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Probiotics in arthralgia and spondyloarthropathies in patients with inflammatory bowel disease: Prospective randomized trials are necessary
Karimi,O.; Pe?a,A. S.;
Revista Espa?ola de Enfermedades Digestivas , 2005, DOI: 10.4321/S1130-01082005000800005
Abstract: arthralgias and spondyloarthropathies of the peripheral and axial joints are common in inflammatory bowel disease. evidence for a strong association between these clinical manifestations and diseases of the joints has been provided by several clinical and epidemiological studies. immunological studies have shown the presence of shared inflammatory cells both in the gut and the synovium in spondyloarthropathies. genetic factors play a crucial role in the pathogenesis of spondyloarthropathies and inflammatory bowel disease. the role of the ubiquitous bacterial flora and pathogenic microorganisms present in the intestinal lumen may induce these joint diseases in patients with inflammatory bowel disease. in this review we will focus on the pathogenesis of spondyloarthropathies and arthralgia in patients suffering from inflammatory bowel disease. based on preliminary clinical observations in patients with arthralgia and ibd, we put forward the hypothesis that probiotics may be helpful in the management of common extraintestinal manifestations such as arthralgia in patients with ulcerative colitis and crohn's disease.
Probiotics in arthralgia and spondyloarthropathies in patients with inflammatory bowel disease: Prospective randomized trials are necessary  [cached]
O. Karimi,A. S. Pe?a
Revista Espa?ola de Enfermedades Digestivas , 2005,
Abstract: Arthralgias and spondyloarthropathies of the peripheral and axial joints are common in inflammatory bowel disease. Evidence for a strong association between these clinical manifestations and diseases of the joints has been provided by several clinical and epidemiological studies. Immunological studies have shown the presence of shared inflammatory cells both in the gut and the synovium in spondyloarthropathies. Genetic factors play a crucial role in the pathogenesis of spondyloarthropathies and inflammatory bowel disease. The role of the ubiquitous bacterial flora and pathogenic microorganisms present in the intestinal lumen may induce these joint diseases in patients with inflammatory bowel disease. In this review we will focus on the pathogenesis of spondyloarthropathies and arthralgia in patients suffering from inflammatory bowel disease. Based on preliminary clinical observations in patients with arthralgia and IBD, we put forward the hypothesis that probiotics may be helpful in the management of common extraintestinal manifestations such as arthralgia in patients with ulcerative colitis and Crohn's disease.
Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease  [cached]
Carlo Salvarani, Walter Fries
World Journal of Gastroenterology , 2009,
Abstract: Inflammation of axial and/or peripheral joints is one of the most frequent extra-intestinal manifestations complicating the clinical course and therapeutic approach in inflammatory bowel diseases (IBD). The frequency of these complications seems to be similar for both diseases, Crohn’s disease and ulcerative colitis. Arthritis associated with IBD belongs to the category of spondyloarthropathies. Axial involvement ranges from isolated inflammatory back pain to ankylosing spondylitis, whereas peripheral arthritis is noted in pauciarticular and in polyarticular disease. Asymptomatic radiological involvement of the sacroiliac joints is reported to occur in up to 50% of patients. Other musculoskeletal manifestations such as buttock pain, dactylitis, calcaneal enthesitis, and thoracic pain are frequently underdiagnosed and, consequently, are not treated appropriately. Several diagnostic approaches and criteria have been proposed over the past 40 years in an attempt to correctly classify and diagnose such manifestations. The correct recognition of spondylarthropathies needs an integrated multidisciplinary approach in order to identify common therapeutic strategies, especially in the era of the new biologic therapies.
Gastrointestinal lesions associated with spondyloarthropathies  [cached]
Ambrogio Orlando, Sara Renna, Giovanni Perricone and Mario Cottone
World Journal of Gastroenterology , 2009,
Abstract: Subclinical gut inflammation has been described in up to two-thirds of patients with spondyloarthropathies (SpA). Arthritis represents an extra-intestinal manifestation of several gastrointestinal diseases, including inflammatory bowel disease (IBD), Whipple’s disease, Behcet’s disease, celiac disease, intestinal bypass surgery, parasitic infections of the gut and pseudomembranous colitis. Moreover about two-thirds of nonsteroidal anti-inflammatory drug users demonstrate intestinal inflammation. Arthritis may manifest as a peripheral or axial arthritis. The spondyloarthropathy family consists of the following entities: ankylosing spondylitis, undifferentiated spondyloarthritis, reactive arthritis, psoriatic arthritis, spondyloarthritis associated with IBD, juvenile onset spondyloarthritis. This topic reviews the major gastrointestinal manifestations that can occur in patients with SpA and in nonsteroidal anti-inflammatory drugs users.
