Background Thiopurines are proven agents in the treatment of Crohn’s disease. While pancreatitis is recognised as an adverse event associated with therapy, the effect-size and morbidity of thiopurine-induced pancreatitis is not known. The aim of this systematic review and meta-analysis was to quantify the risk of pancreatitis with azathioprine and 6-mercaptopurine within Crohn’s disease. Methods We searched six electronic databases from inception to 29th October 2019. The primary outcomes measur...
The role of Mycobacterium avium subspecies paratuberculosis (MAP) in the pathogenesis of Crohn’s disease (CD) has been strongly debated for many years. MAP is the known aetiological agent of Johne’s disease, a chronic enteritis affecting livestock. At present, due to the paucity of high-quality data, anti-MAP therapy (AMT) is not featured in international guidelines as a treatment for CD. Although the much-quoted randomised trial of AMT did not show sustained benefits over placebo, questions hav...
Background/objective Colorectal cancer (CRC) screening is proven to reduce CRC-related mortality. Faecal immunochemical testing (FIT)-positive clients in the Irish National CRC Screening Programme underwent colonoscopy. Round 1 uptake was 40.2%. We sought to identify barriers to participation by assessing knowledge of CRC screening and examining attitudes towards FIT test and colonoscopy. Methods Questionnaires based on a modified Champion’s Health Belief Model were mailed to 3500 invitees: 1000...
A 67-year-old Caucasian man presented to our department with a 10-day history of painless jaundice and generalised pruritus. He reported no alcohol or drug intake, no history of travelling abroad and no significant personal or family medical history. Physical examination was normal except for excoriations. Laboratory studies revealed cholestasis with markedly increased conjugated bilirubin (466.9 µmol/L) and an alkaline phosphatase (AP) level of 445 IU/mL. Transaminase, gamma-glutamyl transferas...
#1Surinder Singh Rana(PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 27
#2Vipin Koushal(PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 3
Last. Rajesh Gupta(PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 11
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We read with interest the article by Mcleod et al 1 describing the use of a specially designed novel acrylic box (endoscopy box; EBOX) for performing endoscopic retrograde cholangiopancreatography (ERCP) as well as endoscopic ultrasound (EUS) in the current era of COVID-19 pandemic.1 We congratulate the authors for designing this enclosure that has potential of mitigating risk of transmission of infections via air droplets during endoscopy. Endoscopy can generate aerosols because of coughing or ...
Last. Deepak Joshi(University of Cambridge)H-Index: 12
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With improvements in the outcomes for cholestatic liver diseases that present in childhood, increasing numbers of patients will require ongoing care as adults. The recent advances in management options coupled with the fact that each adult physician will have a limited number of patients with these conditions means there is a need for those in adult services to develop expertise in these conditions that were historically the domain of paediatrics. This review provides an overview of the most com...
Last. Anssi Mustonen(UTU: University of Turku)H-Index: 6
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Background Inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) are chronic diseases associated with a high and continuous economic burden. The introduction of biologics has changed the distribution of costs over the past two decades, and there are no recent studies on direct costs in Finland. This study aimed to estimate the direct healthcare costs of these diseases in a tertiary-level clinic. Methods The data were collected during a 1-year period of patients with ...
Objective Patient ownership of disease is vital in rare diseases like primary biliary cholangitis (PBC). This survey of UK members of the PBC foundation aimed to assess patients’ perception of their disease management, focusing on key biomarkers and problematic symptoms. Design Registered PBC foundation members were surveyed on their experiences on their most recent clinic visit, covering the type of hospital and clinician and whether biochemical response and symptom burden were discussed, inclu...
Evidence is emerging that inflammatory bowel diseases (IBDs) are becoming increasingly prevalent in developing countries, altering the previously held view that these were diseases of the West. Within this is a substantial increase in the burden of this disease in India, a matter of great importance to the country itself as well as in furthering our understanding of the disease. There is comparatively less data on this, both from the epidemiological standpoint as well as on disease pathogenesis ...
Last. D S Sanders(University of Sheffield)H-Index: 4
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Aims The aim of the study was to assess the provision of dietetic services for coeliac disease (CD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Methods Hospitals within all National Health Service trusts in England were approached (n=209). A custom-designed web-based questionnaire was circulated via contact methods of email, post or telephone. Individuals/teams with knowledge of gastrointestinal (GI) dietetic services within their trust were invited to complete. Results...