Clinical Course in Crohn’s Disease: Results of a Norwegian Population-Based Ten-Year Follow-Up Study

Solberg, Inger Camilla; Vatn, Morten H.; Høie, Ole; Stray, Njaal; Sauar, Jostein; Jahnsen, Jørgen; Moum, Bjørn; Lygren, Idar

doi:10.1016/j.cgh.2007.09.002

Cited by 626 publications

(505 citation statements)

References 27 publications

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“…In addition, few patients with a low disease activity during the first year experienced a significant worsening of the disease over time. [17] In our study, a large proportion of mild CD at 1 year finally did not meet the criteria of mild disease over the time. This is in contradiction with the concept of disease extinction suggested in previously published population-based study [17] and may indicate a recruitment bias: the patients with initial mild disease we recruited are precisely those who lost this mild disease status and were then referred to our centre.…”

Section: Discussionmentioning

confidence: 51%

“…Surgery had to be performed in 43% of the CD patients after more than 15 years of follow-up. Solberg et al [17] reported 38% of surgery after 10 years. The findings from our referral centre are close to the results of this Norwegian population-based cohort taking into account the longer follow-up in our cohort.…”

Section: Discussionmentioning

confidence: 99%

“…In population-based studies, however, about 50% of the patients remained complications free at 5 years. [17] The initial 3 years following diagnosis were the more active and some degree of disease extinction was observed over time. In addition, few patients with a low disease activity during the first year experienced a significant worsening of the disease over time.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Long-term evolution and predictive factors of mild inflammatory bowel disease

Reenaers

Pirard

Vankemseke

et al. 2016

Scandinavian Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term evolution and predictive factors of mild inflammatory bowel disease

Reenaers

Pirard

Vankemseke

et al. 2016

Scandinavian Journal of Gastroenterology

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“…Comparison of the findings of these two studies reveals that the likelihood of surgery has remained essentially stable over time and that roughly half of all patients will require resectional surgery within the first 10 years after diagnosis [3]. In other population-based studies, the cumulative risk of surgery 10 years after diagnosis ranged from approximately 40 to 55 % [4][5][6]. A report published in 2010 found that the probability of intestinal surgery in Welsh patients (1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003) during the first year after diagnosis was independently related to the site(s) of involvement, use of oral steroids within the first 3 months after diagnosis, and early use of thiopurines [7].…”

Section: Epidemiologymentioning

confidence: 99%

Surgery and diagnostic imaging in abdominal Crohn’s disease

et al. 2013

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Surgery is well-established option for the treatment of Crohn's disease that is refractory to medical therapy and for complications of the disease, including strictures, fistulas, abscesses, bleeding that cannot be controlled endoscopically, and neoplastic degeneration. For a condition like Crohn's disease, where medical management is the rule, other indications for surgery are considered controversial, because the therapeutic effects of surgery are limited to the resolution of complications and the rate of recurrence is high, especially at sites of the surgical anastomosis. In the authors' opinion, however, surgery should not be considered a last-resort treatment: in a variety of situations, it should be regarded as an appropriate solution for managing this disease. Based on a review of the literature and their own experience, the authors examine some of the possibilities for surgical interventions in Crohn's disease and the roles played in these cases by diagnostic imaging modalities.Riassunto La chirurgia è un'opzione terapeutica consolidata per il trattamento della malattia di Crohn refrattaria alla terapia medica e per le complicanze legate a tale patologia quali stenosi, fistole, ascessi, sanguinamento non trattabile endoscopicamente, oltre che per i casi di degenerazione neoplastica. Per condizioni come la malattia di Crohn nelle quali il trattamento medico ha un ruolo primario, altre indicazioni per la chirurgia sono controverse, poiché i suoi effetti terapeutici sono limitati alla risoluzione delle complicanze, e la frequenza di recidive è alta, soprattutto a livello dell'anastomosi. Secondo l'opinione degli autori, tuttavia, la chirurgia non deve essere considerata come ultima opzione di trattamento: in diverse situazioni dovrebbe essere ritenuta come una soluzione adeguata nel trattamento multidisciplinare della patologia. Basandosi sulla revisione della letteratura corrente e sulla propria esperienza, gli autori hanno esaminato alcune possibilità di intervento chirurgico nella malattia di Crohn ed il ruolo che svolgono in queste condizioni le tecniche di imaging.

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“…In a population-based study, it has been shown that the cumulative rate for surgery in patients with stricturing CD after 10 years is 64% in Norwegian subjects, and stricturing CD behavior was an independent risk factor for the need of surgery. It is thus well established that stricturing CD leads to the need for intervention in the vast majority of patients [5].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic solutions for stricturing Crohn's disease

Szmola

Rácz

Tulassay

et al. 2012

IMAS

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Abstract:Intestinal stenosis is a frequent and oftentimes recurring problem in patients with Crohn's disease, accompanied by a high-risk for bowel resection and subsequent short bowel syndrome. Medical therapy has not proven successful, and even the most conservative surgical options are hampered by a definite mortality rate (and high recurrence rates) without doubt. Technical improvements in endoscopic devices over recent years have created an operative subspecialty (therapeutic endoscopy) that can be applied to several gastrointestinal diseases. Endoscopic balloon dilatation (EBD) for Crohn's disease has been developed to prevent or delay the need for surgical resection. The endoscopy-assisted dilatation is a safe and effective treatment modality for uncomplicated, short Crohn's strictures, and therefore should be offered to Crohn's disease patients. Here, we briefly review the current knowledge on hydrostatic balloon dilatation and present a relevant case from our clinical practice.

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Clinical Course in Crohn’s Disease: Results of a Norwegian Population-Based Ten-Year Follow-Up Study

Cited by 626 publications

References 27 publications

Long-term evolution and predictive factors of mild inflammatory bowel disease

Long-term evolution and predictive factors of mild inflammatory bowel disease

Surgery and diagnostic imaging in abdominal Crohn’s disease

Endoscopic solutions for stricturing Crohn's disease

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