Crohn's Disease

Inflamed

Overview

Inflammatory Bowel Disease is very tricky to manage. When a young man is diagnosed with Crohn’s Disease, how and when will you decide between corticosteroids, immunomodulators, biologics, and surgery?


  1. Capsular Endoscopy in Crohn's Disease
  2. Conservative management of small bowel obstruction
  3. Endoscopic Features of Crohn's Disease
  4. Histological Features of Crohn's Disease
  5. Legionellosis in Crohn's Disease
  6. Patients unresponsive to steroids
  7. Patients unresponsive to steroids
  8. Radiographic features of small bowel obstruction
  9. Risks and Benefits of Biologics
  10. Smoking and Crohn's Disease
  11. The step-up approach to treatment of Crohn's Disease
  12. Thiopurine Methyltransferase (TPMT) Levels
  13. Toxic megacolon - when is surgery indicated?
  1. 1.VELAYOS FS, SANDBORN WJ. Pneumocystis carinii pneumonia during maintenance anti-tumor necrosis factor-alpha therapy with infliximab for Crohn's disease. Inflamm Bowel Dis [online] 2004 Sep, 10(5):657-60 [viewed 08 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/15472531
  2. 12.SILVA ANA CATARINA, PIMENTA MADALENA, GUIMARAES LUIS S. Small Bowel Obstruction: What to Look For1. RadioGraphics [online] 2009 March, 29(2):423-439 [viewed 09 July 2014] Available from: doi:10.1148/rg.292085514
  3. BOOTH RA, ANSARI MT, TRICCO AC, LOIT E, WEEKS L, DOUCETTE S, SKIDMORE B, HOCH JS, TSOUROS S, SEARS M, SY R, KARSH J, MANI S, GALIPEAU J, YURKIEWICH A, DANIEL R, TSERTSVADZE A, YAZDI F. Assessment of thiopurine methyltransferase activity in patients prescribed azathioprine or other thiopurine-based drugs. Evid Rep Technol Assess (Full Rep) [online] 2010 Dec:1-282 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/23126559
  4. CARA CJ, PENA AS, SANS M, RODRIGO L, GUERRERO-ESTEO M, HINOJOSA J, GARCíA-PAREDES J, GUIJARRO LG. Reviewing the mechanism of action of thiopurine drugs: towards a new paradigm in clinical practice. Med Sci Monit [online] 2004 Nov, 10(11):RA247-54 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/15507865
  5. CARTER D, ELIAKIM R. Current role of endoscopy in inflammatory bowel disease diagnosis and management. Curr Opin Gastroenterol [online] 2014 Jul, 30(4):370-7 [viewed 09 July 2014] Available from: doi:10.1097/MOG.0000000000000074
  6. CHAMBERS TJ, MORSON BC. The granuloma in Crohn's disease. Gut [online] 1979 Apr, 20(4):269-274 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1412385
  7. D'HAENS G. Risks and benefits of biologic therapy for inflammatory bowel diseases Gut [online] 2007 May, 56(5):725-732 [viewed 09 July 2014] Available from: doi:10.1136/gut.2006.103564
  8. HANAUER SB. Crohn's disease: step up or top down therapy. Best Pract Res Clin Gastroenterol [online] 2003 Feb, 17(1):131-7 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/12617888
  9. JACKSON PG, RAIJI MT. Evaluation and management of intestinal obstruction. Am Fam Physician [online] 2011 Jan 15, 83(2):159-65 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/21243991 14. HAYANGA AJ, BASS-WILKINS K, BULKLEY GB. Current management of small-bowel obstruction. Adv Surg [online] 2005:1-33 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/16250544
  10. JACQZ-AIGRAIN E, BESSA E, MEDARD Y, MIRCHEVA Y, VILMER E. Thiopurine methyltransferase activity in a French population: h.p.l.c. assay conditions and effects of drugs and inhibitors. Br J Clin Pharmacol [online] 1994 Jul, 38(1):1-8 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1364830
  11. LEWIS BS. Expanding role of capsule endoscopy in inflammatory bowel disease. World J Gastroenterol [online] 2008 Jul 14, 14(26):4137-41 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/18636657
  12. LIN MV, BLONSKI W, LICHTENSTEIN GR. What is the optimal therapy for Crohn's disease: step-up or top-down? Expert Rev Gastroenterol Hepatol [online] 2010 Apr, 4(2):167-80 [viewed 09 July 2014] Available from: doi:10.1586/egh.10.4
  13. MAYBERRY JF, LOBO A, FORD AC, THOMAS A. NICE clinical guideline (CG152): the management of Crohn's disease in adults, children and young people. Aliment Pharmacol Ther [online] 2013 Jan, 37(2):195-203 [viewed 09 July 2014] Available from: doi:10.1111/apt.12102
  14. MORSON BC. Pathology of Crohn's disease. Ann R Coll Surg Engl [online] 1990 May, 72(3):150-1 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/2192670
  15. SANDBORN WJ, FAUBION WA. Biologics in inflammatory bowel disease: how much progress have we made? Gut [online] 2004 Sep, 53(9):1366-73 [viewed 09 July 2014] Available from: doi:10.1136/gut.2003.025452
  16. SARUTA M, PAPADAKIS KA. Capsule endoscopy in the evaluation and management of inflammatory bowel disease: a future perspective. Expert Rev Mol Diagn [online] 2009 Jan, 9(1):31-6 [viewed 09 July 2014] Available from: doi:10.1586/14737159.9.1.31
  17. SMEDH K, OLAISON G, FRANZéN L, SJöDAHL R. Endoscopic and external bowel changes and histopathology in patients with Crohn's disease. Br J Surg [online] 1995 Feb, 82(2):191-4 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/7749686
  18. THOMAS GA, RHODES J, GREEN JT, RICHARDSON C. Role of smoking in inflammatory bowel disease: implications for therapy. Postgrad Med J [online] 2000 May, 76(895):273-9 [viewed 09 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/10775279
  19. ZHENG JJ, CU XQ, SHI XH, WANG YM, JIA LM, ZHOU XL, WANG FM. Colonoscopic and histologic features of colonic Crohn's disease in Chinese patients. J Dig Dis [online] 2007 Feb, 8(1):35-41 [viewed 09 July 2014] Available from: doi:10.1111/j.1443-9573.2007.00281.x