Clinical presentation of Crohn’s, ulcerative colitis, and indeterminate colitis: Symptoms, extraintestinal manifestations, and disease phenotypes

Yu, Yangyang R.; Rodriguez, J. Rubén

doi:10.1053/j.sempedsurg.2017.10.003

Cited by 251 publications

(182 citation statements)

References 71 publications

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“…Small bowel imaging is recommended in all suspected cases of IBD at diagnosis; however, it can be delayed in a typical UC presentation, based on endoscopy and histology [19]. A typical UC presentation is identified by a continuous mucosal inflammation of the colon, starting from the rectum, without involving the small bowel, and with the presence of a characteristic crypt architecture disruption [4,5,19,29,30]. The inflammation is usually more severe distally and if a reverse gradient is observed, a reconsideration for the diagnosis should be prompted [4,5,19,30].…”

Section: Ibd Etiology and Diagnosis: What Do We Know?mentioning

confidence: 99%

“…A typical UC presentation is identified by a continuous mucosal inflammation of the colon, starting from the rectum, without involving the small bowel, and with the presence of a characteristic crypt architecture disruption [4,5,19,29,30]. The inflammation is usually more severe distally and if a reverse gradient is observed, a reconsideration for the diagnosis should be prompted [4,5,19,30]. It is also worth noting, that five atypical variants of UC are identified, which make the disease diagnosis and treatment more complex and often unsatisfactory [19].…”

Section: Ibd Etiology and Diagnosis: What Do We Know?mentioning

confidence: 99%

“…IBD is characterized by the repeated alternating cycles of clinical relapse and remission [2] and in the absence of an adequate treatment, a chronic inflammation leading to irreversible intestinal damages [3]. Based on the disease manifestation, IBD is classified into three major subtypes [4]: Ulcerative Colitis (UC), which primarily affects the colon, Crohn's disease (CD) which affects various GI sites [5], and a third subtype where histology assessments done on patients do not categorize to either UC or CD. This subtype is defined as "Inflammatory Bowel Disease, type unclassified" or "Undetermined" (IBD-U) [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Integrating omics for a better understanding of Inflammatory Bowel Disease: a step towards personalized medicine

2019

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Background: Inflammatory Bowel Disease (IBD) is a multifactorial chronic disease. Understanding only one aspect of IBD pathogenesis does not reflect the complex nature of IBD nor will it improve its clinical management. Therefore, it is vital to dissect the interactions between the different players in IBD pathogenesis in order to understand the biology of the disease and enhance its clinical outcomes. Aims:To provide an overview of the available omics data used to assess the potential mechanisms through which various players are contributing to IBD pathogenesis and propose a precision medicine model to fill the current knowledge gap in IBD.Results: Several studies have reported microbial dysbiosis, immune and metabolic dysregulation in IBD patients, however, this data is not sufficient to create signatures that can differentiate between the disease subtypes or between disease relapse and remission. Conclusions:We summarized the current knowledge in the application of omics in IBD patients, and we showed that the current knowledge gap in IBD hinders the improvements of clinical decision for treatment as well as the prediction of disease relapse. We propose one way to fill this gap by implementing integrative analysis of various omics datasets generated from one patient at a single time point.

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Section: Ibd Etiology and Diagnosis: What Do We Know?mentioning

confidence: 99%

Section: Ibd Etiology and Diagnosis: What Do We Know?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Integrating omics for a better understanding of Inflammatory Bowel Disease: a step towards personalized medicine

2019

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“…In addition, in Crohn's disease there is accumulating intestinal damage . The IBDs are both generally more severe and active in children than in adults and can cause growth retardation and pubertal delay, particularly Crohn's disease . Ulcerative colitis is more common in younger children, and Crohn's disease more common in adolescents .…”

Section: Clinical Characteristics Of Ulcerative Colitis and Crohn's Dmentioning

confidence: 99%

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Holmes

Harris

Lucas

2018

Photochem & Photobiology

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The incidence and prevalence of inflammatory bowel disease (IBD) are increasing worldwide. Some ecological studies show increasing incidence with increasing latitude. Ambient ultraviolet radiation varies inversely with latitude, and sun exposure of the skin is a major source of vitamin D. Vitamin D deficiency is common in patients with IBD. Sun exposure and vitamin D have immune effects that could plausibly reduce, or be protective for, IBD. One quarter of new IBD cases are diagnosed in childhood or adolescence, but most research is for adult-onset IBD. Here, we review the evidence for low sun exposure and/or vitamin D deficiency as risk factors for IBD, focusing where possible on pediatric IBD, where effects of environmental exposures may be clearer. The literature provides some evidence of a latitude gradient of IBD incidence, and evidence for seasonal patterns of timing of birth or disease onset is inconsistent. High prevalence of vitamin D deficiency occurs in people with IBD, but cannot be interpreted as being a causal risk factor. Evidence of vitamin D supplementation affecting disease activity is limited. Further research on predisease sun exposure and well-designed supplementation studies are required to elucidate whether these potentially modifiable exposures are indeed risk factors for IBD.

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“…Currently the initial treatment in UC is medical treatment (parenteral solutions, antibiotics and intravenous corticosteroids), surgical treatment is left to patients who have a refractory response to medical treatment or in patients who require urgent surgical treatment, as in this case. 2 The perforation represents the most serious complication in UC and is usually associated with instrumentation (colonoscopy) or with the presence of toxic megacolon and delay in diagnosis or attention, due to the consequent presence of perforation. 6 The association between toxic colitis and perforation occurs in approximately 2% of patients with UC and is associated with considerable mortality rates, which can range from 27% to 57%, 7 which increase as the time between perforation is prolonged and the surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Multiple perforations associated with ulcerative colitis

Gonzalez¹

2018

IJFCM

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Clinical presentation of Crohn’s, ulcerative colitis, and indeterminate colitis: Symptoms, extraintestinal manifestations, and disease phenotypes

Cited by 251 publications

References 71 publications

Integrating omics for a better understanding of Inflammatory Bowel Disease: a step towards personalized medicine

Integrating omics for a better understanding of Inflammatory Bowel Disease: a step towards personalized medicine

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Multiple perforations associated with ulcerative colitis

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