Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

Łodyga, Michał; Eder, Piotr; Gawron-Kiszka, Magdalena; Dobrowolska, Agnieszka; Gonciarz, Maciej; Hartleb, Marek; Kłopocka, Maria; Małecka-Wojciesko, Ewa; Radwan, Piotr; Reguła, Jarosław; Zagórowicz, Edyta; Rydzewska, Grażyna

doi:10.5114/pg.2021.110914

Cited by 17 publications

(86 citation statements)

References 315 publications

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“…It showed that with higher daily intake of dairy products, the incidence of UC increased as well [ 62 , 63 ]. In contrast, reports in recent years have failed to confirm the association between lactose intake and the incidence of IBD [ 64 , 65 ] or they even demonstrated the protective effect of dairy products by reducing the severity of symptoms in this group of patients [ 66 , 67 , 68 ]. In a study evaluating the intake of food groups in relation to UC activity, milk and cheese were among the products that alleviated the symptoms [ 66 ].…”

Section: Lactose-free Dietmentioning

confidence: 79%

“…In a study evaluating the intake of food groups in relation to UC activity, milk and cheese were among the products that alleviated the symptoms [ 66 ]. In a study by Octoratou et al, yogurts were products that reduced the risk of CD [ 67 ]. In contrast, in a study by Opstelten et al, a lower intake of milk, but a higher intake of cheese were observed in patients with IBD, as compared to healthy subjects [ 68 ].…”

Section: Lactose-free Dietmentioning

confidence: 99%

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Dietary Interventions in Inflammatory Bowel Disease

et al. 2022

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Inflammatory bowel disease, which primarily includes ulcerative colitis and Crohn's disease, is a group of chronic diseases of the gastrointestinal tract. Mainly affecting young people, it is characterized by periods of exacerbation and remission. In recent years, there has been an increase in the prevalence of inflammatory bowel disease worldwide, including Poland. The potential impact of nutrition and selected dietary components that are directly or indirectly involved in the pathogenesis of intestinal lesions in IBD is not fully clear. Evaluating the impact of diet on the course of IBD is very complex due to the fact that regardless of a dietary model adopted, each one is based on consumption of many different food groups which affect one another. However, the growing need to produce dietary recommendations for these patients has prompted the International Organization for the Study of Inflammatory Bowel Disease (IOIBD) to develop nutrition guidelines for the patients. The present paper characterizes the dietary models most commonly discussed in research studies and their potential impact on IBD activity.

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Section: Lactose-free Dietmentioning

confidence: 79%

Section: Lactose-free Dietmentioning

confidence: 99%

Dietary Interventions in Inflammatory Bowel Disease

et al. 2022

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“…Ulcerative colitis -treatment with biologicals (42) Brazil Brazilian Study Group on In ammatory Bowel Disease, Brazilian Medical Association GRADE British Society of Gastroenterology consensus guidelines on the management of in ammatory bowel disease in adults (43) UK British Society of Gastroenterology and others GRADE Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn's Disease (44) Canada Canadian Association of Gastroenterology (CAG) GRADE Clinical Practice Guideline for the Medical Management of Perianal Fistulizing Crohn's Disease: The Toronto Consensus (45) Canada Canadian Association of Gastroenterology (CAG) GRADE Crohn's disease -treatment with biological medication (46) Brazil Brazilian Study Group on In ammatory Bowel Disease, Brazilian Gastroenterology Federation, Brazilian Coloproctology Society, Brazilian Medical Association GRADE Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn's Disease (47) Canada Canadian Association of Gastroenterology (CAG) GRADE Evidence-based clinical practice guidelines for in ammatory bowel disease 2020 (48) Japan The Japanese Society of Gastroenterology (JSGE) GRADE AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease (49) USA AGA American Gastroenterological Association GRADE WSES-AAST guidelines: management of in ammatory bowel disease in the emergency setting (50) Netherlands (52) ECCO Guidelines on Therapeutics in Crohn's Disease: Medical Treatment (53)…”

Section: Guideline Characteristicsmentioning

confidence: 99%

“…Fourteen CPGs (53.84%) scored above 60% in this domain. (32,38,40,41,(43)(44)(45)(47)(48)(49)(50)(51)(52)(53) See Table 3 for details on domain 2.…”

Section: Domain 2: Stakeholder Involvementmentioning

confidence: 99%

Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of Inflammatory Bowel Disease using the AGREE II instrument: A Systematic Review.

