Objective To improve the knowledge of inflammatory bowel disease complicated with venous thromboembolism for better diagnosis and treatment. Methods One case of patient with ulcerative colitis complicated with a multiple vessel thromboembolism ( pulmonary arterial, deep vein of lower limb, and superior mesenteric vein) was analyzed, and related literatures were reviewed. Results The patient resulted in pulmonary thromboembolism ( PTE) recurrence because of irregular treatment. In addition to deep vein thrombosis of the lower extremity, a new discovery of the superior mesenteric vein embolism ( MVT) was diagnosed. The bleeding risk of heparin or lowmolecular weight heparin ( LMWH) for treatment is low, while that of warfarin is high. Conclusions Venous thromboembolism ( VTE) has a close relationship with inflammatory bowel disease ( IBD) such as ulcerative colitis. The symptomis not so typical that it is easy to misdiagnosis and missed diagnosis. It is noted that mesenteric venous thrombosis ( MVT) should be excluded in IBD patients suffering from VTE, if the source of embolus is not clear. Suitable treatment should be considered according to the risk stratification of VTE and risk-benefit ratio because of a high bleeding risk.
Objective To summarize and review the heterogeneity of bone marrow derived stem cells (BMDSCs) and its formation mechanism and significance, and to analyze the possible roles and mechanisms in intestinal epithel ial reconstruction. Methods The related l iterature about BMDSCs heterogeneity and its role in intestinal epithel ial repair was reviewed and analyzed. Results The heterogeneity of BMDSCs provided better explanations for its multi-potency. The probable mechanisms of BMDSCs to repair intestinal epithel ium included direct implantation into intestinal epithel ium, fusion between BMDSCs and intestinal stem cells, and promotion of injury microcirculation reconstruction. Conclusion BMDSCs have a bright future in gastrointestinal injury caused by inflammatory bowl disease and regeneration.
ObjectiveTo assess whether pre-operative use of infliximab (IFX) will increase the risk of post-operative infectious complications in patients with inflammatory bowel disease (IBD). MethodsPubmed, Web of Science, CBM, CNKI and Wanfang database were searched for all the trials that investigated the effects of infliximab on postoperative infectious complication rates in patients with IBD between January 1990 and April 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. ResultsTotally, 14 cohort studies were finally included in the review. There was no significant difference on infectious complications [RR=0.99, 95%CI (0.47, 2.07), P=0.97] between IFX groups and control groups with ulcerative colitis. The same results were found in patients with Crohn's disease on infectious complications [RR=1.32, 95%CI (0.87, 1.98), P=0.19]. ConclusionPre-operative infliximab use is safe and does not increase the risk of post-operative infectious complications in patients with IBD.
ObjectiveTo systematically review the tumor necrosis factor-α (TNF-α) -308G/A polymorphism and the risk of inflammatory bowel disease (IBD). MethodsAll eligible case-control studies published up to Jan 25th 2015 were identified by searching PubMed, EMbase, CNKI, WanFang Data, CBM and VIP databases. Two reviewers independently screened the studies according to the inclusion and exclusion criteria, extracted data and assessed methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 and Stata 12.0 softwares. ResultsA total of 20 studies involving 2 860 IBD cases and 5 033 controls were included. The results of meta-analysis showed:Compared with the wild genotype GG, genotype GA, AA and genotype GA+AA were associated with susceptibility of ulcerative colitis (UC) (GA vs. GG:OR=1.45, 95%CI 1.02 to 2.07, P=0.04; AA vs. GG:OR=2.01, 95%CI 1.32 to 3.05, P=0.001; GA+AA vs. GG:OR=1.51, 95%CI 1.07 to 2.13, P=0.02); Compared with genotype GA+AA, genotype AA increased the risk of UC (AA vs. GA+GG:OR=1.92, 95%CI 1.26 to 2.91, P=0.002); allele A did not increase the risk of UC; Compared with genotype GG, genotype AA increased the risk of Crohn disease (CD) (AA vs. GG:OR=1.49, 95%CI 1.07 to 2.08, P=0.02); Compared with genotype GA+GG, while genotype AA increased the risk of CD (AA vs. GA+GG:OR=1.50, 95%CI 1.08 to 2.09, P=0.02); genotype GA, GA+AA and allele A did not increase the risk of CD. In stratification analyses by ethnicity, we found that the TNF-α-308G/A was significat associated with IBD in Europeans. ConclusionCurrent evidence indicates that TNF-α-308G/A polymorphism is associated with the susceptibility of IBD, genotype GA, AA and GA+AA increase the risk of suffering from UC while genotype AA increase the risk of suffering from CD. Due to the limited quantity of the included studies, more researches are needed to verify the above conclusion.
