Skip to main content
Top
Published in: Irish Journal of Medical Science (1971 -) 3/2011

01-09-2011 | Original Article

A changing trend in the management of patients with newly diagnosed Crohn’s disease

Authors: A. Qasim, N. Ullah, P. Crotty, N. Swan, N. Breslin, B. Ryan, W. Torreggiani, E. Eguare, P. Neary, H. O’Connor, C. O’Morain

Published in: Irish Journal of Medical Science (1971 -) | Issue 3/2011

Login to get access

Abstact

Background

Epidemiologic shift with rising incidence of Crohn’s disease (CD) has been reported in recent studies.

Aims

To determine disease behaviour and therapeutic interventions undertaken in newly diagnosed patients with CD.

Methods

Patients diagnosed with CD between January 2006 and June 2008 were included. Disease type, location, degree of involvement and type of therapeutic interventions were recorded.

Results

A total of 78 patients were included. Colonic, ileo-colonic, terminal ileal and isolated small bowel disease were present in 37, 27, 9 and 5 patients, respectively. Disease phenotype was inflammatory, stenosing and fistulising in 42, 30 and 6 patients, respectively. Surgery was required in 22 patients, including right hemicolectomy (n = 8), subtotal colectomy (n = 4), segmental colonic resection (n = 2), segmental small bowel resection (n = 2), appendectomy (n = 2) and perianal surgery (n = 4). Fourteen patients underwent surgery at the time of diagnosis. Laparoscopic surgery was performed in 14 patients.

