Diagnostic Delay in Crohn’s Disease: Time for Red Flags

Fiorino, Gionata; Danese, Silvio

doi:10.1007/s10620-016-4298-8

Cited by 20 publications

(22 citation statements)

References 14 publications

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“…arthritis) in Crohn's disease . Diagnostic delay of 5–9 months is more common in Crohn's disease compared to ulcerative colitis due to the variability of the presenting symptoms in the former, including extra‐intestinal symptoms . In the early stages, histological, radiological and endoscopic examination may be needed to diagnose and differentiate between the two diseases .…”

Section: Clinical Characteristics Of Ulcerative Colitis and Crohn's Dmentioning

confidence: 99%

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Holmes

Harris

Lucas

2018

Photochem & Photobiology

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The incidence and prevalence of inflammatory bowel disease (IBD) are increasing worldwide. Some ecological studies show increasing incidence with increasing latitude. Ambient ultraviolet radiation varies inversely with latitude, and sun exposure of the skin is a major source of vitamin D. Vitamin D deficiency is common in patients with IBD. Sun exposure and vitamin D have immune effects that could plausibly reduce, or be protective for, IBD. One quarter of new IBD cases are diagnosed in childhood or adolescence, but most research is for adult-onset IBD. Here, we review the evidence for low sun exposure and/or vitamin D deficiency as risk factors for IBD, focusing where possible on pediatric IBD, where effects of environmental exposures may be clearer. The literature provides some evidence of a latitude gradient of IBD incidence, and evidence for seasonal patterns of timing of birth or disease onset is inconsistent. High prevalence of vitamin D deficiency occurs in people with IBD, but cannot be interpreted as being a causal risk factor. Evidence of vitamin D supplementation affecting disease activity is limited. Further research on predisease sun exposure and well-designed supplementation studies are required to elucidate whether these potentially modifiable exposures are indeed risk factors for IBD.

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Section: Clinical Characteristics Of Ulcerative Colitis and Crohn's Dmentioning

confidence: 99%

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Holmes

Harris

Lucas

2018

Photochem & Photobiology

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“…In the field of CD, recent efforts have been devoted to the identification of signs and symptoms (red flags) that should warn clinicians about the presence of this condition [ 55 , 56 ]. A Red Flag index has been recently developed to improve early diagnosis of CD, but as yet it has not been validated [ 55 ].…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease

et al. 2018

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IntroductionImmune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis and uveitis.MethodsA Delphi consensus-based approach was used to identify a core set of statements. The process included development of initial questions by a steering committee, an exhaustive search of the literature using complementary approaches to identify potential statements and two Delphi voting rounds for finalization of the statements.ResultsConsensus was achieved on the related nature of IMIDs, the existence of a high prevalence of multiple IMIDs in a single patient and the fact that a multidisciplinary approach can result in a more extensive evaluation and comprehensive approach to treatment. The goals of a multidisciplinary team should be to increase diagnosis of concomitant IMIDs, improve the decision-making process, and increase patient satisfaction and adherence. Early referral and diagnosis, early recognition of concomitant IMIDs and optimizing treatment to improve patient quality of life are some of the advantages of using multidisciplinary teams. To be effective, a multidisciplinary team should be equipped with the appropriate tools for diagnosis and follow-up, and at a minimum the multidisciplinary team should include a dermatologist, gastroenterologist and rheumatologist; providing psychologic support via a psychologist and involving an ophthalmologist, general practitioners and nurses in multidisciplinary care is also important.ConclusionThe present Delphi consensus identified a set of overarching principles that may be useful for implementation of a multidisciplinary approach for the management of SpA-related IMIDs.FundingAristea and Hippocrates.

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“…IBD can have severe health consequences, and earlier detection could prevent surgical and other morbidities associated with diagnosis later in the disease course. 17,18 Studies show that delayed IBD diagnosis is associated with poorer outcomes, including bowel resection and increased intestinal surgery risks and complications, with increased health care costs. [17][18][19] In…”

Section: Discussionmentioning

confidence: 99%

Prevalence of inflammatory bowel disease among pediatric patients with hidradenitis suppurativa and the potential role of screening with fecal calprotectin

Lloyd-McLennan

Ali

Kittler

2020

Pediatric Dermatology

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Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease, characterized by painful, suppurating abscesses in apocrine gland-rich sites. Studies have demonstrated an increased prevalence of inflammatory bowel disease (IBD) (3.3%) in adults with HS compared with the general population (0.41%-0.74%). 1-3 It is unknown whether the same association exists in pediatric patients. However, a recent case series described seven pediatric patients with HS associated with Crohn disease, suggesting a similar pattern may exist. 4 If there is an increased prevalence of IBD in this population, data on how best to screen for this potential association are lacking. While endoscopic evaluation with biopsies is the gold standard for

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Diagnostic Delay in Crohn’s Disease: Time for Red Flags

Cited by 20 publications

References 14 publications

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease

Prevalence of inflammatory bowel disease among pediatric patients with hidradenitis suppurativa and the potential role of screening with fecal calprotectin

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