Pathology of Inflammatory Bowel Disease

2015 ◽  
Author(s):  
Deepa T. Patil ◽  
Robert D. Odze
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Indeterminate Colitis ◽  
Pathologic Features ◽  
Common Causes ◽  
Type Pattern ◽  
Microscopic Features ◽  
Practical Guidelines ◽  
Inflammatory Bowel ◽  
Surveillance Endoscopy

Idiopathic inflammatory bowel disease (IBD) encompasses two major types: ulcerative colitis (UC) and Crohn disease (CD). The pathologic features of UC are typically restricted to the mucosa and superficial submucosa, whereas CD is characterized by patchy, segmental, mucosal, and mural inflammation. This review covers the classic pathologic features of IBD, differential diagnosis, dysplasia in IBD, and practical guidelines for clinicians who perform surveillance endoscopy. Figures show gross specimens of UC and CD variations and low- and high-grade dysplasia. Tables list the microscopic features of untreated UC and CD, the most common causes of uncertainty in IBD pathology that lead to a diagnosis of indeterminate colitis, a summary of inflammatory disorders of the colon that may mimic UC or CD on biopsy or resection, and diseases that can occur in patients with established UC or CD and result in changes to the type, pattern, and severity of inflammation. This review contains 5 highly rendered figures, 4 tables, and 75 references. 

PATIENTS’ JOURNEY THROUGH INFLAMMATORY BOWEL DISEASE (IBD): A QUALITATIVE STUDY

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S53-S54
Author(s):  
Tina Aswani Omprakash ◽  
Norelle Reilly ◽  
Jan Bhagwakar ◽  
Jeanette Carrell ◽  
Kristina Woodburn ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Qualitative Study ◽  
Patient Experience ◽  
Bowel Disease ◽  
Quality Care ◽  
Diagnostic Testing ◽  
Healthcare Providers ◽  
Indeterminate Colitis ◽  
Patient Journey ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) is a debilitating intestinal condition, manifesting as Crohn’s disease (CD), ulcerative colitis (UC) or indeterminate colitis (IC). The patient experience is impacted by a lack of awareness from other stakeholders despite growing global disease prevalence. To gain deeper insight of the patient experience, promote quality care, and enhance quality of life, we performed a qualitative study of the patient journey starting from pre-diagnosis through treatment. Methods U.S. patients with IBD were recruited via UC/CD support groups and organizations, social media platforms, blog followers, and personal networks. Participants were screened via an emailed survey and asked to self-identify as medically diagnosed on the basis of reported diagnostic testing. Interviews were conducted by qualitative researchers by phone or web conferencing. Open-ended questions were developed to support and gather information about our learning objectives—primarily, our desire to understand the unique experiences of UC/CD patients in their journey from symptom onset through diagnosis, treatment and maintenance (e.g. “Upon diagnosis, what were your immediate thoughts about the condition?”). This qualitative data were analyzed using Human-Centered Design methodology, including patient typologies (personas), forced temporal zoom (journey maps), forced semantic zoom (stakeholder system mapping), and affinity mapping for pattern recognition of unmet needs. Results A total of 32 patients were interviewed: N=17 CD patients, N=13 UC patients and N=2 IC patients. The interviewed population reflected regional, demographic, and disease-related diversity (Table 1). Five unique, mutually exclusive journeys were identified to understand and classify patient experiences: (1) Journey of Independence, (2) Journey of Acceptance, (3) Journey of Recognition, (4) Journey of Passion and (5) Journey of Determination (Figure 1). Patients with IBD expressed a need for increased awareness, education, and training for providers to shorten the path to diagnosis. Mental health support was found to be a critical gap in care, particularly for major treatment decisions (e.g., surgery). The inclusion of emotional support into the treatment paradigm was perceived as essential to long-term wellness. Patient attitudes and self-advocacy varied on their individual journeys; understanding these journeys may accelerate time to diagnosis and treatment. Conclusion Better understanding of patient journeys can help healthcare providers improve their approach to patient care and coordination.

scholarly journals Diversion colitis: a trigger for ulcerative colitis in the in-stream colon?

