Adenomatous colonic polyps are rare in ulcerative colitis

Kitiyakara, Taya; Bailey, D.M.; McIntyre, A. S.; Gorard, D. A.

doi:10.1111/j.1365-2036.2004.01914.x

Cited by 20 publications

(17 citation statements)

References 46 publications

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“…An observational study from Kitiyakara et al . examined the occurrence of adenomatous polyps in patients with ulcerative colitis 55 . They noted that both adenomatous and metaplastic polyps occurred less frequently in 150 patients with ulcerative colitis than in 205 controls without IBD.…”

Section: Experimental Studiesmentioning

confidence: 99%

Review article: the data supporting a role for aminosalicylates in the chemoprevention of colorectal cancer in patients with inflammatory bowel disease

Eaden

2003

Aliment Pharmacol Ther

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Summary The chemoprevention of colorectal cancer (CRC) with long‐term sulfasalazine and 5‐aminosalicyclic acid (5‐ASA) treatment has been demonstrated through epidemiological and experimental studies, in patients with ulcerative colitis. In a large case‐controlled study, there was a trend for long‐term nonsteroidal anti‐inflammatory consumption to be protective against CRC in patients with inflammatory bowel disease (IBD) (OR, 0.84). Sulfasalazine treatment over a 3‐month period was shown to be protective (OR, 0.38), independently of disease activity. A longer‐term study of sulfasalazine also revealed a relationship with treatment compliance, where 3% of compliant patients developed CRC compared with 31% of the noncompliers. Treatment with 5‐ASA was associated with an increase in apoptosis, a decrease in proliferation of colorectal mucosa and has been shown to lower the rate of spontaneous mutation. In a retrospective, matched case‐control study conducted in the UK, 102 patients with ulcerative colitis and CRC were matched with ulcerative colitis patients without CRC. Incidence was correlated to treatment protocols, family history and other risk factors. Mesalazine was the only treatment to be associated with a statistically significant reduction in the risk of developing cancer. Even after adjusting for variables, mesalazine at doses > 1.2 g / day reduced the risk of cancer by 81% (P = 0.006). Frequent visits to the clinician were also associated with a protective effect.

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Section: Experimental Studiesmentioning

confidence: 99%

Review article: the data supporting a role for aminosalicylates in the chemoprevention of colorectal cancer in patients with inflammatory bowel disease

Eaden

2003

Aliment Pharmacol Ther

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“…Adenomatous colonic polyps are rare in ulcerative colitis. 41 In this 2004 study reviewing 150 patients, only 6 (4%) had adenomatous polyps. The authors postulate that the decreased prevalence of adenomatous polyps in UC may be possibly due to drug treatments undergone by the patients.…”

Section: Resultsmentioning

confidence: 86%

“…As Kitiyakara suggested in 2004, the decreased prevalence of adenomatous polyps in UC may be due to the therapeutic response. 41 However, the presence of these polyps in these younger patients described may be a cause for concern as the standard care for colorectal cancer screening as presented by the U. S. Preventive Services Task Force (USPSTF) is age 50. 9 Although only a small percentage of adenomatous polyps become cancerous, almost all malignant polyps are adenomatous.…”

Section: Discussionmentioning

confidence: 99%

An Observational Chart Review on the Efficacy of Subcutaneous Methotrexate in Mild to Moderate Ulcerative Colitis and the Description of Occurrence of Adenomatous Polyps in Afflicted Patients

Soriano

Blake²,

Gonzalez³

2015

Gastro Open J

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ResearchPage 23 ABSTRACTUlcerative Colitis (UC) is a type of Inflammatory Bowel Disease (IBD) that affects the large intestine and produces mainly symptoms of abdominal pain and bloody stools. Chart reviews of patients from July 2011 to July 2012 with mild to moderate UC enrolled in a community-based NIH trial on the efficacy of 8 weeks of 12.5 mg once daily subcutaneous methotrexate demonstrated no significant improvement of abdominal pain and bloody stools. In their patient diaries and IBD Questionnaire, all 9 patients reported a sense of heaviness or abdominal fullness, bloating or cramps. The patients experienced decreased energy levels and depressed feelings with anxiety and decreased sleep at night. Overall, the majority of them reported a decreased quality of life despite the 8 week trial of MTX. We also noted in the chart review the incidental finding of histopathologically-confirmed distal adenomatous polyps in all 9 patients for which we postulate the following: 1) that distal adenomatous polyps may be a risk factor in UC, 2) that surgical removal or polypectomy for these polyps, if diagnosed earlier especially in those younger than 40 years of age, may delay progression or prevent development of UC, 3) the presence of polyps in all 9 patients could have prevented the desired therapeutic response from methotrexate, and 4) that the presence of the polyps may indicate that low dose methotrexate is not an effective treatment for UC. The presence of intestinal polyps realigns the structural integrity and dynamics of the movement of the intestinal walls and valves, causing affected patients to frequently report feelings of discomfort and lethargy. It is important to understand that further diagnosis and therapies for UC and IBD are accompanied with ethical questions, such as treating affected patients with cytotoxic medications and performing colonoscopies under the standard age care of 50 years. Further research needs to address combination therapies and other risk factors such diets and preservatives to determine the full extent of this potential ground-breaking science.

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“…S irs , We appreciate the interest shown by Dr Rutter 1 in our paper 2 . He re‐emphasizes the difficulties in classifying dysplastic lesions in patients with ulcerative colitis.…”

mentioning

confidence: 80%

Author reply to ‘Letter to the Editor: Are adenomatous polyps rare in ulcerative colitis?’

Gorard¹,

Kitiyakara²,

McIntyre³

2004

Aliment Pharmacol Ther

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Adenomatous colonic polyps are rare in ulcerative colitis

Cited by 20 publications

References 46 publications

Review article: the data supporting a role for aminosalicylates in the chemoprevention of colorectal cancer in patients with inflammatory bowel disease

Review article: the data supporting a role for aminosalicylates in the chemoprevention of colorectal cancer in patients with inflammatory bowel disease

An Observational Chart Review on the Efficacy of Subcutaneous Methotrexate in Mild to Moderate Ulcerative Colitis and the Description of Occurrence of Adenomatous Polyps in Afflicted Patients

Author reply to ‘Letter to the Editor: Are adenomatous polyps rare in ulcerative colitis?’

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