Challenges in the diagnosis and management of inflammatory bowel disease in resource-limited settings in Asia

Banerjee, Rupa; Pal, Partha; Mak, Joyce Wing Yan; Ng, Siew C.

doi:10.1016/s2468-1253(20)30299-5

Cited by 48 publications

(39 citation statements)

References 84 publications

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“…Ulcerative colitis (UC) is classified as an inflammatory bowel disease (IBD) and is an inflammatory disease of unknown cause, which mainly affects colonic mucosa and forms erosions and ulcers (1). Additionally, it is designated as a specific disease similar to Crohn's disease (2). The ages of UC onset are 20-24 y for men and 25-29 y for women (2).…”

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confidence: 99%

“…Additionally, it is designated as a specific disease similar to Crohn's disease (2). The ages of UC onset are 20-24 y for men and 25-29 y for women (2). The number of UC patients exceeds about 11 million worldwide, and it is reported that the incidence is high mainly in developed countries (2).…”

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confidence: 99%

“…The ages of UC onset are 20-24 y for men and 25-29 y for women (2). The number of UC patients exceeds about 11 million worldwide, and it is reported that the incidence is high mainly in developed countries (2). Despite significant advances in UC research, the number of patients is still growing rapidly, and the mechanisms of onset and progression are not fully understood (2).…”

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confidence: 99%

“…The number of UC patients exceeds about 11 million worldwide, and it is reported that the incidence is high mainly in developed countries (2). Despite significant advances in UC research, the number of patients is still growing rapidly, and the mechanisms of onset and progression are not fully understood (2). Injuries of UC begin in the rectum, which spread continuously throughout the large intestines (3).…”

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confidence: 99%

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Vitamin C Enema Advances Induction of Remission in the Dextran Sodium Sulfate-Induced Colitis Model in Rats

Honjo

Toyota

Kanada

et al. 2021

J Nutr Sci Vitaminol

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The current main treatment for ulcerative colitis (UC) is induction therapy by long-term administration of 5-aminosalicylic acid (5-ASA), but various side effects have been reported. Therefore, a radical cure for UC is desired. A vitamin C (VC) has anti-inflammatory effects. Therefore, this study investigated whether a VC solution enema shortens induction of remission in colitis model rats. Wistar rats (6 wk old/male) were allowed to freely ingest a 1% dextran sulfate sodium (DSS) solution for 10 d and then switched to tap water for normal breeding for 10 d (UC group). At the time of switching to tap water, an enema was performed with a 5-ASA solution (40 mg/kg/d) or VC solution (460 mg/kg/d) for 10 d. The neutrophil number, COX-2, which is an index of inflammation, and type III collagen, which is an early healing marker, were significantly increased in the UC group. However, the VC group showed decreases compared with UC groups. Furthermore, compared with UC and 5-ASA groups, the VC group showed increased expression of type I collagen, which is expressed late in healing, and significant epithelial regeneration was observed in colon tissue. The VC solution enema shortened the induction of remission by directly suppressing inflammation of damaged large intestinal tissues and promoting mucosal healing.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Vitamin C Enema Advances Induction of Remission in the Dextran Sodium Sulfate-Induced Colitis Model in Rats

Honjo

Toyota

Kanada

et al. 2021

J Nutr Sci Vitaminol

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“…IBD has become a global disease with increasing prevalence in resource-limited settings; diagnosis and differentiation from IBS pose substantial social and economic burden on health care systems worldwide. [2][3][4][5] Fecal calprotectin (FC) is a noninvasive biomarker used to risk stratify patients and distinguish between IBD and IBS. Despite its usefulness in IBD management, its availability is limited in primary care settings, many health authorities may take weeks to obtain results, and, dependent on the region, it may not be covered by health insurance.…”

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confidence: 99%

Fecal Leukocyte Esterase, an Alternative Biomarker to Fecal Calprotectin in Inflammatory Bowel Disease: A Pilot Series

Trasolini

Klemm

Park

et al. 2022

Gastro Hep Advances

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BACKGROUND AND AIMS: Fecal calprotectin (FC) is a noninvasive biomarker used in inflammatory bowel disease (IBD) management and risk stratification of nonspecific gastrointestinal symptoms. Leukocyte esterase is an inexpensive and widely available point-of-care inflammatory marker present on urinalysis test strips. We aim to assess the diagnostic accuracy of fecal leukocyte esterase (FLE) relative to FC and endoscopy and demonstrate its use as an alternative biomarker for IBD. METHODS: In this prospective cohort study, 70 patients who had FC ordered as part of standard clinical care also received FLE testing. FLE levels were compared with various FC cutoff values and endoscopy and pathology findings as the gold standard. RESULTS: As the FC cutoff increased from 50 to 500 mg/g, FLE sensitivity increased from 67% to 95% while the specificity decreased from 86% to 76%. The area under the receiver operating characteristic (AUROC) curve increased from 0.79 to 0.90. An FLE of 1þ had the best test characteristics. Among patients who underwent endoscopic evaluation, FLE demonstrated an identical sensitivity (75%) and specificity (86%) to FC in predicting endoscopic inflammation. AUROC was 0.80 for FLE and 0.85 for FC with an optimal cutoff of 2þ and 301 mg/g, respectively. When used to distinguish between patients with active IBD and no/inactive IBD, FLE had a sensitivity of 84% and specificity of 90%, comparable with the 84% and 83%, respectively, of FC. AUROC was 0.88 for FLE and 0.91 for FC with an optimal cutoff of 2þ and 145 mg/g, respectively. CONCLUSION: FLE demonstrates adequate correlation and comparable accuracy with FC in predicting endoscopic inflammation and distinguishing between patients with active vs inactive IBD.

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Response to Therapy in Abdominal Tuberculosis

Birda

Sharma

2022

Tuberculosis of the Gastrointestinal System

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Challenges in the diagnosis and management of inflammatory bowel disease in resource-limited settings in Asia

Cited by 48 publications

References 84 publications

Vitamin C Enema Advances Induction of Remission in the Dextran Sodium Sulfate-Induced Colitis Model in Rats

Vitamin C Enema Advances Induction of Remission in the Dextran Sodium Sulfate-Induced Colitis Model in Rats

Fecal Leukocyte Esterase, an Alternative Biomarker to Fecal Calprotectin in Inflammatory Bowel Disease: A Pilot Series

Response to Therapy in Abdominal Tuberculosis

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