From Physical Frailty to Psychosocial Maladaptation: Predicting Mental Reserve and Quality of Life in Patients with Inflammatory Bowel Diseases

Inflammatory bowel disease in children and adolescents: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition.

: The objective of the present study was to quantify the national pediatric inpatient inflammatory bowel disease (IBD) burden in terms of the number of IBD-related hospitalizations, the number of days spent in the hospital, and hospitalization costs. : Hospitalizations for children and adolescents 20 years and younger with a primary diagnosis of either Crohn disease (CD) or ulcerative colitis (UC) were selected from the 2006 Kids' Inpatient Database (KID). Length of the hospital stay in days (LOS) and charges for the hospitalization were found directly in the Kids' Inpatient Database, and cost was calculated using the hospital's cost-to-charge ratio. Predictor variables included patient characteristics, such as age and severity of illness, and hospital characteristics. Ordinary-least-squares regressions were developed and estimated to explain hospitalization costs. : In 2006, there were 10,777 IBD-related hospitalizations. The total and mean costs for CD were $66.3 million and $10,176 (95% confidence interval [CI] $9647-$10,705), and for UC were $48.6 million and $11,836 (95% CI $10,760-$12,912). For CD, 0- to 5-year-old patients had the highest mean LOS (8.10, 95% CI 5.53-10.67, days) and mean cost ($13,894, 95% CI $9053-$18,735), whereas, for UC, 11- to 15-year-old patients had the highest mean LOS (7.49, 95% CI 6.88-8.10, 95% CI 5.53-10.67, days) and mean cost ($13,407, 95% CI $11,704-$15,110). : For a pediatric disease with a rather low prevalence rate, the estimated annual inpatient pediatric burden of IBD is a sizeable $152.4 million (2010 US$) and 64,985 days spent in the hospital. As medications and outpatient treatments improve for the treatment of IBD, there is an opportunity for significant reduction in inpatient burden.

Does Consuming the Recommend Daily Level of Fiber Prevent Crohn's Disease?

This Month in Gastroenterology

AGA Medical Position Statement on the Diagnosis and Management of Colorectal Neoplasia in Inflammatory Bowel Disease

Beyond Gene Discovery in Inflammatory Bowel Disease: The Emerging Role of Epigenetics

An Apple a Day Keeps the Doctor Away: The Effect of a Low-Fat, High-Fiber Diet on Quality of Life, Inflammation, and Dysbiosis in Patients With Ulcerative Colitis

P152 ANALYSIS OF HUMAN COLONIC TISSUE AND PERIPHERAL BLOOD BY MASS CYTOMETRY REVEALS IMMUNE SIGNATURES DIFFERENTIATING INFLAMMATORY STATES IN UC, CD, AND CONTROLS

INTRODUCTION: Inflammatory bowel disease (IBD) refers to diseases characterized by chronic inflammation of the gastrointestinal (GI) tract, including Crohn’s disease (CD) and ulcerative colitis (UC). Major areas of unmet need for many IBD patients include the frequency and severity of symptoms that interfere with day-to-day activities, and the impact symptoms have on work, education, relationships, and/or emotional well-being. We sought to better understand the daily symptom burden of IBD and the resulting impact on patient quality of life. METHODS: An anonymous 19-question online survey was distributed through the social media network MyCrohnsAndColitisTeam.com between November 11 and November 18, 2019 to persons (aged ≥19 years) who self-identified as having CD or UC, living in the United States. RESULTS: A total of 302 patients completed the survey (177 CD, 125 UC), with the majority being female (74% CD, 78% UC), and aged 50 or older (73% CD, 82% UC). The most frequently reported problematic IBD symptoms included moderate to severe abdominal pain (56% CD, 46% UC), diarrhea (62% CD, 67% UC), and fatigue (68% CD, 63% UC) (Figure 1). Most respondents reported that the frequency and severity of their IBD symptoms had a moderate to severe impact on their daily life (80% CD, 81% UC), including limitation of social activities (77% CD, 71% UC), travel (69% CD, 66% UC), and time outside of the home (66% CD, 68% UC), including the ability to work (Figure 2). In addition, patients reported that IBD had a negative impact on their emotional well-being, causing anxiety (82% CD, 81% UC), depression (80% CD, 71% UC), and embarrassment (70% CD & UC), as well as feelings of inadequacy (41% CD, 35% UC) and low self-esteem (50% CD, 46% UC). CONCLUSION: In addition to the burden of the IBD diagnosis and treatment, the disease’s impact on day-to-day physical, practical, and emotional life causes additional stress and burden on patients and may be underestimated by the treating medical team. The results of this survey underscore the importance of a holistic approach to treating IBD, which relies upon frequent and effective communication between the patient and medical team about the emotional and physical burden of IBD. A better mutual understanding of the scope and pervasiveness of the disease burden is essential to improving treatment decisions and patients’ quality of life.Figure 1.: Most Problematic Symptoms for Persons with Living with Crohn’s Disease or Ulcerative Colitis.Figure 2.: Impact of IBD Symptoms on Social and Family Life and Education and Work Activities.Figure 3.: Emotional Impact of Living with Crohn’s Disease or Ulcerative Colitis.

