Silent Inflammatory Bowel Disease

Abstract

Inflammatory bowel disease (IBD) is frequently associated with a variety of problematic symptoms, including abdominal pain and bowel habit changes, which are associated with poor patient quality of life and significant healthcare expenditure. Interestingly, silent IBD, a condition where patients demonstrate reduced perception and/or reporting of symptoms in the setting of active inflammation, may be as clinically consequential. This condition has been associated with serious complications leading to more costly interventions. It is by its nature an under-recognized phenomenon that affects substantial portions of patients with either Crohn’s disease or ulcerative colitis. At the present time, although there are a variety of theories relating to the underlying causes and contributors, little is known about why this phenomenon occurs. As a result, there is a lack of cost-effective, reliable diagnostic methods to identify and manage “at-risk” patients. However, it is significantly likely that further study and an improved understanding of this condition will lead to improved approaches for the diagnosis and treatment of patients with silent IBD as well as other gastrointestinal disorders associated with alterations in symptomatic perception. In this article, we critically review studies that have investigated silent IBD. Specifically, we discuss the following: (1) the methods for defining silent IBD, (2) the known epidemiology of silent IBD, (3) potential causes of and contributors to this clinical entity, (4) current diagnostic modalities available to identify it, and (5) gaps in our understanding as well as potential novel diagnostic and therapeutic applications that could be developed with further study of this condition.

Idiopathic terminal ileitis: myth or true entity?

“…The association between the gastrointestinal symptoms and the progression to Crohn's disease is also weak. The literature suggests that at least onethird of IBD patients with active disease are asymptomatic [36]. Several studies [4,7…”

“…The association between the gastrointestinal symptoms and the progression to Crohn's disease is also weak. The literature suggests that at least one-third of IBD patients with active disease are asymptomatic [36]. Several studies [4,7 ▪▪ ,33] show that symptomatic patients with IDTI are more likely to progress to Crohn's disease or other diagnosis compared to asymptomatic patients, and that IDTI tends to either self-resolve or remain unchanged over time.…”

Bilateral Uveitis in Silent Ulcerative Colitis: Case Report

“…Therefore, the definite diagnosis is of silent ulcerative colitis (UC) which was subclinical for approximately 7 years (►Fig. 1).…”

“…However, silent IBD could be used for patients with undetected versions of these illnesses who fail to manifest and recognize clinical features during active phases. 1 Ulcerative colitis (UC) is an inflammatory systemic illness. Clinical manifestations of the UC are unrestricted to the gastrointestinal tract (GIT), there are massive involvement of other organs, such as ocular, skin, and articular, and occur in up to 45% of patients.…”

The use of core descriptors from the ENiGMA code study in recent literature: a systematic review

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Crohn's disease (CD) is a complex disease with diverse manifestations and progressions that may relate to patient demographics, genetics and environment [1][2][3][4][5]. Attempts to classify CD have been made with the Montreal, Paris and Vienna classifications, but remaining ambiguities limit their clinical utility [1,3].

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