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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

403
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
403
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

873
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
873
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

419
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
419
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

399
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
399
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

703
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
703
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

372
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
372

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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
06:46

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Incidence Rates for Surgery in Crohn's Disease Have Decreased: A Population-based Time-trend Analysis.

Alexandra E Dittrich1, Reed Taylor Sutton1, Kate Haynes1

  • 1Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.

Inflammatory Bowel Diseases
|January 3, 2020
PubMed
Summary
This summary is machine-generated.

Crohn's disease surgery rates declined significantly with increased anti-TNF therapy use and reduced smoking. This suggests a multifactorial decrease in surgical need for Crohn's patients.

Keywords:
Crohn’s diseasebiologic therapyinflammatory bowel diseasesurgerytime-trend study

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Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Epidemiology

Background:

  • Crohn's disease (CD) often necessitates surgery throughout a patient's life.
  • The advent of disease-modifying therapies, such as anti-tumor necrosis factor (anti-TNF) agents, was hypothesized to reduce the population-level incidence of CD-related surgeries.
  • This study investigated temporal trends in surgical rates among adult CD patients following the introduction of anti-TNF therapy.

Purpose of the Study:

  • To evaluate changes in the annual incidence of abdominal surgery for Crohn's disease.
  • To assess the correlation between the uptake of anti-TNF therapy and surgical rates.
  • To identify trends in modifiable risk factors associated with Crohn's disease surgery.

Main Methods:

  • Retrospective review of adult CD patients who underwent abdominal surgery between 1996 and 2013.
  • Manual chart review to confirm diagnosis and collect demographic/disease data.
  • Calculation of population-adjusted annual incidence rates and time-trend analysis using annual percent change (APC).

Main Results:

  • A total of 1410 CD surgeries were identified.
  • The annual surgical rate for Crohn's disease decreased by 8.4% (95% CI, -9.6% to -7.3%).
  • Concurrently, anti-TNF therapy use increased by 36.2% annually (95% CI, 31.3% to 41.5%), and active smoking rates decreased by 2.2% annually (95% CI, -3.7% to -0.6%).

Conclusions:

  • The observed decline in Crohn's disease surgical rates is likely multifactorial.
  • While anti-TNF therapy appears to contribute, other factors such as reduced smoking, earlier diagnosis, improved treatments, and enhanced patient education also play significant roles.
  • These findings highlight evolving management strategies and patient factors influencing surgical outcomes in Crohn's disease.