The IBD and PSC Phenotypes of PSC-IBD

Ricciuto, Amanda; Kamath, Binita M.; Griffiths, Anne M.

doi:10.1007/s11894-018-0620-2

Cited by 68 publications

(69 citation statements)

References 106 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Male sex, nonsmoker status and a history of appendicectomy have been associated with the development of PSC in patients with IBD [28, 29]. IBD mostly presents prior to PSC, but can appear after PSC, including after LT [30].…”

Section: Epidemiologymentioning

confidence: 99%

Specific Features of Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

et al. 2019

View full text Add to dashboard Cite

Primary sclerosing cholangitis (PSC) is a chronic and progressive disease of the biliary tract. PSC is strongly associated with inflammatory bowel disease (IBD), mainly with ulcerative colitis, and most PSC patients have underlying IBD. The pathophysiological interactions between IBD and PSC are unclear, although it seems that the patients with IBD and PSC have a distinct phenotype. IBD with coexisting PSC is more extensive and is characterized by milder activity compared to IBD alone. The coexistence of PSC increases the risk for colorectal cancer in IBD patients and lifelong annual surveillance colonoscopy is recommended. Also, liver transplantation (LT) for PSC may affect the course of IBD. In addition, the management of IBD after LT includes many specific problems. On the other hand, the effect of IBD on the natural history of PSC appears to be milder. However, IBD may increase the risk of postsurgical complications after LT and is a risk factor for recurrent PSC after LT. Overall, the coexistence of IBD with PSC changes the management, natural history and prognosis of both diseases.

show abstract

Section: Epidemiologymentioning

confidence: 99%

Specific Features of Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…This explains the poor association between the macroscopic and microscopic picture of inflammation for IRA patients. (135) Meanwhile, the microscopic examination of pouches detected two times more frequent inflammation than detected on macroscopic evaluation of IPAA. A possible explanation is that rectal mucosa is more tolerant to faecal matter, so it requires a severe inflammation to manifest macro/microscopically while small intestinal mucosa is more vulnerable to faecal matter.…”

Section: Discussionmentioning

confidence: 96%

Cancer and reconstructive surgery in Inflammatory bowel disease

Abdalla

2019

Linköping University Medical Dissertations

View full text Add to dashboard Cite

Ulcerative colitis (UC) is a chronic inflammatory disease that affects the colon. According to the literature, some thirty percent of UC patients may require a subtotal colectomy and ileostomy due to failure of medical treatment, acute toxic colitis or dysplasia/cancer diagnosis. Some patients choose to get continence restored with either an ileorectal anastomosis (IRA) or an ileal pouch-anal anastomosis (IPAA). Worldwide most surgeons prefer an IPAA to an IRA, despite reports of pouchitis, impaired fertility and fecundity. Fear of recurring proctitis and fear of rectal cancer in the remaining rectum is contributing to the choice of an IPAA. Little is known regarding the outcomes of IRA compared with IPAA in UC patients. We aimed to investigate the anorectal function, quality of life (QoL), risk of failure and rectal cancer in patients with UC restored with IRA and IPAA respectively. Methods: Data about all Inflammatory bowel disease (IBD) patients was obtained from the Swedish National Patient Register (NPR) between 1964-2014 and in one study from the Linköping University Hospital medical records 2006-2012. Patients who developed cancer were identified from the Swedish National Cancer Register. We investigated the risk of cancer and inflammation, functional outcome and failure as well as the quality of life for IRA and IPAA patients. Investigation of risk for cancer in IRA and IPAA compared with the background population was performed using survival analytic techniques: uni-and multivariate regression, Kaplan Meier curves and standardized incidence ratio. Results: Twelve percent (7,889 /63,795) of UC patients required colectomy according to the NPR. The relative risk for rectal cancer among patients with an IRA was increased (SIR 8.7). However, the absolute risk was 1.8% after a mean follow up of 8.6 years and the cumulative risk 10-and 20-years after IRA was 1.6% and 5.6%, respectively. Risk factors for rectal cancer were primary sclerosing cholangitis in patients with an IRA (hazard ratio 6.12), and

show abstract

“…It should be mentioned that IBD co-existing with PSC (PSC-IBD) may represent a genetically and clinically distinct entity from IBD alone[59]. Intestinal disease in PSC-IBD is typically more quiescent and is often asymptomatic, thus only found on active screening with colonoscopy with biopsies[54,60].…”

Section: Cancer Epidemiology In Primary Sclerosing Cholangitismentioning

confidence: 99%

Cancer risk in primary sclerosing cholangitis: Epidemiology, prevention, and surveillance strategies

Fung¹,

Lindor²,

Tabibian³

2019

WJG

View full text Add to dashboard Cite

Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease characterized by progressive fibroinflammatory destruction of the intra- and/or extrahepatic biliary ducts. While its features and disease course can be variable, most patients with PSC have concurrent inflammatory bowel disease and will eventually develop liver cirrhosis and end-stage liver disease, with liver transplantation representing the only potentially curative option. Importantly, PSC is associated with a significantly increased risk of malignancy compared to the general population, mainly cholangiocarcinoma, gallbladder carcinoma, hepatocellular carcinoma, and colorectal cancer, with nearly 50% of deaths in patients with PSC being due to cancer. Therefore, robust surveillance strategies are needed, though uncertainty remains regarding how to best do so. In this review, we discuss the epidemiology, prevention, and surveillance of cancers in patients with PSC. Where evidence is limited, we present pragmatic approaches based on currently available data and expert opinion.

show abstract

The IBD and PSC Phenotypes of PSC-IBD

Cited by 68 publications

References 106 publications

Specific Features of Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

Specific Features of Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

Cancer and reconstructive surgery in Inflammatory bowel disease

Cancer risk in primary sclerosing cholangitis: Epidemiology, prevention, and surveillance strategies

Contact Info

Product

Resources

About