Pub Date : 2024-06-26DOI: 10.1136/flgastro-2024-102644
Maria Bishara, Rebecca Smith, Christopher Roberts, Yousra Djouider, Claire Bewshea, Rachel Nice, Nicholas A Kennedy, James R Goodhand, Tariq Ahmad
Objective Why about a quarter of patients with inflammatory bowel disease (IBD) suffer symptoms for more than a year before their diagnosis made is unclear. Low public awareness, embarrassment and the apprehension of invasive tests are cited. The anonymity of direct-to-public calprotectin testing may overcome these barriers. We sought to characterise what calprotectin testing is available directly to the public in the UK. Design/method We conducted a cross-sectional evaluation of the calprotectin assays available online in the UK. Collection kits were procured from eligible providers, and surplus stool tested to receive follow-up advice for known positive (>50–100 μg/g) and negative (<50 μg/g) stool samples. Results Half (54.5% (6/11)) of the available tests were home lateral flow tests and the remainder were laboratory-based ELISAs. The lateral flow tests were considerably cheaper than the laboratory-based tests (median (range) cost £14.20 (£7.85–21.00) vs £75.85 (£59–151), p<0.0001). The median turnaround time for the laboratory tests was 14 (range: 1–23) days. All but one provider used a positivity threshold of 50 μg/g. All tests included written and pictorial instructions with the testing kit. Contact with a physician was recommended for similar proportions of positive and negative calprotectin results (54.5% (6/11) vs 54.5% (6/11), p=1). Conclusion In the UK, the public can choose between inexpensive home-based lateral flow tests or send stool samples for gold-standard laboratory testing of calprotectin. The low cost and rapid turnaround times suggest that direct-to-public calprotectin testing could be promoted to try to reduce the time to IBD diagnosis. Data are available upon reasonable request. The data will be made available to investigators whose proposed use of the data has been approved by an independent review committee. Analyses will be restricted to the aims in the approved proposal. Proposals should be directed to Tariq Ahmad (tariq.ahmad1@nhs.net). To gain full access data, requestors will need to sign a data access agreement.
{"title":"Cross-sectional evaluation of online direct-to-public calprotectin testing","authors":"Maria Bishara, Rebecca Smith, Christopher Roberts, Yousra Djouider, Claire Bewshea, Rachel Nice, Nicholas A Kennedy, James R Goodhand, Tariq Ahmad","doi":"10.1136/flgastro-2024-102644","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102644","url":null,"abstract":"Objective Why about a quarter of patients with inflammatory bowel disease (IBD) suffer symptoms for more than a year before their diagnosis made is unclear. Low public awareness, embarrassment and the apprehension of invasive tests are cited. The anonymity of direct-to-public calprotectin testing may overcome these barriers. We sought to characterise what calprotectin testing is available directly to the public in the UK. Design/method We conducted a cross-sectional evaluation of the calprotectin assays available online in the UK. Collection kits were procured from eligible providers, and surplus stool tested to receive follow-up advice for known positive (>50–100 μg/g) and negative (<50 μg/g) stool samples. Results Half (54.5% (6/11)) of the available tests were home lateral flow tests and the remainder were laboratory-based ELISAs. The lateral flow tests were considerably cheaper than the laboratory-based tests (median (range) cost £14.20 (£7.85–21.00) vs £75.85 (£59–151), p<0.0001). The median turnaround time for the laboratory tests was 14 (range: 1–23) days. All but one provider used a positivity threshold of 50 μg/g. All tests included written and pictorial instructions with the testing kit. Contact with a physician was recommended for similar proportions of positive and negative calprotectin results (54.5% (6/11) vs 54.5% (6/11), p=1). Conclusion In the UK, the public can choose between inexpensive home-based lateral flow tests or send stool samples for gold-standard laboratory testing of calprotectin. The low cost and rapid turnaround times suggest that direct-to-public calprotectin testing could be promoted to try to reduce the time to IBD diagnosis. Data are available upon reasonable request. The data will be made available to investigators whose proposed use of the data has been approved by an independent review committee. Analyses will be restricted to the aims in the approved proposal. Proposals should be directed to Tariq Ahmad (tariq.ahmad1@nhs.net). To gain full access data, requestors will need to sign a data access agreement.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509620","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 : 2024-06-26DOI: 10.1136/flgastro-2024-102742