Zambrano-Sánchez

Alvarez-Mena

Hidalgo³

et al. 2022

Preprint

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Background: The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their methodological quality. Therefore, we aimed to systematically evaluate the quality of CPGs for the diagnosis and treatment of IBD using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Methods: We identified CPGs by searching databases (MEDLINE - PubMed, EMBASE, CINAHL, LILACS) and other sources of gray literature on January 2022. We included guidelines with specific recommendations for the diagnosis and treatment of IBD and evaluated them with the AGREE II instrument to assess their methodological quality. Six independent reviewers assessed the quality of the guidelines and resolved conflicts by consensus. We assessed the degree of agreement using the intraclass correlation coefficient (ICC) and change in quality over time was appraised in two periods: from 2012 to 2017 and from 2018 to 2022.Results: We analyzed and evaluated 26 CPGs that met the inclusion criteria. The overall agreement among reviewers was moderate (ICC: 0.74; 95% CI 0.36 - 0.89). The mean scores of the AGREE II domains were: "Scope and purpose" 84.51%, "Stakeholder involvement" 60.90%, "Rigor of development" 69.95%, "Clarity of presentation" 85.58%, "Applicability" 26.60%, and "Editorial independence" 62.02%. No changes in quality were found over time. Conclusions: The quality of the CPGs evaluated was generally good, with a large majority of the assessed guidelines being "recommended" and "recommended with modifications"; despite this, there is still room for improvement, especially in terms of stakeholder involvement and applicability. Efforts to develop high quality CPGs for IBD need to be further optimized.

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“…Some studies have shown that serum osteocalcin may be higher than in control groups in patients with IBD, especially in the CD population [ 13 , 14 , 15 , 16 ]. Although it is recommended that patients with IBD are scanned for bone mineral disease using [ 17 ] dual-energy X-ray absorptiometry (DXA) [ 18 ], we propose that a biochemical and hormonal work-up using PTH and bone mineral markers may be helpful in the initial work-up for bone mineral alterations.…”

Section: Introductionmentioning

confidence: 99%

Bone Metabolism Alteration in Patients with Inflammatory Bowel Disease

Tulewicz-Marti

Lewandowski

Rydzewska

2022

JCM

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Background: Metabolic bone disease is a common disorder, but there is a lack of data on it in patients with inflammatory bowel disease (IBD). Methods: In this prospective, one-centre study, we assessed bone mineral and vitamin D alterations in 187 IBD patients (119 with Crohn’s disease (CD) and 68 with ulcerative colitis (UC)). Results: While 81.3% of the patients had vitamin D deficiency, 14.2% of them had a severe deficiency. Elevated serum PTH concentrations were found in 14.9% of the patients. Only in 4.1% of cases was there an elevated level of a serum marker for bone formation (osteocalcin), whereas in 14.4% of cases, the bone resorption marker (CTX) was raised. The concentration of phosphate in urine was higher in the CD than in the UC group (51.20 vs. 31.25; p = 0.003). PTH was negatively associated with vitamin D level. Among the patients receiving corticosteroids, the CTX and CRP median levels were higher (0.49 vs. 0.38; p = 0.013 and 6.45 vs. 2.2; p = 0.029, respectively) compared with the group who did not receive them. Urine phosphate levels were lower (48.60 vs. 26.00; p = 0.005), as were osteocalcin (15.50 vs. 23.80; p < 0.001), and PTH (29.05 vs. 36.05; p = 0.018). Conclusions: Bone mineral alterations were common in patients with IBD, mostly in the CD patients. This may be associated with poor absorption, making CD patients vulnerable to changes in bone mineralization. Vitamin D supplementation remains crucial, especially when taking corticosteroids.

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Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

Cited by 17 publications

References 315 publications

Dietary Interventions in Inflammatory Bowel Disease

Dietary Interventions in Inflammatory Bowel Disease

Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of Inflammatory Bowel Disease using the AGREE II instrument: A Systematic Review.

Bone Metabolism Alteration in Patients with Inflammatory Bowel Disease

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