Pub Date : 2016-05-01DOI: 10.1097/MIB.0000000000000762
Badr Al-Bawardy, J. Fletcher, E. Rajan, S. Hansel
To the Editor: We read with interest the recent article published by Al-Bawardy et al. The authors presented a large cohort of 5593 cases undergoing capsule endoscopy (CE), of whom 0.3% retentions occurred and they concluded that small bowel anastomosis and obstruction may be radiologic predictors of capsule retention. We would like to commend the authors on reporting the large study and endeavoring to define radiologic findings predictive of retention. However, we believe that there are several limitations in this study to which we wish to add our consideration. First, the manufacturers of the CE were not presented in the article, as over the last decade, there were 5 types of CE, including Given Imaging (Yokneam, Israel), Olympus EndoCapsule (Olympus, Tokyo, Japan), OMOM pill (Jinshan, Chongqing, China), MiroCam (Seoul, Korea), and CapsoCam (Saratoga, CA), each of which may differ in dimension, field of view, image storing speed, and mode of data transmission. Second, in this study, computed tomography (CT) or computed tomography enterography (CTE) for patients with CE retention and for controls was compared, and CT or CTE was performed within 6 months before CE; however, the condition and patency of the small bowel may change during the period not more than 6 months, especially for those with Crohn’s disease. Third, as shown in Table 2 in their study, 2 cases were retained in the stomach of the 17 retentions, actually cases retained in the stomach can be checked with the tracking system of the CE. In our department, for cases retained in the stomach, gastroscope is used to help pushing the CE into the duodenum if the CE does not enter the duodenum within 2 hours. Finally, we do agree with the authors that careful review of surgical history and imaging before CE may help reduce capsule retention. Nevertheless, capsule retention can also occur even when the CT was normal. Conventional CT often missed the significant strictures and were poor predictors of capsule retention, CTE, and magnetic resonance enterography improving distention of small bowel may be more effective in predicting capsule retention. In summary, until now, no accurate methods can avoid capsule retention absolutely. We believe that previous radiologic evaluation before CE, such as CTE and magnetic resonance enterography, may help predict capsule retention. Further large prospective study is needed to confirm the accuracy of radiologic evaluation predictive of capsule retention.
{"title":"Reply to: Can Radiologic Evaluation Before Capsule Endoscopy Predict Capsule Retention?","authors":"Badr Al-Bawardy, J. Fletcher, E. Rajan, S. Hansel","doi":"10.1097/MIB.0000000000000762","DOIUrl":"https://doi.org/10.1097/MIB.0000000000000762","url":null,"abstract":"To the Editor: We read with interest the recent article published by Al-Bawardy et al. The authors presented a large cohort of 5593 cases undergoing capsule endoscopy (CE), of whom 0.3% retentions occurred and they concluded that small bowel anastomosis and obstruction may be radiologic predictors of capsule retention. We would like to commend the authors on reporting the large study and endeavoring to define radiologic findings predictive of retention. However, we believe that there are several limitations in this study to which we wish to add our consideration. First, the manufacturers of the CE were not presented in the article, as over the last decade, there were 5 types of CE, including Given Imaging (Yokneam, Israel), Olympus EndoCapsule (Olympus, Tokyo, Japan), OMOM pill (Jinshan, Chongqing, China), MiroCam (Seoul, Korea), and CapsoCam (Saratoga, CA), each of which may differ in dimension, field of view, image storing speed, and mode of data transmission. Second, in this study, computed tomography (CT) or computed tomography enterography (CTE) for patients with CE retention and for controls was compared, and CT or CTE was performed within 6 months before CE; however, the condition and patency of the small bowel may change during the period not more than 6 months, especially for those with Crohn’s disease. Third, as shown in Table 2 in their study, 2 cases were retained in the stomach of the 17 retentions, actually cases retained in the stomach can be checked with the tracking system of the CE. In our department, for cases retained in the stomach, gastroscope is used to help pushing the CE into the duodenum if the CE does not enter the duodenum within 2 hours. Finally, we do agree with the authors that careful review of surgical history and imaging before CE may help reduce capsule retention. Nevertheless, capsule retention can also occur even when the CT was normal. Conventional CT often missed the significant strictures and were poor predictors of capsule retention, CTE, and magnetic resonance enterography improving distention of small bowel may be more effective in predicting capsule retention. In summary, until now, no accurate methods can avoid capsule retention absolutely. We believe that previous radiologic evaluation before CE, such as CTE and magnetic resonance enterography, may help predict capsule retention. Further large prospective study is needed to confirm the accuracy of radiologic evaluation predictive of capsule retention.","PeriodicalId":339644,"journal":{"name":"Inflammatory Bowel Disease","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125665185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-01DOI: 10.1097/MIB.0000000000000682
Hester Eppinga, M. Peppelenbosch
{"title":"Worsening of Bowel Symptoms Through Diet in Patients With Inflammatory Bowel Disease.","authors":"Hester Eppinga, M. Peppelenbosch","doi":"10.1097/MIB.0000000000000682","DOIUrl":"https://doi.org/10.1097/MIB.0000000000000682","url":null,"abstract":"","PeriodicalId":339644,"journal":{"name":"Inflammatory Bowel Disease","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133307905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-01DOI: 10.1097/MIB.0000000000000672
A. Mikocka‐Walus, J. Andrews, P. Bampton
Despite a high burden of psychological comorbidity in inflammatory bowel disease (IBD) and recommendations that psychological care should be offered in IBD care,2 we have thus far been unable to show psychological treatment to be effective in this population.
