Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 28 September 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

 28 September 2016 
Global trends in pancreatic cancer mortality
 28 September 2016 
Hep C virus RNA in liver explants
 28 September 2016 
Heterogeneity in endoscopic treatment of Crohn’s
 27 September 2016 
Non-invasive tests of NAFLD
 27 September 2016 
Fecal microbiota transplantation for C.diff in IBD
 27 September 2016 
Fast-track colorectal surgery influences outcomes
 26 September 2016 
Preventing cirrhosis in Hep C with fibrosis
 26 September 2016 
Body image after abdominoperineal excision for rectal cancer
 26 September 2016 
Gastric cancer risk in intestinal metaplasia of the stomach
 23 September 2016 
Sleep quality in nonalcoholic cirrhotic patients
 23 September 2016 
Exercise for NAFLD
 23 September 2016 
BMI history and fatty liver
 22 September 2016 
Predicting small-bowel Crohn’s disease
 22 September 2016 
Colectomy outcomes for ulcerative colitis
 22 September 2016 
Technology vs intervention for weight loss
 21 September 2016 
Employment status and IBD
 21 September 2016 
Cardiopulmonary exercise testing in liver transplant candidates
 21 September 2016 
Patients vs providers on nutrition in IBD
 20 September 2016 
Improving healthcare systems for viral Hepatitis
 20 September 2016 
GI benefits of COX-2 selective inhibitors
 20 September 2016 
Predicting relapse in Crohn's
 19 September 2016 
Prevalence of esophageal cancer in Barrett's
 19 September 2016 
Fecal microbiota transplantation and CDI in IBD
 19 September 2016 
Antibiotic resistance in Helicobacter pylori
 16 September 2016 
Low-residue diet before colonoscopy and bowel cleansing
 16 September 2016 
Genome-wide association in gastric cancer
 16 September 2016 
H. pylori in children with asthma
 15 September 2016 
Improving survival in cholangitis-associated septic shock
 15 September 2016 
Colorectal cancer survival and hospital volumes
 15 September 2016 
Primary sclerosing cholangitis and IBD
 14 September 2016 
Intestinal malabsorption and olmesartan
 14 September 2016 
Infection reduction strategy after colorectal resection
 14 September 2016 
Predicting long-term infliximab use in Crohn's
 13 September 2016 
Predicting survival in refractory celiac disease
 13 September 2016 
Cancer risk stratification in Barrett’s
 13 September 2016 
Screening vs non-screening colonoscopy
 12 September 2016 
Screening in familial colorectal cancer
 12 September 2016 
Metformin improves survival in pancreatic ductal cancer
 12 September 2016 
Consent guidelines for GI endoscopy procedures
 09 September 2016 
Development of IBS
 09 September 2016 
Safe and effective treatment for NASH
 09 September 2016 
Scale for stool measurement in diarrhea-IBS
 08 September 2016 
Prognostic factors for infliximab in Crohn's
 08 September 2016 
Chronic Hep B vs chronic Hep C and mortality
 08 September 2016 
Hematological malignancies in IBD
 07 September 2016 
IBD relapse during pregnancy
 07 September 2016 
New treatments for ulcerative colitis
 07 September 2016 
Alternative to nucleic acid testing in HCV
 06 September 2016 
EHealth technologies in IBD
 06 September 2016 
Endoscopy clinic no-shows
 06 September 2016 
Risk of infection after elective colorectal surgery
 05 September 2016 
Esophageal impedance monitoring
 05 September 2016 
Biomarker for IBD and GI cancer
 05 September 2016 
Family history and IBD clinical course
 02 September 2016 
Dietary carbohydrate intake, insulin resistance and GERD 
 02 September 2016 
Postpolypectomy bleeding in the colorectum
 02 September 2016 
Postop recurrence of Crohn's
 01 September 2016 
Prognostic test for liver transplants
 01 September 2016 
Recovery after colorectal surgery in elderly patients
 01 September 2016 
Obesity and post-ERCP pancreatitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us