Conclusions

A significant proportion of newly diagnosed patients with CD underwent surgical intervention on their first admission to hospital. This may signify a changing trend in the management approach.
Literature
1.
go back to reference Jiang L, Xia B, Li J et al (2006) Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan city, central China. Inflamm Bowel Dis 12:212–217PubMedCrossRef Jiang L, Xia B, Li J et al (2006) Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan city, central China. Inflamm Bowel Dis 12:212–217PubMedCrossRef
2.
go back to reference Aghazadeh R, Zali MR, Bahari A, Amin K, Ghahghaie F, Firouzi F (2005) Inflammatory bowel disease in Iran: a review of 457 cases. J Gastroenterol Hepatol 20:1691–1695PubMedCrossRef Aghazadeh R, Zali MR, Bahari A, Amin K, Ghahghaie F, Firouzi F (2005) Inflammatory bowel disease in Iran: a review of 457 cases. J Gastroenterol Hepatol 20:1691–1695PubMedCrossRef
3.
go back to reference Aamodt G, Jahnsen J, Bengtson MB, Moum B, Vatn MH (2008) IBSEN Study Group. Geographic distribution and ecological studies of inflammatory bowel disease in southeastern Norway in 1990–1993. Inflamm Bowel Dis 14:984–991PubMedCrossRef Aamodt G, Jahnsen J, Bengtson MB, Moum B, Vatn MH (2008) IBSEN Study Group. Geographic distribution and ecological studies of inflammatory bowel disease in southeastern Norway in 1990–1993. Inflamm Bowel Dis 14:984–991PubMedCrossRef
4.
go back to reference McCormick P, Manning D (2001) Chronic inflammatory bowel disease and the ‘over-clean’ environment: rarity in the Irish ‘traveller’ community. Ir Med J 94:203–204PubMed McCormick P, Manning D (2001) Chronic inflammatory bowel disease and the ‘over-clean’ environment: rarity in the Irish ‘traveller’ community. Ir Med J 94:203–204PubMed
5.
go back to reference Loftus EV Jr (2004) Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 126:1504–1517PubMedCrossRef Loftus EV Jr (2004) Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 126:1504–1517PubMedCrossRef
6.
go back to reference Green C, Elliott L, Beaudoin C, Bernstein CN (2006) A population-based ecologic study of inflammatory bowel disease: searching for etiologic clues. Am J Epidemiol 164:615–623 (discussion 624–628)PubMedCrossRef Green C, Elliott L, Beaudoin C, Bernstein CN (2006) A population-based ecologic study of inflammatory bowel disease: searching for etiologic clues. Am J Epidemiol 164:615–623 (discussion 624–628)PubMedCrossRef
7.
go back to reference Feeney MA, Murphy F, Clegg AJ, Trebble TM, Sharer NM, Snook JA (2002) A case–control study of childhood environmental risk factors for the development of inflammatory bowel disease. Eur J Gastroenterol Hepatol 14:529–534PubMedCrossRef Feeney MA, Murphy F, Clegg AJ, Trebble TM, Sharer NM, Snook JA (2002) A case–control study of childhood environmental risk factors for the development of inflammatory bowel disease. Eur J Gastroenterol Hepatol 14:529–534PubMedCrossRef
8.
go back to reference Smyth CM, Picha SB, Rathore O, Deasy J, Patchett SE, Murray FE (2005) Increasing rates and changing patterns of hospital admissions for patients with inflammatory bowel disease in Ireland: 1996–2001. Ir J Med Sci 174:28–32PubMedCrossRef Smyth CM, Picha SB, Rathore O, Deasy J, Patchett SE, Murray FE (2005) Increasing rates and changing patterns of hospital admissions for patients with inflammatory bowel disease in Ireland: 1996–2001. Ir J Med Sci 174:28–32PubMedCrossRef
9.
go back to reference Halfvarson J, Jess T, Magnuson A et al (2006) Environmental factors in inflammatory bowel disease: a co-twin control study of a Swedish–Danish twin population. Inflamm Bowel Dis 12:925–933PubMedCrossRef Halfvarson J, Jess T, Magnuson A et al (2006) Environmental factors in inflammatory bowel disease: a co-twin control study of a Swedish–Danish twin population. Inflamm Bowel Dis 12:925–933PubMedCrossRef
10.
go back to reference Wolters FL, Russel MG, Sijbrandij J et al (2006) Phenotype at diagnosis predicts recurrence rates in Crohn’s disease. Gut 55:1124–1130PubMedCrossRef Wolters FL, Russel MG, Sijbrandij J et al (2006) Phenotype at diagnosis predicts recurrence rates in Crohn’s disease. Gut 55:1124–1130PubMedCrossRef
11.
go back to reference Herrington LJ, Liu L, Fireman B et al (2009) Time trends in therapies and outcomes for adult inflammatory bowel disease, Northern California, 1998–2005. Gastroenterology 137:502–511CrossRef Herrington LJ, Liu L, Fireman B et al (2009) Time trends in therapies and outcomes for adult inflammatory bowel disease, Northern California, 1998–2005. Gastroenterology 137:502–511CrossRef
12.
go back to reference Romberg-Camps MJ, Dagnelie PC, Kester AD et al (2009) Influence of phenotype at diagnosis and of other potential prognostic factors on the course of inflammatory bowel disease. Am J Gastroenterol 104:371–383PubMedCrossRef Romberg-Camps MJ, Dagnelie PC, Kester AD et al (2009) Influence of phenotype at diagnosis and of other potential prognostic factors on the course of inflammatory bowel disease. Am J Gastroenterol 104:371–383PubMedCrossRef
13.
go back to reference Wolters FL, Joling C, Russel MG et al (2007) European Collaborative Study Group on Inflammatory Bowel Disease (EC-IBD). Treatment inferred disease severity in Crohn’s disease: evidence for a European gradient of disease course. Scand J Gastroenterol 42:333–344PubMedCrossRef Wolters FL, Joling C, Russel MG et al (2007) European Collaborative Study Group on Inflammatory Bowel Disease (EC-IBD). Treatment inferred disease severity in Crohn’s disease: evidence for a European gradient of disease course. Scand J Gastroenterol 42:333–344PubMedCrossRef
14.
go back to reference Alvarez-Lobos M, Arostegui JI, Sans M et al (2005) Crohn’s disease patients carrying Nod2/CARD 15 gene variants have an increased and early need for first surgery due to structuring disease and higher rate of surgical recurrence. Ann Surg 242:693–700PubMedCrossRef Alvarez-Lobos M, Arostegui JI, Sans M et al (2005) Crohn’s disease patients carrying Nod2/CARD 15 gene variants have an increased and early need for first surgery due to structuring disease and higher rate of surgical recurrence. Ann Surg 242:693–700PubMedCrossRef
15.