{"title":"Cognitive Behavioral Therapy for IBD.","authors":"A. Mikocka‐Walus, J. Andrews, P. Bampton","doi":"10.1097/MIB.0000000000000672","DOIUrl":"https://doi.org/10.1097/MIB.0000000000000672","url":null,"abstract":"Despite a high burden of psychological comorbidity in inflammatory bowel disease (IBD) and recommendations that psychological care should be offered in IBD care,2 we have thus far been unable to show psychological treatment to be effective in this population.","PeriodicalId":339644,"journal":{"name":"Inflammatory Bowel Disease","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127987004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-01DOI: 10.1097/MIB.0000000000000683
Shishira S. Bharadwaj, Bo Shen
One-third of patients with Crohn's disease (CD) present as stricturing phenotype characterized by progressive luminal narrowing and obstructive symptoms. The diagnosis and management of these patients have been intriguing and challenging. Immunomodulators and biologics have been successfully used in treating inflammatory and fistulizing CD. There are issues of efficacy and safety of biological agents in treating strictures in CD. Rapid mucosal healing from potent biological agents may predispose patients to the development of new strictures or worsening of existing strictures. On the other hand, strictures constitute one-fifth of the reasons for surgery in patients with CD. Disease recurrence is common at or proximal to the anastomotic site with the majority of these patients developing new endoscopic lesions within 1 year of surgery. The progressive nature of the disease with repetitive cycle of inflammation and stricture formation results in repeated surgery, with a risk of small bowel syndrome. There is considerable quest for bowel conserving endoscopic and surgical strategies. Endoscopic balloon dilation and stricturoplasty have emerged as valid alternatives to resection. Endoscopic balloon dilation has been shown to be feasible, safe, and effective for the short primary or anastomotic strictures. However, repeated dilations are often needed, and long-term outcomes of endoscopic balloon dilation remain to be investigated. The introduction of stricturoplasty has added another dimension to bowel saving strategy. Although postoperative recurrence rate after stricturoplasty is comparable with surgical resection, there are concerns for increased risk of malignancy in preserved bowel. Laparoscopic surgery has widely been performed with similar outcomes to open approach with fewer complications, quicker recovery, better cosmesis, and lower cost. All of these issues should be considered by physicians involved in the management of patients with stricturing CD.
{"title":"Therapeutic Armamentarium for Stricturing Crohn's Disease: Medical Versus Endoscopic Versus Surgical Approaches.","authors":"Shishira S. Bharadwaj, Bo Shen","doi":"10.1097/MIB.0000000000000683","DOIUrl":"https://doi.org/10.1097/MIB.0000000000000683","url":null,"abstract":"One-third of patients with Crohn's disease (CD) present as stricturing phenotype characterized by progressive luminal narrowing and obstructive symptoms. The diagnosis and management of these patients have been intriguing and challenging. Immunomodulators and biologics have been successfully used in treating inflammatory and fistulizing CD. There are issues of efficacy and safety of biological agents in treating strictures in CD. Rapid mucosal healing from potent biological agents may predispose patients to the development of new strictures or worsening of existing strictures. On the other hand, strictures constitute one-fifth of the reasons for surgery in patients with CD. Disease recurrence is common at or proximal to the anastomotic site with the majority of these patients developing new endoscopic lesions within 1 year of surgery. The progressive nature of the disease with repetitive cycle of inflammation and stricture formation results in repeated surgery, with a risk of small bowel syndrome. There is considerable quest for bowel conserving endoscopic and surgical strategies. Endoscopic balloon dilation and stricturoplasty have emerged as valid alternatives to resection. Endoscopic balloon dilation has been shown to be feasible, safe, and effective for the short primary or anastomotic strictures. However, repeated dilations are often needed, and long-term outcomes of endoscopic balloon dilation remain to be investigated. The introduction of stricturoplasty has added another dimension to bowel saving strategy. Although postoperative recurrence rate after stricturoplasty is comparable with surgical resection, there are concerns for increased risk of malignancy in preserved bowel. Laparoscopic surgery has widely been performed with similar outcomes to open approach with fewer complications, quicker recovery, better cosmesis, and lower cost. All of these issues should be considered by physicians involved in the management of patients with stricturing CD.","PeriodicalId":339644,"journal":{"name":"Inflammatory Bowel Disease","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123677216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-01DOI: 10.1097/MIB.0000000000000645
E. Hiejima, H. Nakase, T. Heike
{"title":"Reply: To PMID 25946569.","authors":"E. Hiejima, H. Nakase, T. Heike","doi":"10.1097/MIB.0000000000000645","DOIUrl":"https://doi.org/10.1097/MIB.0000000000000645","url":null,"abstract":"","PeriodicalId":339644,"journal":{"name":"Inflammatory Bowel Disease","volume":" 47","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120937347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1097/MIB.0000000000000997
R. Coelho, H. Ribeiro, G. Maconi
The high frequency of intestinal strictures in patients with Crohn's disease and the different treatment approaches specific for each type of stenosis make the differentiation between fibrotic and inflammatory strictures crucial in management of the disease. However, there is no standardized approach to evaluate and discriminate intestinal strictures, and until now, there was no established cross-sectional imaging modality to detect fibrosis. New techniques, such as contrast-enhanced ultrasound and sonoelastography allow the assessment of vascularization and mechanical properties of stenotic bowel tissue, respectively. These techniques have shown great potential to characterize strictures in Crohn's disease. The aim of this review is to sum up the current knowledge on bowel ultrasound tools to discriminate inflammatory from fibrotic stenosis in Crohn's disease considering the most recent published studies in the field.