Jan Kubovy, Matthew Drake, Rajan N Patel
Cold snare polypectomy (CSP) is the treatment of choice for polyps less than 10 mm in size and sessile serrated lesions.1 We present a 66-year-old woman with Crohn’s colitis. Inflammatory bowel disease (IBD) was in complete clinico-endoscopic remission and colonoscopy was performed for dysplasia surveillance. …
{"title":"Delayed colonic perforation secondary to cold snare polypectomy","authors":"Jan Kubovy, Matthew Drake, Rajan N Patel","doi":"10.1136/flgastro-2024-102742","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102742","url":null,"abstract":"Cold snare polypectomy (CSP) is the treatment of choice for polyps less than 10 mm in size and sessile serrated lesions.1 We present a 66-year-old woman with Crohn’s colitis. Inflammatory bowel disease (IBD) was in complete clinico-endoscopic remission and colonoscopy was performed for dysplasia surveillance. …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141530114","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 : 2024-06-20DOI: 10.1136/flgastro-2024-102764
Heng Chi, Michael Staessens, Wim J Lammers, Pieter Jan F de Jonge
A 65-year-old woman with a medical history of cholecystectomy 20 years ago was referred to our hospital for recurrent colic pain in the upper abdomen with intermittent cholestatic liver enzyme abnormalities. She also experienced an episode of acute pancreatitis 2 weeks before the presentation. CT showed a dilated common bile duct with a hyperdense object of 10×4 mm in the distal common bile duct, suspecting …
{"title":"Uncommon cause of pancreatitis 20 years after cholecystectomy","authors":"Heng Chi, Michael Staessens, Wim J Lammers, Pieter Jan F de Jonge","doi":"10.1136/flgastro-2024-102764","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102764","url":null,"abstract":"A 65-year-old woman with a medical history of cholecystectomy 20 years ago was referred to our hospital for recurrent colic pain in the upper abdomen with intermittent cholestatic liver enzyme abnormalities. She also experienced an episode of acute pancreatitis 2 weeks before the presentation. CT showed a dilated common bile duct with a hyperdense object of 10×4 mm in the distal common bile duct, suspecting …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509521","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 : 2024-06-20DOI: 10.1136/flgastro-2024-102722
Benjamin Wipper, Hanna Blaney, Robert Giraneza, Prosper Ingabire, Vincent Dusabejambo, Udit Asija, Erik C von Rosenvinge
A Rwandan man in his 40s underwent an upper gastrointestinal endoscopy for evaluation of solid-food dysphagia. Of note, the patient also reported a long-standing history of anaemia, which was originally diagnosed in 2000. He had required four transfusions since and noted that he had previously been prescribed tot’hema syrup (a form of iron supplementation) but was no longer taking it. Laboratory tests around the time of endoscopy showed microcytic anaemia (haemoglobin 99.1 g/L, median corpuscular volume 61.84 fL) with an elevated reticulocyte count (91×109/L). Further labs showed low serum iron (28 mcg/dL) and ferritin (20.5 ng/mL). The patient denied ever experiencing melena or haematochezia. Endoscopic examination revealed a partially obstructing Schatzki’s ring as the explanation for his dysphagia and this was treated with balloon dilation. The endoscopy also revealed numerous blue-violet vascular-appearing …