Factors Associated with Low Intake of Dietary Fiber in Inflammatory Bowel Disease Patients  [PDF]
Vanessa Rosa Brito Oliveira, Raquel Rocha, Mirella Brasil Lopes, Fernanda Gomes Coqueiro, Naiade Silveira Almeida, Sandra Santos Valois, Genoile Oliveira Santana
Health (Health) , 2014, DOI: 10.4236/health.2014.611159
Abstract: Inflammatory bowel disease patients reduce their intake of foods rich in dietary fibers in an attempt to prevent recurrence of the disease, predisposing these patients to nutritional losses. The aim of this study was to evaluate the intake of dietary fiber and associated factors in a group of patients with inflammatory bowel disease. This was a cross-sectional study with 61 inflammatory bowel disease patients, and all participants were outpatients in Salvador, Bahia. Patients completed a semi-structured questionnaire that included questions about demographics, socioeconomic status and anthropometric and clinical information and a food frequency questionnaire to assess the intake of dietary fiber. The mean intake of dietary fiber was 28.2 ± 14.8 g/day for inflammatory bowel disease patients, 27.9 ± 10.1 g/day for ulcerative colitis (UC) patients and 28.9 ± 21.1 g/days for those with Crohn’s disease (CD) (p > 0.05). Most inflammatory bowel disease patients (52.5%) had intake below that recommended for dietary fiber. Inadequate consumption was present in 56.3% of CD patients and 43.8% of those with UC (p = 0.28). Men had lower fiber intake than women (p = 0.04). No significant associations between fiber intake and disease activity, location, presence of complications, gastrointestinal complaints, and nutrition counseling were found (p > 0.05). The low intake of dietary fiber was present in most patients, and the greatest inadequacy was found in males. Insufficient intake of dietary fiber appears to be linked to demographic features and not necessarily clinical characteristics relevant to inflammatory bowel disease.
Factors associated with disease evolution in Greek patients with inflammatory bowel disease
Constantinos Chatzicostas, Maria Roussomoustakaki, Spiros Potamianos, Gregorios Paspatis, Ioannis Mouzas, John Romanos, Helen Mavrogeni, Elias Kouroumalis
BMC Gastroenterology , 2006, DOI: 10.1186/1471-230x-6-21
Abstract: 116 Crohn's disease and 256 ulcerative colitis patients were followed-up for at least 5 years after diagnosis. Crohn's disease patients were classified according to the Vienna criteria. Data were analysed actuarially.B1 phenotype accounted for 68.9% of Crohn's disease patients at diagnosis. The cumulative probability of change in disease behaviour in B1 patients was 43.6% at 10 years after diagnosis. Active smoking (Hazard Ratio: 3.01) and non-colonic disease (non-L2) (Hazard Ratio: 3.01) were associated with behavioural change in B1 patients. Proctitis and left-sided colitis accounted for 24.2%, and 48.4% of ulcerative colitis patients at diagnosis. The 10 year cumulative probability of proximal disease extension in patients with proctitis and left-sided colitis was 36.8%, and 17.1%, respectively (p: 0.003). Among proctitis patients, proximal extension was more common in non-smokers (Hazard Ratio: 4.39).Classification of Crohn's disease patients in B1 phenotype should be considered as temporary. Smoking and non-colonic disease are risk factors for behavioural change in B1 Crohn's disease patients. Proximal extension is more common in ulcerative colitis patients with proctitis than in those with left-sided colitis. Among proctitis patients, proximal extension is more common in non-smokers.Inflammatory bowel diseases (IBD) are chronic heterogeneous disorders with unpredictable clinical course. Studies on Crohn's disease (CD) behaviour have been hampered by the variability of classifications used and by their unsatisfactory degree of inter-rater agreement [1-4]. The Vienna classification of CD [5] has been proposed in an effort to stratify patients on the basis of widely accepted and reproducible criteria [6]. Although CD location, as defined by the Vienna classification is a relatively stable phenotype, its behaviour varies over time [7]. The majority of patients with B1 phenotype (i.e. non-stricturing non-penetrating disease) will develop over time a stricturing or
Eosinophil associated genes in the inflammatory bowel disease 4 region: Correlation to inflammatory bowel disease revealed  [cached]
Kristin Blom,Jenny Rubin,Jonas Halfvarson,Leif T?rkvist
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i44.6409
Abstract: AIM: To study the association between inflammatory bowel disease (IBD) and genetic variations in eosinophil protein X (EPX) and eosinophil cationic protein (ECP). METHODS: DNA was extracted from ethylene diamine tetraacetic acid blood of 587 patients with Crohn’s disease (CD), 592 with ulcerative colitis (UC) and 300 healthy subjects. The EPX405 (G > C, rs2013109), ECP434 (G > C, rs2073342) and ECP562 (G > C, rs2233860) gene polymorphisms were analysed, by the 5’-nuclease allelic discrimination assay. For determination of intracellular content of EPX and ECP in granulocytes, 39 blood samples was collected and extracted with a buffer containing cetyltrimethylammonium bromide. The intracellular content of EPX was analysed using an enzyme-linked immunosorbent assay. The intracellular content of ECP was analysed with the UniCAP system as described by the manufacturer. Statistical tests for calculations of results were χ2 test, Fisher’s