go back to reference Henriksen M, Jahnsen J, Lygren I et al (2007) Clinical course in Crohn’s disease: results of a five-year population-based follow-up study (the IBSEN study). Scand J Gastroenterol 42:602–610PubMedCrossRef Henriksen M, Jahnsen J, Lygren I et al (2007) Clinical course in Crohn’s disease: results of a five-year population-based follow-up study (the IBSEN study). Scand J Gastroenterol 42:602–610PubMedCrossRef
16.
go back to reference Solberg IC, Vatn MH, Høie O et al (2007) Clinical course in Crohn’s disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol 5:1430–1438PubMedCrossRef Solberg IC, Vatn MH, Høie O et al (2007) Clinical course in Crohn’s disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol 5:1430–1438PubMedCrossRef
17.
go back to reference Latella G, Cocco A, Angelucci E et al (2009) Clinical course of Crohn’s disease first diagnosed at surgery for acute abdomen. Dig Liver Dis. 41:269–276PubMedCrossRef Latella G, Cocco A, Angelucci E et al (2009) Clinical course of Crohn’s disease first diagnosed at surgery for acute abdomen. Dig Liver Dis. 41:269–276PubMedCrossRef
18.
go back to reference Amre D (2005) Gene–environment interactions in the etiopathogenesis of inflammatory bowel disease. J Pediatr Gastroenterol Nutr 40(Suppl 1):S39PubMed Amre D (2005) Gene–environment interactions in the etiopathogenesis of inflammatory bowel disease. J Pediatr Gastroenterol Nutr 40(Suppl 1):S39PubMed
19.
go back to reference Lennard-Jones JE (1989) Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl 170:2–6PubMedCrossRef Lennard-Jones JE (1989) Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl 170:2–6PubMedCrossRef
20.
go back to reference Jess T, Riis L, Vind I et al (2007) Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen. Denmark Inflamm Bowel Dis 13:481–489CrossRef Jess T, Riis L, Vind I et al (2007) Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen. Denmark Inflamm Bowel Dis 13:481–489CrossRef
21.
go back to reference Moum B, Ekbom A, Vatn MH et al (1997) Clinical course during the 1st year after diagnosis in ulcerative colitis and Crohn’s disease. Results of a large, prospective population-based study in southeastern Norway 1990–93. Scand J Gastroenterol 32:1005–1012PubMedCrossRef Moum B, Ekbom A, Vatn MH et al (1997) Clinical course during the 1st year after diagnosis in ulcerative colitis and Crohn’s disease. Results of a large, prospective population-based study in southeastern Norway 1990–93. Scand J Gastroenterol 32:1005–1012PubMedCrossRef
22.
go back to reference Tanaka S, Matsuo K, Sasaki T, Nakano M, Shimura H, Yamashita Y (2009) Clinical outcomes and advantages of laparoscopic surgery for primary Crohn’s disease: are they significant? Hepatogastroenterology 56:416–420PubMed Tanaka S, Matsuo K, Sasaki T, Nakano M, Shimura H, Yamashita Y (2009) Clinical outcomes and advantages of laparoscopic surgery for primary Crohn’s disease: are they significant? Hepatogastroenterology 56:416–420PubMed
23.
go back to reference Florin TH, Paterson EW, Fowler EV, Radford-Smith GL (2006) Clinically active Crohn’s disease in the presence of a low C-reactive protein. Scand J Gastroenterol 41:306–311PubMedCrossRef Florin TH, Paterson EW, Fowler EV, Radford-Smith GL (2006) Clinically active Crohn’s disease in the presence of a low C-reactive protein. Scand J Gastroenterol 41:306–311PubMedCrossRef
24.
go back to reference Rodgers AD, Cummins AG (2007) CRP correlates with clinical score in ulcerative colitis but not in Crohn’s disease. Dig Dis Sci 52:2063–2068PubMedCrossRef Rodgers AD, Cummins AG (2007) CRP correlates with clinical score in ulcerative colitis but not in Crohn’s disease. Dig Dis Sci 52:2063–2068PubMedCrossRef
25.
go back to reference Cellier C, Sahmoud T, Froguel E et al (1994) Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn’s disease. A prospective multicentre study of 121 cases. The Groupe d’Etudes Thérapeutiques des affections inflammatoires digestives. Gut 35:231–235PubMedCrossRef Cellier C, Sahmoud T, Froguel E et al (1994) Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn’s disease. A prospective multicentre study of 121 cases. The Groupe d’Etudes Thérapeutiques des affections inflammatoires digestives. Gut 35:231–235PubMedCrossRef
26.
go back to reference Aratari A, Papi C, Leandro G, Viscido A, Capurso L, Caprilli R (2007) Early versus late surgery for ileo-caecal Crohn’s disease. Aliment Pharmacol Ther 26:1303–1312PubMedCrossRef Aratari A, Papi C, Leandro G, Viscido A, Capurso L, Caprilli R (2007) Early versus late surgery for ileo-caecal Crohn’s disease. Aliment Pharmacol Ther 26:1303–1312PubMedCrossRef
27.
go back to reference Cullen G, O’Toole A, Keegan D, Sheahan K, Hyland JM, O’Donoghue DP (2007) Long-term clinical results of ileocaecal recsection for Crohn’s disease. Inflamm Bowel Dis 13:1369–1373PubMedCrossRef Cullen G, O’Toole A, Keegan D, Sheahan K, Hyland JM, O’Donoghue DP (2007) Long-term clinical results of ileocaecal recsection for Crohn’s disease. Inflamm Bowel Dis 13:1369–1373PubMedCrossRef
28.
go back to reference Ogura Y, Bonen DK, Inohara N et al (2001) A frameshift mutation in NOD2 associated with susceptibility to Crohn’s disease. Nature 411:603–606PubMedCrossRef Ogura Y, Bonen DK, Inohara N et al (2001) A frameshift mutation in NOD2 associated with susceptibility to Crohn’s disease. Nature 411:603–606PubMedCrossRef
29.
go back to reference Halme L, Turunen U, Heliö T et al (2002) Familial and sporadic inflammatory bowel disease: comparison of clinical features and serological markers in a genetically homogenous population. Scand J Gastroenterol 37:692–698PubMedCrossRef Halme L, Turunen U, Heliö T et al (2002) Familial and sporadic inflammatory bowel disease: comparison of clinical features and serological markers in a genetically homogenous population. Scand J Gastroenterol 37:692–698PubMedCrossRef
Metadata
Title
A changing trend in the management of patients with newly diagnosed Crohn’s disease
Authors
A. Qasim
N. Ullah
P. Crotty
N. Swan
N. Breslin
B. Ryan
W. Torreggiani
E. Eguare
P. Neary
H. O’Connor
C. O’Morain
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
Irish Journal of Medical Science (1971 -) / Issue 3/2011
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-011-0706-4

Other articles of this Issue 3/2011

Irish Journal of Medical Science (1971 -) 3/2011 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.