Gut ◽  
1999 ◽  
Vol 44 (2) ◽  
pp. 279-282 ◽  
Author(s):  
A G Lim ◽  
F L Langmead ◽  
R M Feakins ◽  
D S Rampton
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Risk Factor ◽  
Large Intestine ◽  
Bowel Disease ◽  
Rectosigmoid Colon ◽  
Diversion Colitis ◽  
End Colostomy ◽  
Microscopic Features ◽  
Inflammatory Bowel

The aetiology of ulcerative colitis is unknown. Two patients without pre-existing inflammatory bowel disease in whom end colostomy for faecal incontinence was complicated by diversion colitis in the defunctioned rectosigmoid colon, are described. In both instances, colitis with the clinical, colonoscopic, and microscopic features of ulcerative colitis developed about a year later in the previously normal in-stream colon proximal to the colostomy. These cases suggest that diversion colitis may be a risk factor for ulcerative colitis in predisposed individuals and that ulcerative colitis can be triggered by anatomically discontinuous inflammation elsewhere in the large intestine.

scholarly journals Incidence of Inflammatory Bowel Disease in Kaunas Region, Lithuania

Medicina ◽  
2012 ◽  
Vol 48 (8) ◽  
pp. 64 ◽  
Author(s):  
Gediminas Kiudelis ◽  
Laimas Jonaitis ◽  
Kęstutis Adamonis ◽  
Aida Žvirblienė ◽  
Algimantas Tamelis ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Western Europe ◽  
Age At Onset ◽  
Its Region ◽  
Indeterminate Colitis ◽  
Inflammatory Bowel

Objective. The aim of this study was to evaluate the incidence of inflammatory bowel disease in Kaunas and its region during a 3-year period. Material and Methods. The study was conducted during the 3-year period (2007–2009) and enrolled the patients from Kaunas with its region, which has a population of 381 300 inhabitants. The data were collected from all practices in the area where the diagnosis of inflammatory bowel disease was made by practicing gastroenterologists and consulting pediatricians along with endoscopists. Only new cases of inflammatory bowel disease were included into analysis. The diagnosis of ulcerative colitis and Crohn’s disease was strictly made according to the Copenhagen criteria. Age- and sex-standardized incidence was calculated for each year of the study period. Results. A total of 108 new inflammatory bowel disease cases were diagnosed during the study period: 87 had ulcerative colitis, 16 Crohn’s disease, and 5 indeterminate colitis. The incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis for each study year was 6.85, 5.33, and 7.38 per 100 000; 0.95, 1.11, and 1.57 per 100 000; and 0.47, 0.21, and 0.42 per 100 000, respectively. The average 3-year standardized incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis was 6.52, 1.21, and 0.37 per 100 000, respectively. The mean patients’ age at onset of ulcerative colitis, indeterminate colitis, and Crohn’s disease was 49.95 (SD, 17.03), 49.80 (SD, 17.71), and 34.94 years (SD, 0.37), respectively. Conclusions. The average 3-year incidence of ulcerative colitis in Kaunas region was found to be lower as compared with that in many parts of Central and Western Europe. The incidence of Crohn’s disease was low and very similar to other countries of Eastern Europe. Age at onset of the diseases appeared to be older than that reported in the Western industrialized countries.

CMV Colitis Mimicking Recurrent Inflammatory Bowel Disease: Report of Three Cases

2007 ◽  
Vol 73 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Dorna Rezania ◽  
Abderrhman Ouban ◽  
Jorge Marcet ◽  
Scott Kelley ◽  
Domenico Coppola
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cytomegalovirus Infection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Cytomegalovirus Colitis ◽  
Pathologic Features ◽  
Appropriate Therapy ◽  
Inflammatory Bowel ◽  
Cmv Colitis

The association between cytomegalovirus infection and inflammatory bowel disease challenges both the clinician and the pathologist to establish the correct diagnosis and to prescribe the most appropriate form of therapy. To understand this association the authors report three patients who presented with signs and symptoms mimicking reactivated inflammatory bowel disease who responded poorly to aggressive treatment of inflammatory bowel disease. Microscopic examination, in all three cases revealed numerous nuclear and cytoplasmic viral inclusions, as demonstrated by cytomegalovirus immunohistochemistry, as well as histologic findings consistent with inflammatory bowel disease (ulcerative colitis and/or Crohn's disease). Because the clinical pathologic features of cytomegalovirus colitis and inflammatory bowel disease often overlap, and because of the possible coexistence of cytomegalovirus colitis with idiopathic colitis, the possibility of cytomegalovirus infection should be always considered, so that the most appropriate therapy can be instituted for these patients.