exact test, ANOVA, Student-Newman-Keuls test, and Kaplan-Meier survival curve with Log-rank test for trend, the probability values of P < 0.05 were considered statistically significant. RESULTS: The genotype frequency for males with UC and with an age of disease onset of ≥ 45 years (n = 57) was for ECP434 and ECP562, GG = 37%, GC = 60%, CC = 4% and GG = 51%, GC = 49%, CC = 0% respectively. This was significantly different from the healthy subject’s genotype frequencies of ECP434 (GG = 57%, GC = 38%, CC = 5%; P = 0.010) and ECP562 (GG = 68%, GC = 29%,CC = 3%; P = 0.009). The genotype frequencies for females, with an age of disease onset of ≥ 45 years with CD (n = 62), was for the ECP434 and ECP562 genotypes GG = 37%, GC = 52%, CC = 11% and GG = 48%, GC = 47% and CC = 5% respectively. This was also statistically different from healthy controls for both ECP434 (P = 0.010) and ECP562 (P = 0.013). The intracellular protein concentration of EPX and ECP was calculated in μg/106 eosinophils and then correlated to the EPX 405 genotypes. The protein content of EPX was highest in the patients with the CC genotype of EPX405 (GG = 4.65, GC = 5.93, and CC = 6.57) and for ECP in the patients with the GG genotype of EPX405 (GG = 2.70, GC = 2.47 and CC = 1.90). ANOVA test demonstrated a difference in intracellular protein content for EPX (P = 0.009) and ECP (P = 0.022). The age of disease onset was linked to haplotypes of the EPX405, ECP434 and ECP562 genotypes. Kaplan Maier curve showed a difference between haplotype distributions for the females with CD (P = 0.003). The highest age of disease onset was seen in females with the EPX405CC, EC
The cytokines in inflammatory bowel disease
Beata Polińska,Joanna Matowicka-Karna,Halina Kemona
Post?py Higieny i Medycyny Do?wiadczalnej , 2009,
Abstract: Inflammatory bowel disease includes ulcerative colitis and Crohn’s disease. It is a group of chronic disorders of unknown etiology characterized by inflammation of the gastrointestinal tract. The etiopathogenesis of inflammatory bowel disease is multifactorial. Recent data show that the development of inflammatory bowel disease is associated with the interplay of genetic, bacterial, and environmental factors and dysregulation of the intestinal immune system. The latest research is focused on the key role of cytokines in inflammatory bowel disease. In patients with inflammatory bowel disease, a number of recruited monocytes and activated macrophages are the source of cytokines in the inflamed alimentary tract mucosa. The role of pro-inflammatory cytokines (IL-1α, IL-1β, IL-2, -6, -8, -12, -17, -23, TNF, IFN) in inflammatory bowel disease is associated with the initiation and progression of ulcerative colitis and Crohn’s disease. Anti-inflammatory cytokines (IL-4, -10, -13) also contribute to the pathogenesis of inflammatory bowel disease, decreasing the inflammatory response by down-regulating proinflammatory cytokine production.
Treatment of Inflammatory Bowel Disease Associated E. coli with Ciprofloxacin and E. coli Nissle in the Streptomycin-Treated Mouse Intestine  [PDF]
Andreas Munk Petersen,Susanne Schj?rring,Sarah Choi Gerstr?m,Karen Angeliki Krogfelt
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0022823
Abstract: E. coli belonging to the phylogenetic group B2 are linked to Inflammatory Bowel Disease (IBD). Studies have shown that antimicrobials have some effect in the treatment of IBD, and it has been demonstrated that E. coli Nissle has prophylactic abilities comparable to 5-aminosalicylic acid (5-ASA) therapy in ulcerative colitis. The objective of this study was to test if ciprofloxacin and/or E. coli Nissle could eradicate IBD associated E. coli in the streptomycin-treated mouse intestine.
Chronic fatigue is associated with increased disease-related worries and concerns in inflammatory bowel disease  [cached]
Lars-Petter Jelsness-J?rgensen,Tomm Bernklev,Magne Henriksen,Roald Torp
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i5.445
Abstract: AIM: To investigate the impact of chronic fatigue on disease-related worries in inflammatory bowel disease (IBD) and the potential multicolinearity between subjective questionnaires. METHODS: Patients in remission or with mild-to-moderate disease activity completed the fatigue questionnaire (FQ), the rating form of IBD patient concerns (RFIPC), the Short-Form 36 (SF-36), and IBD questionnaire (N-IBDQ). In addition, clinical and epidemiological data were obtained. RESULTS: In total, 140 patients were included; of which 92 were diagnosed with ulcerative colitis and 48 with Crohn’s disease. The mean age of patients with chronic fatigue was 44.2 years (SD = 15.8) and for non-fatigued patients was 44.7 years (SD = 16.0). Chronic fatigued patients had clinically significantly increased levels of disease-related worries, as measured by Cohen’s d effect size. Worries about having an ostomy bag, loss of bowel control, and energy levels were most prominent in both chronic fatigued and non-chronic fatigued IBD patients. Variance inflation factor (VIF) and tolerance indicated that there were no problematic multicolinearity among the FQ, RFIPC, SF-36 and N-IBDQ responses (VIF < 5 and tolerance > 2). CONCLUSION: Chronic fatigue is associated with increased levels of disease-related worries and concerns in IBD. Increased levels of worries were also associated with impaired health-related quality of life.
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