Prevention and Countermeasures for Suture Failure in Patient with Crohn's Disease

Inflammatory bowel disease (IBD) is a general term for chronic or remitting/relapsing inflammatory diseases of the intestinal tract and generally refers to ulcerative colitis (UC) and Crohn’s disease (CD). Since 1950, the number of patients with IBD in Japan has been increasing. The etiology of IBD remains unclear; however, recent research data indicate that the pathophysiology of IBD involves abnormalities in disease susceptibility genes, environmental factors and intestinal bacteria. The elucidation of the mechanism of IBD has facilitated therapeutic development. UC and CD display heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management depends on the understanding and tailoring of evidence-based interventions by physicians. In 2020, seventeen IBD experts of the Japanese Society of Gastroenterology revised the previous guidelines for IBD management published in 2016. This English version was produced and modified based on the existing updated guidelines in Japanese. The Clinical Questions (CQs) of the previous guidelines were completely revised and categorized as follows: Background Questions (BQs), CQs, and Future Research Questions (FRQs). The guideline was composed of a total of 69 questions: 39 BQs, 15 CQs, and 15 FRQs. The overall quality of the evidence for each CQ was determined by assessing it with reference to the Grading of Recommendations Assessment, Development and Evaluation approach, and the strength of the recommendation was determined by the Delphi consensus process. Comprehensive up-to-date guidance for on-site physicians is provided regarding indications for proceeding with the diagnosis and treatment.

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“…These statements were made with reference to [16,26,111,[324][325][326][327][328][329][330][331][332][333][334][335][336][337][338].…”

Section: Statementsmentioning

confidence: 99%

Evidence-based clinical practice guidelines for inflammatory bowel disease 2020

et al. 2021

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“…Two series evaluated infliximab before a primary drainage procedure, and both showed improved healing and decreased recurrence of fistulae compared with surgery alone (85,86). Another study evaluating a protocol of primary drainage or seton placement for abscesses or fistulae, followed by infliximab (average of 7.68 AE 7.85 doses given), then followed by seton removal and maintenance methotrexate resulted in an 85% response rate (74% complete response) that was maintained in 50% at 1 year and noted significant decrease in PDAI (87). In a retrospective review of 93 patients with fistula who had setons placed followed by infliximab, 70% were able to avoid further surgical treatment (88).…”

Section: Infliximabmentioning

confidence: 99%

Diagnosis and Treatment of Perianal Crohn Disease

Zoeten

Pasternak²,

Mattei³

et al. 2013

J. pediatr. gastroenterol. nutr.

136

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Inflammatory bowel disease is a chronic inflammatory disorder of the gastrointestinal tract that includes both Crohn disease (CD) and ulcerative colitis. Abdominal pain, rectal bleeding, diarrhea, and weight loss characterize both CD and ulcerative colitis. The incidence of IBD in the United States is 70 to 150 cases per 100,000 individuals and, as with other autoimmune diseases, is on the rise. CD can affect any part of the gastrointestinal tract from the mouth to the anus and frequently will include perianal disease. The first description connecting regional enteritis with perianal disease was by Bissell et al in 1934, and since that time perianal disease has become a recognized entity and an important consideration in the diagnosis and treatment of CD. Perianal Crohn disease (PCD) is defined as inflammation at or near the anus, including tags, fissures, fistulae, abscesses, or stenosis. The symptoms of PCD include pain, itching, bleeding, purulent discharge, and incontinence of stool. In this report, we review and discuss the etiology, diagnosis, evaluation, and treatment of PCD.

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Evidence-based clinical practice guidelines for inflammatory bowel disease

et al. 2018

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Inflammatory bowel disease (IBD) is a chronic disorder involving mainly the intestinal tract, but possibly other gastrointestinal and extraintestinal organs. Although etiology is still uncertain, recent knowledge in pathogenesis has accumulated, and novel diagnostic and therapeutic modalities have become available for clinical use. Therefore, the previous guidelines were urged to be updated. In 2016, the Japanese Society of Gastroenterology revised the previous versions of evidence-based clinical practice guidelines for ulcerative colitis (UC) and Crohn’s disease (CD) in Japanese. A total of 59 clinical questions for 9 categories (1. clinical features of IBD; 2. diagnosis; 3. general consideration in treatment; 4. therapeutic interventions for IBD; 5. treatment of UC; 6. treatment of CD; 7. extraintestinal complications; 8. cancer surveillance; 9. IBD in special situation) were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases. The guidelines were developed with the basic concept of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Recommendations were made using Delphi rounds. This English version was produced and edited based on the existing updated guidelines in Japanese.

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Prevention and Countermeasures for Suture Failure in Patient with Crohn's Disease

Cited by 5 publications

References 6 publications

Evidence-based clinical practice guidelines for inflammatory bowel disease 2020

Evidence-based clinical practice guidelines for inflammatory bowel disease 2020

Diagnosis and Treatment of Perianal Crohn Disease

Evidence-based clinical practice guidelines for inflammatory bowel disease

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