Help
Subscribe


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

 01 July 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

Recommendation of care varies for women with ulcerative colitis postileal pouch–anal anastomosis

The latest issue of the Digestive Diseases and Sciences reports significant variation in recommendation of care for women of reproductive age with ulcerative colitis postileal pouch–anal anastomosis.

News image

Ileal pouch–anal anastomosis (IPAA) is the preferred surgical option for treatment refractory ulcerative colitis.

Infertility risk post IPAA and sphincter injury concerns with vaginal delivery has led to a lack of consensus regarding timing and recommended mode of delivery post-IPAA.

To better understand these issues, Dr Kara Bradford and colleagues surveyed gastroenterologists, colorectal surgeons, and obstetricians to assess practice variation in recommendations for delivery post IPAA.

Clinical vignettes were developed to assess knowledge, attitudes, and beliefs surrounding the impact of IPAA on fertility, IPAA timing around pregnancy, recommended mode of delivery after IPAA, and which specialist should advise on MOD.

These were emailed to providers using specialty society address lists.

Univariate analyses tested differences among groups.
The majority of gastroenterologists quoted fertility reduction of more than 20% post-IPAA
Digestive Diseases & Sciences

The team reported that a total of 244 gastroenterologists, 158 colorectal surgeons and 39 obstetricians responded to the survey.

The majority of gastroenterologists and colorectal surgeons quoted fertility reduction of more than 20% post-IPAA versus 11% obstetricians.

More GI than colorectal surgeons recommended delaying IPAA until after pregnancy, and this was more commonly suggested by colorectal surgeons in practice less than 10 years, and less than 45 years old.

The research team recommended vaginal delivery post-IPAA in 43%, 20% and 57% for gastroenterologists, colorectal surgeons and obstetricians, respectively.

The team found that only 28% colorectal surgeons versus 59% obstetricians thought obstetricians should primarily advise on mode of delivery.

Dr Bradford's team concludes, "There is significant intra- and inter-group variation in management of women post-IPAA."

"There is need for consensus among subspecialists involved in managing women with this complex condition."

Dig Dis Sci 2014: 59(6): 1115-1120
19 June 2014

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

 01 July 2016 
Aspirin and colorectal cancer
 01 July 2016 
Outcome measures in celiac disease
 01 July 2016 
Growth factor activity and IBD
 30 June 2016 
Staging system for familial adenomatous polyposis
 30 June 2016 
Antibiotics in children and obesity
 30 June 2016 
IBS-type symptoms in pediatric IBD
 29 June 2016 
Hep C eradication in people who inject drugs
 29 June 2016 
Anti-tumor necrosis factor in mothers and newborns
 29 June 2016 
Progression to esophageal carcinoma in Barrett's
 28 June 2016 
Gastric cancer screening in the USA
 28 June 2016 
Acute severe ulcerative colitis
 28 June 2016 
Cancer recurrence after immune-suppressive therapies
 27 June 2016 
Epidemiology of NAFLD
 27 June 2016 
Tobacco smoking and ulcerative colitis
 27 June 2016 
The Toronto Consensus for H. pylori treatment
 24 June 2016 
Statins and colorectal cancer in IBD
 24 June 2016 
Dietary trends in the USA
 24 June 2016 
Fibre for chronic idiopathic constipation
 23 June 2016 
Biomarker for eosinophilic esophagitis diagnosis
 23 June 2016 
Touch screens in the IBD outpatient clinic
 23 June 2016 
Adverse events after colonoscopy bowel preparations
 22 June 2016 
Benefits and harms of colorectal cancer screening
 22 June 2016 
IBS symptoms in IBD
 22 June 2016 
Outcomes among US veterans with Hep B
 21 June 2016 
Screening for colorectal cancer
 21 June 2016 
Tenofovir and Hep B transmission in mothers
 21 June 2016 
Access to liver subspecialty care and survival
 20 June 2016 
Genes for colorectal cancer risk
 20 June 2016 
Patients and gastroenterologists’ perceptions on IBD
 20 June 2016 
Hep C treatment in people who inject drugs
 17 June 2016 
Noninvasive markers of liver fibrosis
 17 June 2016 
Predictors of starting with long-term PPIs
 17 June 2016 
Extrahepatic manifestations of Hep C
 16 June 2016 
Assessing progression of NAFLD
 16 June 2016 
Endotracheal intubation and endoscopy unit efficiency metrics
 16 June 2016 
Bile acid diarrhea
 15 June 2016 
Consensus for acute severe ulcerative colitis
 15 June 2016 
Dental erosions in GERD
 15 June 2016 
Pharmacological treatments for obesity with weight loss
 14 June 2016 
Antibiotics and gut inflammation
 14 June 2016 
Liver-related mortality in the developed world
 14 June 2016 
Hep C patient outcomes treated with different anti-viral regimens
 13 June 2016 
Obesity in the USA
 13 June 2016 
Celiac disease drug development
 13 June 2016 
Pneumonia risk in celiac disease
 10 June 2016 

Celiac disease drug development

 10 June 2016 
Rectal cancer surgery checklist
 10 June 2016 
Breath as a marker for IBS
 09 June 2016 
Psychological morbidity in young people with IBD
 09 June 2016 
Predicting hepatic encephalopathy in cirrhosis
 09 June 2016 
Evaluation of endoscopic findings from patients with Crohn's
 08 June 2016 
Adult obesity trends in the USA
 08 June 2016 
Pediatric IBD unclassified vs other IBD
 08 June 2016 
Dark chocolate and NASH oxidation
 07 June 2016 
Flexible endoscopy for Zenker's diverticulum
 07 June 2016 
Predicting risk of hepatic encephalopathy in cirrhosis
 07 June 2016 
Electronic learning system for colon capsule endoscopy
 06 June 2016 
Disturbed sleep and symptoms in IBS
 06 June 2016 
Oral contraceptives and Crohn’s complications
 06 June 2016 
Eosinophilic esophagitis

Blackwell Publishing


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