Silent disease revealed by a fruit

Slim, Raoudha; Chemaly, Marwan; Yaghi, César; Honein, Khalil; Moucari, Rami; Sayegh, Rony R.

doi:10.1136/gut.2005.073270

Cited by 6 publications

(6 citation statements)

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“…Unfortunately, these studies were: a) not specifically designed to evaluate silent or hypoalgesic IBD; b) focused primarily on one form of IBD; and/or c) utilized less reliable symptom-based disease activity scores (e.g., CD activity index) [10] to make determinations about intestinal inflammatory status. Other clinical features, including disease location (e.g., upper gastrointestinal tract CD) [11], a variety of extraintestinal manifestations (EIMs) [12][13][14][15][16], and IBD-associated complications [17][18][19][20] have previously been implicated as potential signs of silent disease, but it is not clear how effective they are for screening.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal hypoalgesia in inflammatory bowel disease

Coates¹,

Soriano²,

Dalessio³

et al. 2019

aog

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Background Pain perception is critical for detection of noxious bodily insults. Gastrointestinal hypoalgesia in inflammatory bowel disease (IBD) is a poorly understood phenomenon previously linked to poor patient outcomes. We aimed to evaluate the risk factors associated with this condition and to discern characteristics that might differentiate these patients from pain-free quiescent counterparts. Methods We performed a retrospective analysis using an IBD natural history registry based in a single tertiary care referral center. We compared demographic and clinical features in 3 patient cohorts defined using data from simultaneous pain surveys and ileocolonoscopy: a) active IBD without pain (hypoalgesic IBD); b) active IBD with pain; and c) inactive IBD without pain. Results One hundred fifty-three IBD patients had active disease and 43 (28.1%) exhibited hypoalgesia. Hypoalgesic IBD patients were more likely to develop non-perianal fistulae (P=0.03). On logistic regression analysis, hypoalgesic IBD was independently associated with male sex, advancing age and mesalamine use, and inversely associated with anxious/depressed state and opiate use. Hypoalgesic IBD patients were demographically and clinically similar to the painfree quiescent IBD cohort (n=59). Platelet count and C-reactive protein were more likely to be pathologically elevated in hypoalgesic IBD (P=0.03), though >25% did not exhibit elevated inflammatory markers. Conclusions Hypoalgesia is common in IBD, particularly in male and older individuals, and is associated with an increased incidence of fistulae and corticosteroid use. Novel noninvasive diagnostic tools are needed to screen for this population, as inflammatory markers are not always elevated.

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Section: Introductionmentioning

confidence: 99%

Gastrointestinal hypoalgesia in inflammatory bowel disease

Coates¹,

Soriano²,

Dalessio³

et al. 2019

aog

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“…We have presented a case of acute-on-chronic abdominal dysfunction due to Crohn's disease that presented as small bowel obstruction secondary to a FB. The literature includes only five other published cases of a FB initiating the diagnosis of Crohn's disease [5][6][7][8][9]. FB's may often only be detected incidentally during investigations such as plain X-ray, ultrasonography, gastrointestinal contrast studies, computerised tomography, magnetic resonance imaging or therapeutic modalities such as colonoscopy or laparotomy.…”

Section: Discussionmentioning

confidence: 95%

Crohn’s disease of the terminal ileum: a cheap diagnosis

et al. 2007

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“…In the literature, isolated cases of obstruction caused by a fruit stone stuck near to the ileocaecal valve have been reported [3][4][5]. For example, Kaufman et al described a case of a male patient in whom the cause of intestinal obstruction was a plum stone stuck in the area of the ileocaecal valve.…”

Section: Discussionmentioning

confidence: 99%