scholarly journals Diagnostic Radiation Exposure in Patients with Inflammatory Bowel Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Catherine Langevin ◽  
Lysanne Normandeau ◽  
Mickael Bouin
Keyword(s):  
Inflammatory Bowel Disease ◽  
Radiation Exposure ◽  
Bowel Disease ◽  
Indeterminate Colitis ◽  
Number Of Patients ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Effects Of Radiation ◽  
And Control

Background. Because of the chronic and relapsing nature of inflammatory bowel disease (IBD), which often requires characterization with CT scan, IBD patients might be exposed to a large amount of radiation. As a cumulative effective dose (CED) ≥ 100 mSv is considered significant for stochastic risks of cancer, it is important to monitor and control the radiation exposure of the IBD patients. In the present work, we aimed to quantify the mean CED in IBD patients to assess any harmful effects of radiation. Methods. This study includes 200 IBD patients, identified retrospectively, from the outpatient clinics of the Centre Hospitalier de l’Université de Montréal between January 1, 2010, and February 15, 2017, from the gastroenterologists’ patients lists. The number and type of each radiology test performed were listed for each patient during the study period and the CED was calculated using our institution’s dose index when available and standardized tables. Results. Among the 200 IBD patients, 157 patients had Crohn’s disease (CD), 41 had ulcerative colitis (UC), and 2 had indeterminate colitis. The mean CED for IBD patients was 23.1 ± 45.2 mSv during a mean follow-up duration of 4.3 years. CED was higher among patients with CD than with UC (27.5 ± 49.5 versus 6.8 ± 14.8 mSv; p<0.01). Six patients were exposed to a high CED (>100 mSv) and all had CD. Conclusion. While potentially harmful levels of radiation exposure are of concern in only a small number of patients, strategies to limit such exposure are encouraged when clinically appropriate.

Faecal markers of gastrointestinal inflammation

2012 ◽  
Vol 65 (11) ◽  
pp. 981-985 ◽  
Author(s):  
Roy A Sherwood
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Waiting Times ◽  
Indeterminate Colitis ◽  
Faecal Calprotectin ◽  
Infectious Colitis ◽  
Inflammatory Conditions ◽  
Gi Symptoms ◽  
Rome Iii ◽  
Inflammatory Bowel

Gastrointestinal (GI) symptoms including abdominal pain, bloating and diarrhoea are a relatively common reason for consulting a physician. They may be due to inflammatory bowel disease (inflammatory bowel disease; Crohn's disease, ulcerative colitis and indeterminate colitis), malignancy (colorectal cancer), infectious colitis or irritable bowel syndrome (IBS). Differentiation between these involves the use of clinical, radiological, endoscopic and serological techniques, which are invasive or involve exposure to radiation. Serological markers include C-reactive protein, erythrocyte sedimentation rate and antibodies (perinuclear antineutrophil cytoplasm antibody and anti-Saccharomyces cerevisiae antibody). Faecal markers that can aid in distinguishing inflammatory disorders from non-inflammatory conditions are non-invasive and generally acceptable to the patient. As IBS accounts for up to 50% of cases presenting to the GI clinic and is a diagnosis of exclusion (Rome III criteria), any test that can reliably distinguish IBS from organic disease could speed diagnosis and reduce endoscopy waiting times. Faecal calprotectin, lactoferrin, M2-PK and S100A12 will be reviewed.

scholarly journals Characteristics of Inflammatory Bowel Disease Serology in Patients With Indeterminate Colitis

2014 ◽  
Vol 48 (4) ◽  
pp. 351-355 ◽  
Author(s):  
Siddharth P. Sura ◽  
Awais Ahmed ◽  
Adam S. Cheifetz ◽  
Alan C. Moss
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Indeterminate Colitis ◽  
Inflammatory Bowel
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