Prevention of Colorectal Cancer in Inflammatory Bowel Disease: Value of Screening and 5-Aminosalicylates

Munkholm, Pia; Loftus, Edward V.; Reinacher‐Schick, Anke; Kornbluth, Asher; Mittmann, U.; Esendal, Burak

doi:10.1159/000090763

Cited by 37 publications

(11 citation statements)

References 110 publications

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“…However, the consumption of steroids was monitored closely and a reduction in dose was regarded as an important outcome measure. No attempt was made to withdraw mesalamine as not only is this drug effective in preventing relapse in ulcerative colitis but there is now accumulating evidence that in the same condition it may also help to protect from the development of colon cancer (Munkholm et al, 2006). Furthermore, it was not felt that it would be justified to withdraw azathioprine in any Downloaded by [University of California, San Francisco] at 08:13 14 December 2014 hypnotherapy responders as this drug also helps to maintain remission, and the main purpose of this study was to ascertain whether disease severity could be reduced by hypnosis rather than assessing whether azathioprine could be withdrawn.…”

Section: Methodsmentioning

confidence: 99%

Treatment of Inflammatory Bowel Disease:A Role for Hypnotherapy?

Miller

Whorwell

2008

International Journal of Clinical and Experimental Hypnosis

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Fifteen patients with severe or very severe inflammatory bowel disease on corticosteroids but not responding to medication received 12 sessions of "gut-focused hypnotherapy" and were followed up for a mean duration of 5.4 years with disease severity being graded as remission, mild, moderate, severe, or very severe. Two patients (13.4%) failed to respond and required surgery. At follow-up for the remaining 13 patients, 4 (26.6%) were in complete remission, 8 (53.3%) had mild severity, and 1 (6.7%) was moderately severe. Quality of life became good or excellent in 12 (79.9%). Corticosteroid requirements dramatically declined with 60% of patients stopping them completely and not requiring any during follow-up. Hypnotherapy appears to be a promising adjunctive treatment for inflammatory bowel disease and has steroid sparing effects. Controlled trials to clearly define its role in this disease area are justified.

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Section: Methodsmentioning

confidence: 99%

Treatment of Inflammatory Bowel Disease:A Role for Hypnotherapy?

Miller

Whorwell

2008

International Journal of Clinical and Experimental Hypnosis

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“…Chronic use of 5-ASA compounds as maintenance therapy for ulcerative colitis is associated with a decreased risk of developing both dysplasia and colorectal cancer [757,758]. The relative risk reduction for colorectal cancer seen with 5-ASA use is 46%-81% in a series of retrospective studies.…”

Section: Colon Cancer Dysplasia and Colonoscopic Surveillancementioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

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In the US, H. pylori vacA shows allelic variation in the signal sequence (which may be type sla, slb or s2) and the mid-region (type ml or m2). Previous PCR-based vacA mid-region typing classified most, but not all, Asian and South American strains tested as ml or m2. We now sought to investigate vacA mid-region diversity further.MotlmodL We studied 13 Japanese, 6 Chinese, 9 Thai, and 8 Peruvian H. pylori isolates. cagA was identified by colony hybridisation (CH), vacA signal sequence was typed by PCR, and vacA mid-region was typed proximally by CH and distally by PCR. Sections of the vacA mid-region from 8 strains were PCR-amplified, sequenced, and compared with known sequences from 8 other strains.Rcuts Of the 36 Asian and South American strains studied, 35 were cagA+ (the cagA-was Peruvian) and 35 were vacA sla (1 cagA + Peruvian was slb). vacA mid-regions from the 13 Japanese strains were not PCR-amplified by ml or m2-specific primers, but hybridised weakly with an ml probe. Sequence analysis of vacA from 1 Japanese strain revealed 91% nucleotide identity with the ml probe but only 71% identity with the m2 probe. The previously equivocal Thai and Peruvian strains also had ml-like mid-region sequences. A Chinese strain was ml in the proximal mid-region and m2 distally, showing a clear crossover site. Final mid-region types were: Japanese, all 13 ml; Chinese, 1 ml, 1 ml/m2, 4 m2; Thai, 3 ml, 6 m2; Peruvian 4 ml, 4 m2. Distal mid-region sequences of 16 strains, compared over 294 bp, clustered into 2 groups, ml and m2. Nucleotide identity between ml and m2 strains ranged from 73-78%. Within groups, m2 strains were less diverse than ml strains (m2 range 94-99.7%, ml 88-99.3%, p<0.001). Sequence analysis of 7 ml and 3 m2 strains over 1.1kb proximally showed maintenance of clustering outside the 294bp region C duions These Asian and South American strains are similar in terms of cagA status and vacA sla genotype, but fall into 2 vacA midregion groups. ml sequences are more diverse than m2, and thus may be phylogenetically older. The vacA sequence of 1 Chinese strain suggests recombination in vivo between ml and m2 alleles. Introduction: H.pylori antimicrobial susceptibility is an important determinant ofthe efficacy of eradication therapies'. The prevalence of antimicrobial resistance varies within the UK and may increase given the increased use of eradication therapy. This multicentre study assesses the prevalence and possible associations ofH.pylon antimicrobial resistance. Methods: H.pylon was isolated from antral biopsies of patients undergoing routine endoscopy and cultured according to standard microbiological methods. Antimicrobial resistance was determined using "E-tests" or disc tests (tinidazole only) with breakpoints defined by previous studies. Results: H.pyloni was isolated from 32% (1222/3823) of patients and antimicrobial susceptibility determined in 90% (1077/1222) Previous case-control studies of IBD have used hospital or community derived controls. There are obvious inherent biases in both metho...

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“…Pooled results of observational studies support a protective association between 5-ASA and CRC or a combined endpoint of CRC/dysplasia in patients with ulcerative colitis (UC) [37–39]. …”

Section: Chemopreventionmentioning

confidence: 99%

Strategies for colon cancer prevention

Björk

2010

EPMA Journal

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Colorectal cancer (CRC) is common and is associated with a considerable mortality. Morbidity and thereby mortality can be reduced by using different prevention strategies such as lifestyle interventions and chemoprevention. Endoscopic surveillance of high-risk individuals and population-based endoscopic screening of average-risk individuals enables detection and removal of premalignant lesions (adenomas) as well as presymptomatic detection of cancer. Implementation of cancer detection tests such as fecal occult blood tests (FOBTs) is another strategy to reduce cancer mortality by early detection of CRC. Personalized management, based on estimates of the individual risk using information concerning environmental factors, lifestyle, family history, personality, social background and phenotype in combination with a variety of biomarkers such as genotype, will become more important as a strategy to optimize CRC prevention in the future.

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Prevention of Colorectal Cancer in Inflammatory Bowel Disease: Value of Screening and 5-Aminosalicylates

Cited by 37 publications

References 110 publications

Treatment of Inflammatory Bowel Disease:A Role for Hypnotherapy?

Treatment of Inflammatory Bowel Disease:A Role for Hypnotherapy?

Inflammatory Bowel Disease

Strategies for colon cancer prevention

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