{"title":"Rwandan man with a case of the blues","authors":"Benjamin Wipper, Hanna Blaney, Robert Giraneza, Prosper Ingabire, Vincent Dusabejambo, Udit Asija, Erik C von Rosenvinge","doi":"10.1136/flgastro-2024-102722","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102722","url":null,"abstract":"A Rwandan man in his 40s underwent an upper gastrointestinal endoscopy for evaluation of solid-food dysphagia. Of note, the patient also reported a long-standing history of anaemia, which was originally diagnosed in 2000. He had required four transfusions since and noted that he had previously been prescribed tot’hema syrup (a form of iron supplementation) but was no longer taking it. Laboratory tests around the time of endoscopy showed microcytic anaemia (haemoglobin 99.1 g/L, median corpuscular volume 61.84 fL) with an elevated reticulocyte count (91×109/L). Further labs showed low serum iron (28 mcg/dL) and ferritin (20.5 ng/mL). The patient denied ever experiencing melena or haematochezia. Endoscopic examination revealed a partially obstructing Schatzki’s ring as the explanation for his dysphagia and this was treated with balloon dilation. The endoscopy also revealed numerous blue-violet vascular-appearing …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509621","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 : 2024-06-18DOI: 10.1136/flgastro-2024-102765
Joaquin Fisac-Vazquez, Laura G-Pastrian, Marta de Uribe-Viloria, Maria Dolores Martin-Arranz
An asymptomatic 65-year-old woman was referred to our endoscopy unit after a screening positive faecal occult blood test. Colonoscopy revealed a pale, whitish colonic mucosa with yellowish specks (figure 1), congestive areas and foci of lymphoid follicular hyperplasia (figure 2). Sessile lesions (0-Is) with whitish speckling on their surface were also identified. Figure 1 Whitish colonic mucosa with yellowish specks. Figure 2 Congestive areas and foci of lymphoid follicular hyperplasia. On histology, a dense infiltrate of foamy macrophages was …
{"title":"Whitish colonic mucosa","authors":"Joaquin Fisac-Vazquez, Laura G-Pastrian, Marta de Uribe-Viloria, Maria Dolores Martin-Arranz","doi":"10.1136/flgastro-2024-102765","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102765","url":null,"abstract":"An asymptomatic 65-year-old woman was referred to our endoscopy unit after a screening positive faecal occult blood test. Colonoscopy revealed a pale, whitish colonic mucosa with yellowish specks (figure 1), congestive areas and foci of lymphoid follicular hyperplasia (figure 2). Sessile lesions (0-Is) with whitish speckling on their surface were also identified. Figure 1 Whitish colonic mucosa with yellowish specks. Figure 2 Congestive areas and foci of lymphoid follicular hyperplasia. On histology, a dense infiltrate of foamy macrophages was …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509524","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 : 2024-06-14DOI: 10.1136/flgastro-2024-102718
Jonathan Richard White, Saqib Ahmad, Fahad Ashraf, Stephen Foley, Said Din, R. Das, Nina Mary Charles, João Pinheiro, Altaf Palejwala, Pamela Wright, Manoharan Andiappan, Myriam Alexander, Burhan Uddin, D. Hoshen, David A Elphick, Tufail Qamar, Nivin Rezwan, Mohammad Viquaruddin Hamza, John Glover, R. Robinson, Veena Gopakumar, A. Sajjad, Muhammad Shahzad, Gordon Moran
To evaluate the effectiveness of ustekinumab in treating Crohn’s disease (CD) in a UK real-world setting.This was a multicentre, retrospective observational study of patients (aged ≥18 years) with CD or inflammatory bowel disease of unclassified type (IBDU) starting ustekinumab between 11 November 2016 and 1 August 2020 across eight English hospitals. The primary objective was to determine the proportion of patients achieving corticosteroid-free remission at week 52 for patients with CD/IBDU following initiation with ustekinumab. Corticosteroid-free remission was defined as achieving a clinical Harvey-Bradshaw Index (HBI) score of ≤4 and corticosteroid-free status.The analysis included 422 patients with CD/IBDU. Corticosteroid-free remission was 41% (68/166) at week 16, 41% (47/115) at week 30 and 48% (38/80) at week 52. Clinical remission was 51% (85/166) at week 16 and 50% (40/80) at week 52. Clinical response was 34% (43/125) at week 16 and 32% (17/53) at week 52. Objective remission was 40% (4/10) at week 16 and 70% (7/10) at week 52. Corticosteroid-free remission at week 52 was achieved in patients with previous exposure to 1–2 biologics and/or small oral molecules (56%; 35/63), those without surgical history (64%; 16/25), and those without penetrating disease (54%; 29/54). Patients who achieved clinical remission at week 16 were more likely to achieve corticosteroid-free remission at week 52 (70%; 14/20) versus those who did not (20%; 4/20). In total, 37 adverse events occurred in 21 patients.This multicentre study provides real-world experience of ustekinumab in patients with CD/IBDU in England.
