen by age group in women. There were no deficiencies by sex or age for vitamins A, C, D and niacin. There were no observed nutrient intake differences between ulcerative colitis and Crohn’s disease groups. Patients receiving vitamin or mineral supplementation showed significant decreases in quality of life, regardless of diagnosis (Crohn’s disease or ulcerative colitis) group. The H/WSQFFQ is a useful tool for assessment of the nutritional status of the IBD patient because it not only provides valuable measurement data to the clinician, but also adds to patient awareness about nutritional problems associated with IBD.

Prebiotics and Probiotics in Inflammatory Bowel Disease: Where are we now and where are we going?

2020 ◽  
Vol 15 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Syed Ali ◽  
Sami Samiullah ◽  
Veysel Tahan
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Clinical Trials ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adverse Effects ◽  
Bowel Disease ◽  
Relapse Prevention ◽  
Remission Induction ◽  
Inflammatory Bowel

The incidence, prevalence, and cost of care associated with diagnosis and management of inflammatory bowel disease are on the rise. The role of gut microbiota in the causation of Crohn's disease and ulcerative colitis has not been established yet. Nevertheless, several animal models and human studies point towards the association. Targeting intestinal dysbiosis for remission induction, maintenance, and relapse prevention is an attractive treatment approach with minimal adverse effects. However, the data is still conflicting. The purpose of this article is to provide the most comprehensive and updated review on the utility of prebiotics and probiotics in the management of active Crohn’s disease and ulcerative colitis/pouchitis and their role in the remission induction, maintenance, and relapse prevention. A thorough literature review was performed on PubMed, Ovid Medline, and EMBASE using the terms “prebiotics AND ulcerative colitis”, “probiotics AND ulcerative colitis”, “prebiotics AND Crohn's disease”, “probiotics AND Crohn's disease”, “probiotics AND acute pouchitis”, “probiotics AND chronic pouchitis” and “prebiotics AND pouchitis”. Observational studies and clinical trials conducted on humans and published in the English language were included. A total of 71 clinical trials evaluating the utility of prebiotics and probiotics in the management of inflammatory bowel disease were reviewed and the findings were summarized. Most of these studies on probiotics evaluated lactobacillus, De Simone Formulation or Escherichia coli Nissle 1917 and there is some evidence supporting these agents for induction and maintenance of remission in ulcerative colitis and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited. The results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be more beneficial and effective in patients with inflammatory bowel disease.

scholarly journals The Changing Prognosis of Ulcerative Colitis and Crohn’s Disease by Decades

2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Therapy ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
Inflammatory Bowel

Abstract We present a bird’s eye view of the prognosis for both ulcerative colitis and Crohn’s disease as contained in the database of an Inflammatory Bowel Disease gastroenterologist covering the period from 1950 until the present utilizing the variables of medical therapy, surgical intervention, complications and deaths by decades.

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