Letter: comparative safety and efficacy of infliximab vs. adalimumab in Crohn's disease – should one consider disease location? Authors’ reply

Narula, N; Reinisch, Walter

doi:10.1111/apt.13768

Cited by 1 publication

(1 citation statement)

References 4 publications

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“…Pelvic pouch reconstruction surgery, RPC-IPAA, is the criterion standard surgical procedure for patients with UC [ 74 , 75 ]. The 5- and 10-year cumulative risk of colectomy (emergence or elective) is 10–15%, primarily limited to patients with moderate to severe disease activity; a subset of hospitalized patients with acute severe UC (ASUC), also called fulminant UC, have short-term colectomy rates of 25–30% [ 47 , 78 , 79 , 80 , 81 ]. In some cases, it is not possible to maintain a pouch due to subsequent complications; in this case, a permanent terminal ileostomy may be required [ 44 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Inflammatory Bowel Disease: Clinical Diagnosis and Surgical Treatment-Overview

M’Koma

2022

Medicina

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This article is an overview of guidelines for the clinical diagnosis and surgical treatment of predominantly colonic inflammatory bowel diseases (IBD). This overview describes the systematically and comprehensively multidisciplinary recommendations based on the updated principles of evidence-based literature to promote the adoption of best surgical practices and research as well as patient and specialized healthcare provider education. Colonic IBD represents idiopathic, chronic, inflammatory disorders encompassing Crohn’s colitis (CC) and ulcerative colitis (UC), the two unsolved medical subtypes of this condition, which present similarity in their clinical and histopathological characteristics. The standard state-of-the-art classification diagnostic steps are disease evaluation and assessment according to the Montreal classification to enable explicit communication with professionals. The signs and symptoms on first presentation are mainly connected with the anatomical localization and severity of the disease and less with the resulting diagnosis “CC” or “UC”. This can clinically and histologically be non-definitive to interpret to establish criteria and is classified as indeterminate colitis (IC). Conservative surgical intervention varies depending on the disease phenotype and accessible avenues. The World Gastroenterology Organizations has, for this reason, recommended guidelines for clinical diagnosis and management. Surgical intervention is indicated when conservative treatment is ineffective (refractory), during intractable gastrointestinal hemorrhage, in obstructive gastrointestinal luminal stenosis (due to fibrotic scar tissue), or in the case of abscesses, peritonitis, or complicated fistula formation. The risk of colitis-associated colorectal cancer is realizable in IBD patients before and after restorative proctocolectomy with ileal pouch-anal anastomosis. Therefore, endoscopic surveillance strategies, aimed at the early detection of dysplasia, are recommended. During the COVID-19 pandemic, IBD patients continued to be admitted for IBD-related surgical interventions. Virtual and phone call follow-ups reinforcing the continuity of care are recommended. There is a need for special guidelines that explore solutions to the groundwork gap in terms of access limitations to IBD care in developing countries, and the irregular representation of socioeconomic stratification needs a strategic plan for how to address this serious emerging challenge in the global pandemic.

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Section: Surgical Treatmentmentioning

confidence: 99%

Inflammatory Bowel Disease: Clinical Diagnosis and Surgical Treatment-Overview

M’Koma

2022

Medicina

View full text Add to dashboard Cite

show abstract

Letter: comparative safety and efficacy of infliximab vs. adalimumab in Crohn's disease – should one consider disease location? Authors’ reply

Cited by 1 publication

References 4 publications

Inflammatory Bowel Disease: Clinical Diagnosis and Surgical Treatment-Overview

Inflammatory Bowel Disease: Clinical Diagnosis and Surgical Treatment-Overview

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