Ulcerative Colitis and Crohn's Disease Genetics: More Similar Than We Thought?

Inflammatory bowel disease.

After a new look at the history of the Marchioness del Valles conspiracy as part of the tensions that queen Margaret and her ladies caused at the Court of Philip III, the essay stresses the doubts, questions poned and interest that these circumstances aroused in the Spanish political and popular media in the early 17th century. Special attention is given to the information media which prepared and passed on these facts: rumours and oral narrations, announcements, historical and literary texts, relations of ambassadors, all in the framework of a budding public opinion structure.

Quality of life (QoL) in patients with inflammatory bowel diseases (IBD) may change in association with changes in disease activity. A validated instrument, the short IBD questionnaire (SIBDQ), is able to quantify and detect meaningful changes in health related QoL. We aimed to determine baseline QoL in patients with Crohn's disease (CD) and ulcerative colitis (UC) in a national Internet cohort of patients with self-reported IBD (CCFA Partners®). We then aimed to determine if QoL changed with disease activity or with duration of IBD. We finally aimed to compare QoL in patients with active UC to QoL in patients status post colectomy with pouch formation. We developed an Internet cohort (CCFA Partners®) of patients with IBD. Invitations to join the cohort were sent via email to individuals listed on CCFA rosters. Respondents completed a baseline survey that included modules on disease course, disease activity (short CD activity index (CDAI) and simple clinical colitis activity index (SCCAI)), and quality of life (SIBDQ). Only adults (age>17) with IBD were eligible for inclusion. Descriptive statistics were used to compare QoL by CD or UC and also by levels of disease activity. Bivariate analyses and linear regression were to evaluate the effects of disease duration on QoL. A total of 7819 individuals with self-reported IBD joined CCFA Partners®. In the overall population, the median SIBDQ score was 50 (IQR 41-58), CD 50 (IQR 40-58), UC 52 (42-59), p<0.01. The SIBDQ ranges from 10 (poor) to 70 (optimum). See tables below for SIBDQ by disease activity and disease duration. No Caption available. No Caption available. No Caption available. No Caption available. Using logistic regression to control for disease activity, disease duration remained significantly associated with SIBDQ for both CD and UC (Beta coefficient 0.07, 0.06 respectively, p<0.01). SIBDQ in UC patients with more active disease (defined as SCCAI>median) was significantly lower than SIBDQ in UC patients status post colectomy with pouch formation; 40.8 (sd 10.2) vs. 50.1 (sd 11.9), p<0.01. CD is associated with significantly lower QoL than UC. Increasing levels of disease activity, as measured by validated indices for self-report in CD and UC, are associated with worsened QoL. Increasing IBD duration is associated with improvements in QoL. In UC, colectomy with pouch formation is associated with improved QoL when compared to active disease states. Future studies within CCFA Partners® will include other measurements of QoL within the IBD population, and repeated measurements of QoL over time.

Background Sexual dysfunction is often associated with impaired body image and quality of life in patients. However, little data exists on sexual dysfunction (SD) in patients with Chronic Inflammatory Bowel Disease (IBD). The aim of this study was to assess the prevalence and risk factors for sexual dysfunction in patients with IBD. Methods This is a cross-sectional study of all patients followed for IBD. Sexual function was assessed by the Female Sexual Index Function (FSIF) for women and the International Index of Erectile Function (IIEF) for men. Sexual dysfunction was confirmed when the total FSIF score was less than 26, or the IIEF score less than 26. Crohn’s disease (CD) activity was assessed by the Harvey-Bradshaw index (HBI), and that of ulcerative colitis (UC), by the clinical Mayo scores. Results We collected 100 patients, with a mean age of 42.18 ± 15.71 and a sex ratio (M / F) = 1.5. Sixty eight patients had CD and 32 patients had UC. Ano-perineal manifestations were present in 38.2% of cases. Severe disease activity was noted in 14 patients (20.6%) with CD and 10 patients (31.3%) with UC. Twelve patients had proctitis. 38% of patients had surgical treatment: 18.75% for patients with UC and 47.05% for those with CD. Total colectomy was performed in 12% of cases. At the time of the study, 20% of patients were on systemic corticosteroid therapy, 22% on Azathioprine, 4% on Salazopyrine, 8% on 5-ASA and 46% on Anti-TNFα. Sexual dysfunction was reported by 42.9% of women: 57.14% (UC) vs 38.46% (CD) (p = 0.042). On the other hand, sexual dysfunction was reported by 27.6% of men: 22.2% of men with UC and 28.57% with CD, with no statistically significant difference (p = 0.78). A significant association was found between sexual dysfunction and the degree of disease activity (p &amp;lt;0.001 for CD, p = 0.003 for UC), as well as pancolitic involvement in women with UC (p = 0.002). However, the presence of anoperineal manifestations, rectal involvement and history of surgery were not significantly associated with the frequency of sexual disturbances. Conclusion Our study showed a high prevalence of sexual dysfunction in patients with IBD. Training gastroenterologists in the management of sexual dysfunction would make it possible to satisfy patient expectations.

Anti–Integrin αvβ6 Antibody as a Diagnostic Marker for Pediatric Patients With Ulcerative Colitis