Journal of gastroenterology, pancreatology & liver disorders最新文献

Background and aims: Definitive diagnosis of IBD requires endoscopic and pathologic confirmation. These tools are also used to classify disease activity. Our aim was to determine if the fractional exhaled nitric oxide (FeNO) could be utilized to screen for IBD and assess for disease activity.

Methods: We matched weighted IBD cases and controls from the 2009-2010 NHANES dataset. All subjects underwent measurement of FeNO using standardized techniques. We assessed for potential confounders for FeNO measurement including age, height, and asthma. For IBD subjects, we used the presence of diarrhea, fatigue, and weight loss as a proxy for IBD activity. Laboratory parameters examined to estimate disease activity included anemia (≤ 10 g/dl), iron deficiency (ferritin ≤ 20 ng/ml), hypoalbuminemia (≤ 3.2 g/dl), and CRP (≥ 1.1 mg/dl).

Results: The weighted sample represented 199,414,901 subjects. The weighted prevalence of IBD was 2,084,895 (1.0%). IBD subjects had nearly the same FeNO level as those without IBD (17.0 ± 16.2 vs. 16.7 ± 14.5 ppb). The odds of a FeNO > 25 ppb was half (OR=0.501; 95% CI 0.497-0.504) for subjects with IBD compared to those without IBD after controlling for confounders. The AUROC curve for FeNO was 0.47 (0.35-0.59). FeNO levels were not higher in patients with laboratory values suggestive of active disease. FeNO levels were higher in IBD patients with diarrhea, rectal urgency, and fatigue but were lower in those with unintentional weight loss.

Conclusion: Measurement of FeNO does not appear to be useful to screen for IBD or assess disease activity.

Objective: Over the last decade, a strong association has been found between smoking and chronic pancreatitis. Some studies suggest that smoking may be a more important cause of chronic pancreatitis than alcohol and the two are additive. The primary purpose of our study was to test the use of a questionnaire to assess patient's knowledge regarding the association of smoking with pancreatic disease.

Methods: The questionnaire was administered prospectively during a 9 month period in 2013 to patients referred to a pancreas clinic at the University of Alabama Birmingham. The primary purpose of the questionnaire was to investigate patient awareness regarding the association of smoking with pancreatic disease; however, it was also designed for assessing doctor-patient communication regarding smoking in general and pancreatic disease specifically and the patient's stage of change for quitting smoking.

Results: Eighteen patients (mean age 52 years; 85% male) were used for the analysis. The data analysis showed that 56% of patients were aware of the relationship between smoking and chronic pancreatitis and 72% were aware about alcohol and pancreatitis. Patients related that physicians were an important reference source for their knowledge regarding the causes of chronic pancreatitis, but only 39% stated that their physician had specifically mention the effect of smoking on the pancreas.

Conclusion: Elaborate studies involving greater number of study population, are necessary to better define measuring tools and to further assess patient's knowledge regarding the relationship between smoking and chronic pancreatitis. Additionally, efforts should be directed towards enhancing physician's knowledge on this established relationship and the importance of patient education as well.