Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Proximal Crohn's disease location associated with disease behavior and surgery

This month's American Journal of Gastroenterology examines the relationship between proximal Crohn's disease location and disease behavior and surgery.

News image

In classifying Crohn's disease location, proximal disease includes esophagogastroduodenal and jejunal disease.

Dr Mark Lazarev from Maryland, USA determined the influence of proximal disease on outcomes of behavior and need for surgery.

In addition, the team determined if there was significant clinical heterogeneity between esophagogastroduodenal and jejunal disease.

The team of doctors performed a cross-sectional query of the NIDDK Inflammatory Bowel Disease Genetics Consortium database of patients with a confirmed diagnosis of Crohn's disease and phenotyped per the Inflammatory Bowel Disease Genetics Consortium  manual.

Presence of any location, proximal location, proximal-esophagogastroduodenal, L4-jejunal, and non-location, proximal disease was compared with demographic features including age, race, ethnicity, smoking and inflammatory bowel disease  family history, diagnosis age, disease duration, clinical outcomes of inflammatory, stricturing or penetrating behavior, and Crohn's disease abdominal surgeries.

Among 2,105 patients with complete disease location data, 346 had location, proximal disease with 321 having concurrent L1-L3 disease.

Stricturing risks were ileal site, longer disease duration
American Journal of Gastroenterology

In all, 1,759 had only L1-L3 disease.

The doctors noted that proximal patients were more likely to be younger at diagnosis, non-smokers, have coexisting ileal involvement, and have stricturing disease.

The team noted that proximal-esophagogastroduodenal patients were at least twice as likely to have had ileal disease, stricturing behavior, and any or multiple abdominal surgeries.

The research team noted that proximal-jejunal patients had more stricturing behavior and multiple abdominal surgeries than non-location, proximal ileal disease patients.

The researchers showed that stricturing risks were ileal site, longer disease duration, jejunal site, and older age at diagnosis.

Multiple surgery risks were disease duration, penetrating disease, and jejunal site, with short duration from diagnosis to first surgery protective.

Dr Lazarev's team commented, "Jejunal disease is a significantly greater risk factor for stricturing disease and multiple abdominal surgeries than either esophagogastroduodenal or ileal disease."

"The Montreal site classification should be revised to include separate designations for jejunal and esophagogastroduodenal disease."

Am J Gastroenterol 2013; 108:106–112
21 January 2013

Go to top of page Email this page Email this page to a colleague

 24 April 2014

Advanced search
 24 April 2014 
Imaging liver fat in children
 24 April 2014 
Vitamin D levels in adults with Crohn's disease
 24 April 2014 
Gut microbiota in IBS
 23 April 2014 
Cancer risk after resection of polypoid dysplasia
 23 April 2014 
Fecal microbiota transplantation therapy
 23 April 2014 
Colorectal cancer risk in MUTYH mutation carriers
 22 April 2014 
Endoscopy guidelines to select patients for colonoscopy
 22 April 2014 
PPI use and cancer in Barrett's
 22 April 2014 
Ledipasvir and sofosbuvir for HCV genotype 1
 17 April 2014 
Screening for low bone mineral density among ulcerative colitis
 17 April 2014 
Diabetes mellitus and acute pancreatitis
 17 April 2014 
Bowel cleansing for colonoscopy
 16 April 2014 
Evaluating pharmacologic agents in IBS
 16 April 2014 
Isotretinoin and IBD risk
 16 April 2014 
Mortality in bleeding Mallory-Weiss syndrome vs peptic ulcer bleeding
 15 April 2014 
Dietary fat and risk of IBD
 15 April 2014 
Quality of life in microscopic colitis
 15 April 2014 
New prognostic score for cirrhosis
 14 April 2014 

5-aminosalicylates in early pregnancy and congenital malformation risk

 14 April 2014 
Changing liver cancer mortality rates in the United States
 14 April 2014 
Inflammatory sacroiliitis by MRI in IBD
 11 April 2014 
H pylori resistance to antibiotics
 11 April 2014 
Predictors of corticosteroid treatment outcomes for ulcerative colitis
 11 April 2014 
Antibiotic combination therapy for ulcerative colitis
 10 April 2014 
Mortality in Crohn's disease
 10 April 2014 
Prophylaxis against venous thromboembolism in hospitalized ulcerative colitis
 10 April 2014 
Probiotic treatment and infant colic
 09 April 2014 
Preventing death in general intensive care
 09 April 2014 
Neoplasm risk after polypectomy
 09 April 2014 
Disclosure program and gastroenterology-related claims
 08 April 2014 

Regurgitation and health-related quality of life in GERD

 08 April 2014 
H. pylori resistance to antibiotics
 08 April 2014 
Management of chronic diarrhea
 07 April 2014 
Gastrointestinal angiodysplastic lesions
 07 April 2014 
Meat intake and liver cancer
 07 April 2014 
Adenoma detection and colorectal cancer risk
 04 April 2014 
Stool DNA tests for colorectal cancer
 04 April 2014 
PET-CT predicts outcome in colorectal liver metastases
 04 April 2014 

Prophylaxis of post-ERCP pancreatitis

 03 April 2014 
Management of esophageal or gastric variceal bleeding
 03 April 2014 
Exclusionary diets for IBD
 03 April 2014 
Mortality with chronic pancreatitis
 02 April 2014 
Disease course of early-onset pediatric IBD
 02 April 2014 
Risk of liver fibrosis progression in chronic hep B
 02 April 2014 
Colorectal cancer and patient survival
 01 April 2014 
Outcomes in patients with Hep C
 01 April 2014 
Diagnosis of functional dyspepsia
 01 April 2014 
Genetic risk factors for stenosis and infections in primary sclerosing cholangitis
 31 March 2014 
Diet-gene interactions and Crohn's
 31 March 2014 
Transjugular intrahepatic portosystemic stent-shunts in Budd–Chiari syndrome
 31 March 2014 
Hepatic decompensation in antiretroviral-treated patients
 28 March 2014 
Glucocorticoids and mortality after colorectal cancer surgery
 28 March 2014 
Long-term metformin use and gastric cancer risk
 28 March 2014 
Distance from a liver transplant center and survival
 27 March 2014 
Radiofrequency ablation vs endoscopy for Barrett's
 27 March 2014 
Omega-3 fatty acid and Crohn's disease
 27 March 2014 
Thromboembolism prophylaxis in IBD
 26 March 2014 
Disparities in evaluation of rectal bleeding
 26 March 2014 
Prediction of H. pylori status after endoscopy
 26 March 2014 
Fatigue and depression in IBD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us