scholarly journals Inflammatory Bowel Diseases: Is There a Role for Nutritional Suggestions?

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1387
Author(s):  
Lorenzo Bertani ◽  
Davide Giuseppe Ribaldone ◽  
Massimo Bellini ◽  
Maria Gloria Mumolo ◽  
Francesco Costa
Keyword(s):  
Surgical Treatment ◽  
Inflammatory Bowel Diseases ◽  
Current Knowledge ◽  
Hospitalized Patients ◽  
Nutritional Deficiencies ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Impact ◽  
Macro Nutrients ◽  
Over Time

Nutrition has an important impact on inflammatory bowel diseases (IBD). In particular, several studies have addressed its role in their pathogenesis, showing how the incidence of IBD significantly increased in recent years. Meanwhile, nutrition should be considered a component of the treatment of the disease, both as a therapy itself, and especially in the perspective of correcting the various nutritional deficiencies shown by these patients. In this perspective, nutritional suggestions are very important even in the most severe forms of IBD, requiring hospitalization or surgical treatment. Although current knowledge about nutrition in IBD is increasing over time, nutritional suggestions are often underestimated by clinicians. This narrative review is an update summary of current knowledge on nutritional suggestions in IBD, in order to address the impact of nutrition on pathogenesis, micro- and macro-nutrients deficiencies (especially in the case of sarcopenia and obesity), as well as in hospitalized patients.

scholarly journals OP02 Impact of therapeutic strategies on intestinal resection rate in paediatric inflammatory bowel diseases: A population-based cohort study over a 24-year period (1988–2011)

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S001-S003
Author(s):  
D Ley ◽  
A Leroyer ◽  
C Dupont ◽  
H Sarter ◽  
V Bertrand ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Intestinal Resection ◽  
Population Based ◽  
Therapeutic Strategies ◽  
Resection Rate ◽  
Related Hospitalisation ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Impact ◽  
Over Time

Abstract Background Few data are available at the population level on the impact of the changes in therapeutic strategies over the last decades on inflammatory bowel diseases (IBD) long-term outcomes. We have evaluated the impact of immunosuppressants (IS) and anti-TNF introduction on intestinal resection rate, hospitalisation, and Crohn’s disease (CD) behaviour progression in a large population-based paediatric-onset IBD cohort. Methods Paediatric-onset IBD (<17 years) were issued from a prospective population-based study in France between 1988 and 2011 and were retrospectively followed until 2013. Risks for intestinal resection, hospitalisation and complicated CD behaviour (stricturing or penetrating) were compared between three diagnostic periods: 1988–1993 (P1), 1994–2000 (P2) and 2001–2011 (P3) using Kaplan–Meier survival analyses. Results One thousand and sixty-one patients diagnosed with CD (n = 800) or ulcerative colitis (UC, n = 261) were followed up during a median of 8.9 years (IQR: 5.0–14.7). Median age at diagnosis was 14.3 years (IQR: 11.8–16.0) and half of patients were female (n = 530, 50%). Over time, in CD, the IS and anti-TNF exposure rate increased from, respectively, 32% (P1) to 75% (P3) and from 0% (P1) to 51% (P3) at 5 years. In UC, IS and anti-TNF exposure increased from, respectively, 9% (P1) to 65% (P3) and from 0% (P1) to 40% (P3) at 5 years. In parallel, risk for intestinal resection at 5 years significantly declined in CD (P1: 35%, P2: 30%, P3: 20%, p < 0.05). No significant change in 5-year colectomy risk in UC was observed (P1: 14%, P2: 19%, P3: 9%, p = 0.08). Exposure to corticosteroid at 5 years of diagnosis did not change over time (P1: 10%, P2: 10%, P3: 8%, p = 0.54). Risk for IBD-flare-related hospitalisation at 5 years was similar over time in CD (P1: 43%, P2: 45%, P3: 43%, p = 0.60) and UC (P1: 31%, P2: 46%, P3: 52%, p = 0.10). Progression to a complicated behaviour in CD at 5 years did not change over time (P1: 31%, P2: 33%, P3: 25%, p = 0.20). Conclusion In parallel with the increased use of IS and anti-TNF agents, risk for intestinal resection within 5 years after diagnosis decreased in paediatric CD, whereas risks for flare-related hospitalisation and behaviour progression remained unchanged over a 24-year period.

scholarly journals Predictors and Early Markers of Response to Biological Therapies in Inflammatory Bowel Diseases

2021 ◽  
Vol 10 (4) ◽  
pp. 853
Author(s):  
Giuseppe Privitera ◽  
Daniela Pugliese ◽  
Gian Ludovico Rapaccini ◽  
Antonio Gasbarrini ◽  
Alessandro Armuzzi ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Current Knowledge ◽  
Real Life ◽  
Response To Therapy ◽  
Significant Heterogeneity ◽  
Intestinal Damage ◽  
Biological Therapies ◽  
Early Markers ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel diseases (IBD) are chronic conditions that primarily affect the gastrointestinal tract, with a complex pathogenesis; they are characterized by a significant heterogeneity of clinical presentations and of inflammatory pathways that sustain intestinal damage. After the introduction of the first biological therapies, the pipeline of therapies for IBD has been constantly expanding, and a significant number of new molecules is expected in the next few years. Evidence from clinical trials and real-life experiences has taught us that up to 40% of patients do not respond to a specific drug. Unfortunately, to date, clinicians lack a valid tool that can predict each patient’s response to therapies and that could help them in choosing what drug to administer. Several candidate biomarkers have been investigated so far, with conflicting results: clinical, genetic, immunological, pharmacokinetic and microbial markers have been tested, but no ideal marker has been identified so far. Based on recent evidence, multiparametric models seemingly hold the greatest potential for predicting response to therapy. In this narrative review, we aim to summarize the current knowledge on predictors and early markers of response to biological therapies in IBD.