{"title":"Bowel Thickening in Crohn's Disease: Fibrosis or Inflammation? Diagnostic Ultrasound Imaging Tools.","authors":"R. Coelho, H. Ribeiro, G. Maconi","doi":"10.1097/MIB.0000000000000997","DOIUrl":"https://doi.org/10.1097/MIB.0000000000000997","url":null,"abstract":"The high frequency of intestinal strictures in patients with Crohn's disease and the different treatment approaches specific for each type of stenosis make the differentiation between fibrotic and inflammatory strictures crucial in management of the disease. However, there is no standardized approach to evaluate and discriminate intestinal strictures, and until now, there was no established cross-sectional imaging modality to detect fibrosis. New techniques, such as contrast-enhanced ultrasound and sonoelastography allow the assessment of vascularization and mechanical properties of stenotic bowel tissue, respectively. These techniques have shown great potential to characterize strictures in Crohn's disease. The aim of this review is to sum up the current knowledge on bowel ultrasound tools to discriminate inflammatory from fibrotic stenosis in Crohn's disease considering the most recent published studies in the field.","PeriodicalId":339644,"journal":{"name":"Inflammatory Bowel Disease","volume":"152 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131423838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1097/MIB.0000000000000665
M. Long, Kimberly N Weaver, M. Kappelman, H. Herfarth, Clare A. Pipkin
REFERENCES 1. Qin X. Food additives should not be ruled out as the possible causative factors of inflammatory bowel disease in Korea. Inflamm Bowel Dis. 2015; 22:E1. 2. Qin X. How to explain the dramatic increase around 2000 but recent leveling off of inflammatory bowel disease in Korea? Inflamm Bowel Dis. 2015;21: E16–E17. 3. Yang SK, Yun S, Kim JH, et al. Epidemiology of inflammatory bowel disease in the SongpaKangdong district, Seoul, Korea, 1986-2005: a KASID study? Inflamm Bowel Dis. 2008;14:542–549. 4. Kim HJ, Hann HJ, Hong SN, et al. Incidence and natural course of inflammatory bowel disease in Korea, 2006-2012: a nationwide population-based study. Inflamm Bowel Dis. 2015;21:623–630. 5. Kyungnam newspaper: return of saccharine. Available at: http://www.knnews.co.kr/news/articleView. php?idxno1⁄41119119&gubun1⁄4life. Accessed August 11, 2015. 6. Ahn HS. Increased incidence of inflammatory bowel disease in Korea may not be explained by food additives. Inflamm Bowel Dis. 2015;21:E17.
{"title":"Photosensitivity to Ultraviolet Light in Patients with Inflammatory Bowel Disease Newly Initiating Immunosuppressive Therapy.","authors":"M. Long, Kimberly N Weaver, M. Kappelman, H. Herfarth, Clare A. Pipkin","doi":"10.1097/MIB.0000000000000665","DOIUrl":"https://doi.org/10.1097/MIB.0000000000000665","url":null,"abstract":"REFERENCES 1. Qin X. Food additives should not be ruled out as the possible causative factors of inflammatory bowel disease in Korea. Inflamm Bowel Dis. 2015; 22:E1. 2. Qin X. How to explain the dramatic increase around 2000 but recent leveling off of inflammatory bowel disease in Korea? Inflamm Bowel Dis. 2015;21: E16–E17. 3. Yang SK, Yun S, Kim JH, et al. Epidemiology of inflammatory bowel disease in the SongpaKangdong district, Seoul, Korea, 1986-2005: a KASID study? Inflamm Bowel Dis. 2008;14:542–549. 4. Kim HJ, Hann HJ, Hong SN, et al. Incidence and natural course of inflammatory bowel disease in Korea, 2006-2012: a nationwide population-based study. Inflamm Bowel Dis. 2015;21:623–630. 5. Kyungnam newspaper: return of saccharine. Available at: http://www.knnews.co.kr/news/articleView. php?idxno1⁄41119119&gubun1⁄4life. Accessed August 11, 2015. 6. Ahn HS. Increased incidence of inflammatory bowel disease in Korea may not be explained by food additives. Inflamm Bowel Dis. 2015;21:E17.","PeriodicalId":339644,"journal":{"name":"Inflammatory Bowel Disease","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132812826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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