{"title":"Real-world clinical effectiveness of ustekinumab in the treatment of Crohn’s disease in the East Midlands UK","authors":"Jonathan Richard White, Saqib Ahmad, Fahad Ashraf, Stephen Foley, Said Din, R. Das, Nina Mary Charles, João Pinheiro, Altaf Palejwala, Pamela Wright, Manoharan Andiappan, Myriam Alexander, Burhan Uddin, D. Hoshen, David A Elphick, Tufail Qamar, Nivin Rezwan, Mohammad Viquaruddin Hamza, John Glover, R. Robinson, Veena Gopakumar, A. Sajjad, Muhammad Shahzad, Gordon Moran","doi":"10.1136/flgastro-2024-102718","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102718","url":null,"abstract":"To evaluate the effectiveness of ustekinumab in treating Crohn’s disease (CD) in a UK real-world setting.This was a multicentre, retrospective observational study of patients (aged ≥18 years) with CD or inflammatory bowel disease of unclassified type (IBDU) starting ustekinumab between 11 November 2016 and 1 August 2020 across eight English hospitals. The primary objective was to determine the proportion of patients achieving corticosteroid-free remission at week 52 for patients with CD/IBDU following initiation with ustekinumab. Corticosteroid-free remission was defined as achieving a clinical Harvey-Bradshaw Index (HBI) score of ≤4 and corticosteroid-free status.The analysis included 422 patients with CD/IBDU. Corticosteroid-free remission was 41% (68/166) at week 16, 41% (47/115) at week 30 and 48% (38/80) at week 52. Clinical remission was 51% (85/166) at week 16 and 50% (40/80) at week 52. Clinical response was 34% (43/125) at week 16 and 32% (17/53) at week 52. Objective remission was 40% (4/10) at week 16 and 70% (7/10) at week 52. Corticosteroid-free remission at week 52 was achieved in patients with previous exposure to 1–2 biologics and/or small oral molecules (56%; 35/63), those without surgical history (64%; 16/25), and those without penetrating disease (54%; 29/54). Patients who achieved clinical remission at week 16 were more likely to achieve corticosteroid-free remission at week 52 (70%; 14/20) versus those who did not (20%; 4/20). In total, 37 adverse events occurred in 21 patients.This multicentre study provides real-world experience of ustekinumab in patients with CD/IBDU in England.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338757","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 : 2024-06-12DOI: 10.1136/flgastro-2024-102744
Jin Keng Stephen Lam, Lucy Rabuszko, C. Fitzpatrick, Deborah Williams, Daniel Richardson
The antimicrobial treatment options for patients with intestinal spirochaetosis (caused byBrachyspira pilosicoliandBrachyspira aalborgi) are not well defined. We aimed to systematically review the literature to explore antimicrobial treatment options to inform future clinical guidelines.We systematically searched three bibliographical databases (MEDLINE, EMBASE, SCOPUS and Web of Science) for manuscripts written in English up to January 2024. The primary author conducted an initial abstract screen and two authors conducted independent full-text reviews. We included manuscripts which included primary data for patients with intestinal spirochaetosis who had received antimicrobial treatment and had an outcome measured. Quality and risk of bias was assessed independently by two authors using the Joanna Briggs Institute critical appraisal tools. We used the nine-point synthesis method to synthesise narrative data.There were 58 manuscripts included in this review published between 1977 and 2023 (42 case reports, 12 case series, 3 cross-sectional studies, and 1 prospective cohort). In total, there were 270 individuals with intestinal spirochaetosis: 225 patients received oral metronidazole monotherapy, 1 intravenous metronidazole, 2 rectal metronidazole, 5 metronidazole as part of a dual/triple regimen, 17 doxycycline monotherapy, 5 doxycycline (or tetracycline) dual therapy with either a beta-lactam, or neomycin, 4 benzathine penicillin, 1 procaine penicillin/steroids and 3 other antimicrobials including clarithromycin and vancomycin. 230 (85%) of patients in this review had an adequate clinical and or histological response to treatment with a median follow-up period of 30 days (IQR 14–90). The combined treatment response to all metronidazole-based treatment was 195/233 (84%).Metronidazole, doxycycline and parenteral penicillin are the most frequently used antimicrobials for the treatment of human intestinal spirochaetosis and treatment response is generally good. More work is needed to understand the pathophysiology and treatment outcomes in patients with symptomatic intestinal spirochaetosis including the development of non-invasive diagnostic tools.
