Mo1041 MRE Findings at Crohn's Disease Diagnosis: Disease Activity, Bowel Damage and Predictive Value for Long-Term Outcomes

Fiorino, Gionata; Biroulet, Laurent Peyrin; Naccarato, Patrizia; Cassan, Chiara De; Bonifacio, Cristiana; Sociale, Orsola; Minuti, Francesco; Balzarini, Luca; Malesci, Alberto; Danese, Silvio

doi:10.1016/s0016-5085(12)62223-9

Cited by 2 publications

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“…Little is known about the natural history of pre-clinical CD and much of what we know is based on its course after diagnosis. We know that the large majority of CD patients will develop complications (especially strictures and fistulas) over the long term if left untreated [6,9,10] due to the basic process of inflammation, repair and collagen deposition [6,7,8,9,10,11,12].…”

Section: What We Know About Preclinical CDmentioning

confidence: 99%

“…Since patients at diagnosis might already present with complications [4,6,7,8,13,14,15], it is clear that—in general—by the time the disease has caused symptoms it might have already run a long, several years-course. This conclusion is also based on the natural history of post-operative CD recurrence—which starts with minimal, asymptomatic inflammation at the neo-terminal ileum [16] and later proceeds to more severe inflammation, symptomatic relapse and stricturing.…”

Section: What We Know About Preclinical CDmentioning

confidence: 99%

“…This is partly due to the complex nature of these diseases [5], to their clinical similarity to more benign, frequent conditions in the same age population (e.g., irritable bowel syndrome [IBS]) and to other still incompletely defined factors [4]. Even when IBD are promptly diagnosed at symptom onset a significant proportion of patients might already present with strictures and other complications [6,7,8]—this suggesting that the disease has already run a long silent course causing extensive damage. Hence, therapeutic response in IBD is often poor with patients often requiring hospital admission and surgery despite the great progress made with new medications.…”

Section: Introductionmentioning

confidence: 99%

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Capturing the Biologic Onset of Inflammatory Bowel Diseases: Impact on Translational and Clinical Science

Sorrentino

Nguyen

Chitnavis

2019

Cells

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While much progress has been made in the last two decades in the treatment and the management of inflammatory bowel diseases (IBD)—both ulcerative colitis (UC) and Crohn’s Disease (CD)—as of today these conditions are still diagnosed only after they have become symptomatic. This is a major drawback since by then the inflammatory process has often already caused considerable damage and the disease might have become partially or totally unresponsive to medical therapy. Late diagnosis in IBD is due to the lack of accurate, non-invasive indicators that would allow disease identification during the pre-clinical stage—as it is often done in many other medical conditions. Here, we will discuss what is known about the biologic onset and pre-clinical CD with an emphasis on studies conducted in patients’ first degree relatives. We will then review the possible strategies to diagnose IBD very early in time including screening, available disease markers and imaging, and the possible clinical implications of treating these conditions at or close to their biologic onset. Later, we will review the potential impact of conducting translational research in IBD during the pre-clinical stage, especially focusing on the role of the microbiome in disease etiology and pathogenesis. Finally, we will highlight possible future developments in the field and how they can impact IBD management and our scientific knowledge of these conditions.

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Section: What We Know About Preclinical CDmentioning

confidence: 99%

Section: What We Know About Preclinical CDmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Capturing the Biologic Onset of Inflammatory Bowel Diseases: Impact on Translational and Clinical Science

Sorrentino

Nguyen

Chitnavis

2019

Cells

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Preclinical and Undiagnosed Crohnʼs Disease

Sorrentino

2016

Inflammatory Bowel Diseases

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Little is known on the natural history of Crohn's disease (CD) before diagnosis. By the time the patient is diagnosed, the disease has often produced considerable damage to the intestinal mucosa and sometimes other organs. Such period before diagnosis might involve both a silent and a symptomatic phase. The silent phase, or preclinical CD, might last several years after the biological disease onset. Evidence is accumulating that the symptomatic phase might also go undiagnosed for months or years. In fact, for each established case of CD, there are probably several undiagnosed cases, a classic iceberg phenomenon of disease. Such status quo--lagging behind diagnostic standards for many other diseases--effectively hampers efforts to block disease evolution and the development of complications. This is no longer tenable because CD is a debilitating, severe, and costly affection, whose incidence is rapidly rising worldwide. Here, we will review what is currently known on preclinical and undiagnosed CD and what could be done to improve accuracy and timeliness of diagnosis.

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Mo1041 MRE Findings at Crohn's Disease Diagnosis: Disease Activity, Bowel Damage and Predictive Value for Long-Term Outcomes

Cited by 2 publications

References 0 publications

Capturing the Biologic Onset of Inflammatory Bowel Diseases: Impact on Translational and Clinical Science

Capturing the Biologic Onset of Inflammatory Bowel Diseases: Impact on Translational and Clinical Science

Preclinical and Undiagnosed Crohnʼs Disease

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