Most Read Articles
11 Apr 2019
Cannabis use disorder appears to exert a beneficial effect on the risk of disorders of gut–brain interaction and inflammatory bowel disease in patients with schizophrenia but not in population controls, a study has found. This finding raises the possibility of new targets for treatment and prevention of digestive organ disorders in schizophrenia.
10 Apr 2019
An individualized, food-based diet may be a potential treatment approach for patients with active Crohn’s disease, successfully replicating microbiome changes elicited by exclusive enteral nutrition and reducing gut inflammation, a recent study has shown.
12 Nov 2018
Individuals with severe and frequent gastro-oesophageal reflux disease (GERD) are at increased risk of Barrett’s oesophagus (BE), especially in the absence of frequent proton pump inhibitor (PPI) use, a recent study has found. Family history of BE and early age of symptom onset are strong predictors of BE among people with GERD.

Colonic resection ups postsurgery recurrence in Crohn’s disease

09 Feb 2019
Crohn’s is not the end of the world, as Kathleen Baker’s silver medal proves

Crohn’s disease patients who undergo colonic resection are more prone to postsurgery recurrence of the disease, reports a recent study.

The study included 193 Crohn’s disease patients (mean age 52±12 years; 107 males), of whom 105 had ileal and 36 had colonic disease. Most of the participants did not have perianal (n=145) or extraintestinal (n=180) disease. Mesalamine was the most common concomitant therapy at enrolment.

Over a median follow-up duration of 56 months, more than half (53 percent; n=102) of the participants experienced postsurgery recurrence of Crohn’s disease. In most of these, medical therapy was sufficient to treat the recurring disease (71 percent); a second surgery was required in 29 percent of the cases.

Multivariate logistic regression analysis identified active smoking after surgery (hazard ratio [HR], 2.3; 95 percent CI, 1.3–4.2; p=0.007) and being 40 years of age at initial Crohn’s disease diagnosis (HR, 2.1; 1.1–4.3; p=0.03) as significant and independent risk factors for recurrence. Cox regression modelling further specified that compared to nonsmokers, the median time to recurrence was shorter in smokers (45 vs 82 months).

Notably, univariate analysis showed that colonic or ileocolonic resection significantly increased the risk of recurrence relative to ileal resection (HR, 3.0; 1.4–6.2; p=0.004). The same was true for the lack of immunosuppressive or biologic therapy after surgery (HR, 2.3; 1.0–5.3; p=0.05).

Exclusion of patients who received postsurgery prophylactic treatment from the surgery did not attenuate the interaction between colonic/ileocolonic resection on the risk of recurrence (HR, 3.2; 1.1–8.9; p=0.03). Survival analysis further showed that recurrence-free time was significantly reduced in patients who underwent isolated colonic resection (p=0.006).

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Most Read Articles
11 Apr 2019
Cannabis use disorder appears to exert a beneficial effect on the risk of disorders of gut–brain interaction and inflammatory bowel disease in patients with schizophrenia but not in population controls, a study has found. This finding raises the possibility of new targets for treatment and prevention of digestive organ disorders in schizophrenia.
10 Apr 2019
An individualized, food-based diet may be a potential treatment approach for patients with active Crohn’s disease, successfully replicating microbiome changes elicited by exclusive enteral nutrition and reducing gut inflammation, a recent study has shown.
12 Nov 2018
Individuals with severe and frequent gastro-oesophageal reflux disease (GERD) are at increased risk of Barrett’s oesophagus (BE), especially in the absence of frequent proton pump inhibitor (PPI) use, a recent study has found. Family history of BE and early age of symptom onset are strong predictors of BE among people with GERD.