Increasing rates and changing patterns of hospital admissions for patients with inflammatory bowel disease in Ireland: 1996 – 2001

Smyth, C; Picha, S. Bacheer; Rathore, Omar; Deasy, Joseph; Patchett, Stephen; Murray, Frank E.

doi:10.1007/bf03168978

Cited by 12 publications

(10 citation statements)

References 9 publications

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“…Rates of inflammatory bowel disease (IBD) are better documented, possibly because they result in hospital admissions. Researchers noted increases of 25–100% in the incidence or rates of hospitalization for IBD during the 1990's in the United States [ 118 ], Ireland [ 119 ], Scotland [ 120 ] and Italy [ 121 ] but not in Canada [ 122 ] or Minnesota [ 123 ]. In some areas, the increase was most pronounced in individuals 18-years old and younger, with a doubling of the incidence of IBD in Scotland in individuals aged 12–18 years [ 120 ].…”

Section: Reviewmentioning

confidence: 99%

Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection

Boorom¹,

et al. 2008

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Blastocystis is a prevalent enteric protozoan that infects a variety of vertebrates. Infection with Blastocystis in humans has been associated with abdominal pain, diarrhea, constipation, fatigue, skin rash, and other symptoms. Researchers using different methods and examining different patient groups have reported asymptomatic infection, acute symptomatic infection, and chronic symptomatic infection. The variation in accounts has lead to disagreements concerning the role of Blastocystis in human disease, and the importance of treating it. A better understanding of the number of species of Blastocystis that can infect humans, along with realization of the limitations of the existing clinical laboratory diagnostic techniques may account for much of the disagreement. The possibility that disagreement was caused by the emergence of particular pathogenic variants of Blastocystis is discussed, along with the potential role of Blastocystis infection in irritable bowel syndrome (IBS). Findings are discussed concerning the role of protease-activated receptor-2 in enteric disease which may account for the presence of abdominal pain and diffuse symptoms in Blastocystis infection, even in the absence of fever and endoscopic findings. The availability of better diagnostic techniques and treatments for Blastocystis infection may be of value in understanding chronic gastrointestinal illness of unknown etiology.

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Section: Reviewmentioning

confidence: 99%

Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection

Boorom¹,

et al. 2008

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“… 32 However, a study from Northern California, from the health maintenance organisation Kaiser Permanente, which has arguably similar constraints on healthcare provision to the NHS, found a 33% and 29% decrease in hospital admission rates for CD and UC, respectively, between 1998 and 2005 but importantly the study did not include day case activity. 31 . An Irish study, of both day cases and inpatients, also reported an overall rise in national IBD admission rates between 1996 and 2001.…”

Section: Discussionmentioning

confidence: 99%

Changing nationwide trends in endoscopic, medical and surgical admissions for inflammatory bowel disease: 2003–2013

Ahmad

Laverty

Alexakis

et al. 2018

BMJ Open Gastroenterol

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Background and study aimsIn the last decade, there have been major advances in inflammatory bowel disease (IBD) management but their impact on hospital admissions requires evaluation. We aim to investigate nationwide trends in IBD surgical/medical elective and emergency admissions, including endoscopy and cytokine inhibitor infusions, between 2003 and 2013.Patients and methodsWe used Hospital Episode Statistics and population data from the UK Office for National Statistics.ResultsAge-sex standardised admission rates increased from 76.5 to 202.9/100 000 (p<0.001) and from 69.5 to 149.5/100 000 (p<0.001) for Crohn’s disease (CD) and ulcerative colitis (UC) between 2003–2004 and 2012–2013, respectively. Mean length of stay (days) fell significantly for elective (from 2.6 to 0.7 and from 2.0 to 0.7 for CD and UC, respectively) and emergency admissions (from 9.2 to 6.8 and from 10.8 to 7.6 for CD and UC, respectively). Elective lower gastrointestinal (GI) endoscopy rates decreased from 6.3% to 3.7% (p<0.001) and from 18.4% to 17.6% (p=0.002) for CD and UC, respectively. Elective major abdominal surgery rates decreased from 2.8% to 1.0% (p<0.001) and from 4.9 to 2.4 (p=0.010) for CD and UC, respectively, with emergency rates also decreasing significantly for CD. Between 2006-2007 and 2012-2013, elective admission rates for cytokine-inhibitor infusions increased from 11.1 to 57.2/100 000 and from 1.4 to 12.1/100 000 for CD and UC, respectively.ConclusionsRising IBD hospital admission rates in the past decade have been driven by an increase in the incidence and prevalence of IBD. Lower GI endoscopy and surgery rates have fallen, while cytokine inhibitor infusion rates have risen. There has been a concurrent shift from emergency care to shorter elective hospital stays. These trends indicate a move towards more elective medical management and may reflect improvements in disease control.

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“…Indeed, a number of studies [24][25][26][27][28] have shown that the percentage of age-adjusted hospitalizations involving major surgery for CD in North America and elsewhere have remained unchanged up to the early 2000s. Likewise, Lazarev et al found that the rate of small bowel resection for CD in a large referral center in the USA has remained unchanged despite increasing use of anti-TNFs [29].…”

Section: Incidence Of Surgerymentioning

confidence: 99%

Surgery for Crohn’s disease and anti-TNF agents: the changing scenario

Sorrentino

Fogel

Bogaerde

2013

Expert Review of Gastroenterology & Hepatology

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Surgery has been a mainstay of therapy for Crohn's disease for a long time, essentially as a consequence of the fairly modest efficacy of traditional medications such as immunomodulators, antibiotics and 5-ASA, especially in severe cases. However, in the past decade and half, the advent of anti-TNF agents has greatly changed the medical approach to this disease and may modify its general management as well. Here, we have reviewed the current literature on incidence of surgery, timing of surgery and postoperative recurrence of Crohn's disease before and after the advent of anti-TNF agents. In addition, we have reviewed the risk of perioperative complications in patients on anti-TNF agents before surgery. The data show that the use of these medications is changing or expecting to change shortly a number of surgical aspects of Crohn's disease management.

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Increasing rates and changing patterns of hospital admissions for patients with inflammatory bowel disease in Ireland: 1996 – 2001

Cited by 12 publications

References 9 publications

Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection

Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection

Changing nationwide trends in endoscopic, medical and surgical admissions for inflammatory bowel disease: 2003–2013

Surgery for Crohn’s disease and anti-TNF agents: the changing scenario

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