ObjectiveTo elucidate the characteristics of colonic Crohn’s disease (CD) and evaluate effectiveness of surgical treatment.MethodClinical data of 28 cases with colonic CD who underwent surgery at West China Hospital of Sichuan University between Feb. 2009 and Jan. 2017 were retrospectively analyzed.ResultsDefinite diagnosis of colonic CD was performed in 12 cases preoperatively (42.9%), but 16 cases (57.1%) were misdiagnosed as other disease, ulcerative colitis (5 cases, 17.9%), tumor (4 cases, 14.3%), appendiceal disease (4 cases, 14.3%), and intestinal tuberculosis (3 cases, 10.7%) were the major causes of preoperative misdiagnosed disease. Of the 28 cases, elective surgery was performed in 26 cases and emergency surgery in 2 cases. The major surgical procedures were segmental colectomy(10 cases) and right hemicolectomy (6 cases), as well as ilecolostomy (9 cases), colocolostomy(6 cases), ileostomy(9 cases), colostomy (6 cases), and so on. The length of the first hospital stay of operation related to intestinal lesions in this group was 5–74 d (mean of 25.4 d). Postoperative complications were occurred in 9 cases (32.1%), all these cases didn’t receave medical treatment. Twenty cases were followed up, and the follow-up time was 7–78 months (mean of 33.4 months), 8 cases lost follow-up. The prognosis of the follow-up cases was good.ConclusionsColonic CD has occult clinical manifestation, resulting in misdiagnosis and mistreatment. Segmental resection of the colon is the important treatment for colonic CD. For patients with complications, multidisciplinary diagnosis and treatment is necessary. In addition, systematic medical treatment before surgery helps to reduce the risk of the first surgery associated with intestinal lesions.
Inflammatory bowel disease (IBD) is a group of chronic, recurrent, and non-specific intestinal inflammatory diseases. It usually occurs between 20 and 40 years old, overlapping with the patient’s childbearing age. Active IBD may lead to decreased fertility and adverse pregnancy outcomes, and pregnancy may also lead to recurrence of IBD. Through studying domestic and foreign related literature on pregnancy and IBD, this article elaborates on the guidance and management of IBD before pregnancy, the disease management of IBD during pregnancy, the disease management of IBD during lactation, and the current status and prospects of traditional Chinese medicine treatment. It aims to provide references for patients and clinicians to have a more scientific understanding of pregnancy with IBD.
ObjectiveTo systematically review the effect of different psychological intervention methods on depressive symptoms in patients with inflammatory bowel disease. MethodsPubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials(RCTs) on psychological interventions on depression of patients with inflammatory bowel disease from inception to January 12, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then conducted by using software Stata and GeMTC. ResultsA total of 18 articles, 1 567 patients and 6 psychological intervention methods were included. The results of the network meta-analysis showed that, compared with conventional nursing, music therapy, mindfulness therapy and cognitive behavioral therapy had statistically significant differences in the intervention effect of depression in patients with inflammatory bowel disease (P<0.05); Among the six psychological intervention methods included, there was a statistically significant difference in relaxation therapy compared with music therapy, writing expression and mindfulness therapy (P<0.05); The difference between cognitive behavioral therapy and music therapy and mindfulness therapy was statistically significant (P<0.05), while there was no statistically significant difference in other interventions (P>0.05). The SUCRA ranking probability chart showed that music therapy was the best intervention method for depression in patients with inflammatory bowel disease, followed by mindfulness therapy and cognitive behavioral therapy. ConclusionThe current evidence suggests that music therapy has an advantage in relieving depression in patients with inflammatory bowel disease, followed by mindfulness therapy or cognitive behavioral therapy. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Inflammatory bowel disease (IBD) is characterized by recurrent abdominal pain, diarrhea, and mucopurulent bloody stools as its main clinical manifestations. In recent years, its parenteral manifestations have received increasing attention. Fatigue, as one of the extraintestinal manifestations of IBD, affects the quality of life of patients, and results in considerable distress for patients. The influencing factors of fatigue symptoms in IBD patients include inflammation, psychological comorbidities, sleep disorders, anemia, micronutrient deficiency, changes in microbiota, and metabolomics. The pathogenesis is currently unclear and may be related to disorders in tryptophan metabolism. This article will review the influencing factors and pathogenesis of fatigue symptoms in IBD patients, aiming to provide a basis for the prevention and treatment of IBD fatigue.
ObjectiveTo conduct a two-sample Mendelian randomization (MR) study to assess the bidirectional causal relationship between multiple sclerosis and inflammatory bowel disease. MethodsWe performed two-sample bidirectional MR analysis using publicly available genome-wide association study (GWAS) data. The primary analysis method used was the inverse variance weighted (IVW) method, with MR-Egger weighted median as a supplementary analysis. Sensitivity analyses were conducted. ResultsIVW, weighted median, and weighted mode all supported a causal relationship between multiple sclerosis and an increased risk of ulcerative colitis (OR=1.07, 95%CI 1.01 to 1.13, P=0.018), while no association was found between multiple sclerosis and Crohn's disease. Sensitivity analyses suggested that the study results were not affected by pleiotropy. ConclusionGenetic predisposition to multiple sclerosis is associated with an elevated risk of developing ulcerative colitis but not Crohn’s disease.