scholarly journals Epigenetics of Inflammatory Bowel Disease: Unraveling Pathogenic Events

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Beatriz Mateos ◽  
Cora Palanca-Ballester ◽  
Esteban Saez-Gonzalez ◽  
Inés Moret ◽  
Adrian Lopez ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Inflammatory Bowel Diseases ◽  
Drug Response ◽  
Current Knowledge ◽  
Epigenetic Biomarkers ◽  
Bowel Diseases ◽  
Potential Applicability ◽  
Inflammatory Bowel ◽  
New Biomarkers

Abstract Epigenetics has emerged as a new and promising field in recent years. Because there exists a need to find new biomarkers and improve diagnosis, prognosis, and drug response for inflammatory bowel diseases, the research on epigenetic biomarkers for molecular diagnostics encourages the translation of this field from the bench to the clinical practice. In this review, we present an overview of the current knowledge and its potential applicability of this emerging field in inflammatory bowel diseases.

scholarly journals P295 VALIDation of the IBD-Disk instrument for assessing disability in inflammatory bowel diseases in a population-based cohort: The VALIDate study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S299-S301
Author(s):  
C Le Berre ◽  
A Bourreille ◽  
M Flamant ◽  
G Bouguen ◽  
L Siproudhis ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Inflammatory Bowel Diseases ◽  
Population Based ◽  
Large Cohort ◽  
Inactive Disease ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Physician Patient ◽  
Over Time

Abstract Background Inflammatory bowel diseases (IBD) are disabling disorders. The IBD-Disability Index (IBD-DI) was developed for quantifying disability in IBD patients but is difficult to use. The IBD-Disk is a shortened and visual adaptation of the IBD-DI. It has not been validated yet. The main objectives were to validate the IBD-Disk in a large cohort of IBD patients and to assess its variability over time. Methods From March 2018 to July 2019, IBD patients from three university-affiliated hospitals responded twice to both IBD-Disk and IBD-DI at 3–12 months intervals (NCT03590639). Validation included concurrent validity, reproducibility, internal consistency, and evaluation of IBD-Disk correlation with IBD activity. Variability was assessed by comparing scores between baseline and follow-up visits. Results A total of 559 patients (73% Crohn’s disease, 27% ulcerative colitis) were included and 389 were followed up (Table 1). There was a good correlation between IBD-Disk and IBD-DI scores (r = 0.75, p < 0.001) (Figure 1). The IBD-Disk was significantly higher in patients with active disease according to Physician/Patient Global Assessment (Figure 2), clinical scores (Figure 3), and biomarkers levels, compared with patients with inactive disease. Reproducibility was excellent (intra-class correlation coefficient = 0.90), as well as internal consistency (Cronbach’s α = 0.89). The IBD-Disk score significantly decreased in patients becoming inactive over time. Conclusion This is the first study to validate the IBD-Disk in a large cohort of IBD patients, demonstrating that it is a valid and reliable tool for quantifying disability in clinical practice. Further studies are warranted to assess its correlation with endoscopic activity, to explore its responsiveness to change, and to evaluate the factors associated with disability.

scholarly journals Evidence for a Potential Role of Metallothioneins in Inflammatory Bowel Diseases

2009 ◽  
Vol 2009 ◽  
pp. 1-9 ◽  
Author(s):  
Anouk Waeytens ◽  
Martine De Vos ◽  
Debby Laukens
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Potential Role ◽  
Current Knowledge ◽  
Zinc Homeostasis ◽  
Central Position ◽  
Small Proteins ◽  
Immune Mediated ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel diseases (IBDs) are a group of chronic, relapsing, immune-mediated disorders of the intestine, including Crohn's disease and ulcerative colitis. Recent studies underscore the importance of the damaged epithelial barrier and the dysregulated innate immune system in their pathogenesis. Metallothioneins (MTs) are a family of small proteins with a high and conserved cysteine content that are rapidly upregulated in response to an inflammatory stimulus. Herein, we review the current knowledge regarding the expression and potential role of MTs in IBD. MTs exert a central position in zinc homeostasis, modulate the activation of the transcription factor nuclear factor (NF)-B, and serve as antioxidants. In addition, MTs could be involved in IBD through their antiapoptotic effects or through specific immunomodulating extracellular effects. Reports on MT expression in IBD are contradictory but clearly demonstrate a deviant MT expression supporting the idea that these aberrations in IBD require further clarification.

Recommendation of surgical treatment in patients with inflammatory bowel diseases – part 3: ulcerative colitis, indications for surgery

2016 ◽  
Vol 70 (3) ◽  
pp. 252-261
Author(s):  
Zuzana Šerclová ◽  
Ondřej Ryska ◽  
Martin Bortlík ◽  
Dana Ďuricová ◽  
Robert Gürlich ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Surgical Treatment ◽  
Inflammatory Bowel Diseases ◽  
Indications For Surgery ◽  
Bowel Diseases ◽  
Inflammatory Bowel
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