{"title":"Antimicrobial treatment for human intestinal spirochaetosis: a systematic review","authors":"Jin Keng Stephen Lam, Lucy Rabuszko, C. Fitzpatrick, Deborah Williams, Daniel Richardson","doi":"10.1136/flgastro-2024-102744","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102744","url":null,"abstract":"The antimicrobial treatment options for patients with intestinal spirochaetosis (caused byBrachyspira pilosicoliandBrachyspira aalborgi) are not well defined. We aimed to systematically review the literature to explore antimicrobial treatment options to inform future clinical guidelines.We systematically searched three bibliographical databases (MEDLINE, EMBASE, SCOPUS and Web of Science) for manuscripts written in English up to January 2024. The primary author conducted an initial abstract screen and two authors conducted independent full-text reviews. We included manuscripts which included primary data for patients with intestinal spirochaetosis who had received antimicrobial treatment and had an outcome measured. Quality and risk of bias was assessed independently by two authors using the Joanna Briggs Institute critical appraisal tools. We used the nine-point synthesis method to synthesise narrative data.There were 58 manuscripts included in this review published between 1977 and 2023 (42 case reports, 12 case series, 3 cross-sectional studies, and 1 prospective cohort). In total, there were 270 individuals with intestinal spirochaetosis: 225 patients received oral metronidazole monotherapy, 1 intravenous metronidazole, 2 rectal metronidazole, 5 metronidazole as part of a dual/triple regimen, 17 doxycycline monotherapy, 5 doxycycline (or tetracycline) dual therapy with either a beta-lactam, or neomycin, 4 benzathine penicillin, 1 procaine penicillin/steroids and 3 other antimicrobials including clarithromycin and vancomycin. 230 (85%) of patients in this review had an adequate clinical and or histological response to treatment with a median follow-up period of 30 days (IQR 14–90). The combined treatment response to all metronidazole-based treatment was 195/233 (84%).Metronidazole, doxycycline and parenteral penicillin are the most frequently used antimicrobials for the treatment of human intestinal spirochaetosis and treatment response is generally good. More work is needed to understand the pathophysiology and treatment outcomes in patients with symptomatic intestinal spirochaetosis including the development of non-invasive diagnostic tools.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354451","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 : 2024-06-11DOI: 10.1136/flgastro-2024-102714
Scott James Mcildowie, Antonia MD Churchhouse, Katie Robertson, Jonathan M Blackwell
Tacrolimus is a calcineurin inhibitor rarely associated with gastrointestinal injury and reported only a handful of times in the literature. We present a case report demonstrating late-onset colitis in a patient taking tacrolimus for years, with typical histological features, associated with delayed mucosal healing. We hope this highlights the potential variability in both presentation and resolution in cases of tacrolimus-induced colitis.
{"title":"Late-onset tacrolimus-induced colitis associated with delayed mucosal healing: a case report","authors":"Scott James Mcildowie, Antonia MD Churchhouse, Katie Robertson, Jonathan M Blackwell","doi":"10.1136/flgastro-2024-102714","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102714","url":null,"abstract":"Tacrolimus is a calcineurin inhibitor rarely associated with gastrointestinal injury and reported only a handful of times in the literature. We present a case report demonstrating late-onset colitis in a patient taking tacrolimus for years, with typical histological features, associated with delayed mucosal healing. We hope this highlights the potential variability in both presentation and resolution in cases of tacrolimus-induced colitis.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141357595","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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