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Stephen Padilla, 13 Feb 2019
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Understanding the factors which induce visceral hypersensitivity (VH) in patients with functional gastrointestinal disorders (FGIDs) may help doctors manage patients and develop new treatments, says an expert.

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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
Stephen Padilla, 13 Feb 2019
The Mandarin-speaking population in Singapore (SG) has deemed the translated Chronic Liver Disease Questionnaire (CLDQ) culturally acceptable, with only two items that needed revision in the finalized CLDQ-SG, according to a recent study.
Rachel Soon, 30 Sep 2016

Understanding the factors which induce visceral hypersensitivity (VH) in patients with functional gastrointestinal disorders (FGIDs) may help doctors manage patients and develop new treatments, says an expert.

Dr. Angela V. Ignacio, 21 Feb 2017
Administration of a probiotic appears to be a safe and effective therapeutic alternative for minimal hepatic encephalopathy (MHE) in patients with liver cirrhosis, according to a Greek study presented at the 26th Conference of the Asian Pacific Association for the Study of the Liver (APASL) held in Shanghai, China.