Pub Date : 2022-11-22DOI: 10.33590/emjgastroenterol/10141377
T. Kugler
{"title":"Anxiety, Depression, and Quality of Life in Patients with Functional Dyspepsia: A Cross-Sectional Study","authors":"T. Kugler","doi":"10.33590/emjgastroenterol/10141377","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10141377","url":null,"abstract":"","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73550793","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 : 2022-11-22DOI: 10.33590/emjgastroenterol/10070852
I. Latras-Cortés, M. C. Cid Martínez, S. Diez Ruiz, V. Blázquez Ávila, I. González Puente, L. Alcoba Vega, R. González Núñez, A. Martín Izquierdo, S. Borrego Rivas, L. Vaquero Ayala, A. D. Domínguez Carbajo, D. López Cuesta, S. Vivas Alegre, F. Jorquera Plaza
{"title":"Clinical Effectiveness of Gluten Immunogenic Peptides During Follow-Up of Coeliac Disease","authors":"I. Latras-Cortés, M. C. Cid Martínez, S. Diez Ruiz, V. Blázquez Ávila, I. González Puente, L. Alcoba Vega, R. González Núñez, A. Martín Izquierdo, S. Borrego Rivas, L. Vaquero Ayala, A. D. Domínguez Carbajo, D. López Cuesta, S. Vivas Alegre, F. Jorquera Plaza","doi":"10.33590/emjgastroenterol/10070852","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10070852","url":null,"abstract":"","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90638513","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 : 2022-11-04DOI: 10.33590/emjgastroenterol/10106137
Nicola Humphry
The over-production of TNF-α can lead to chronic inflammation and organ damage in immune-mediated inflammatory diseases (IMID), such as rheumatoid arthritis (RA), axial spondyloarthritis, psoriasis, and inflammatory bowel disease (IBD). Anti-TNF therapy is generally considered to be an effective, well-tolerated treatment option for the management of chronic inflammation in these conditions. Over the past decade, patents for the original reference anti-TNF agents have expired, permitting the development of anti-TNF products that are biologically similar, termed ‘biosimilar’, to the original reference product. Differences in the approval process mean that biosimilars are often available to healthcare services at a considerably lower cost compared with the reference products, providing an opportunity to improve patient access to the benefits of anti-TNF therapy. However, despite the spreading use of biosimilars across healthcare services, some clinicians remain reluctant to prescribe them. The gradual accumulation of long-term data on the real-world use of biosimilars, and an improved understanding of the development and approval process for these products, may help to increase clinicians’ confidence to increase usage of biosimilars. This mini review summarises the current status of anti-TNF biosimilars in clinical practice, including the requirements for regulatory approval, real-word evidence for their equivalence to novel anti-TNFs, guidelines for their use, and challenges to their acceptance by both clinicians and patients.
{"title":"The Rise of Anti-TNF Biosimilars: Guidelines, Real-World Evidence, and Challenges to Acceptance","authors":"Nicola Humphry","doi":"10.33590/emjgastroenterol/10106137","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10106137","url":null,"abstract":"The over-production of TNF-α can lead to chronic inflammation and organ damage in immune-mediated inflammatory diseases (IMID), such as rheumatoid arthritis (RA), axial spondyloarthritis, psoriasis, and inflammatory bowel disease (IBD). Anti-TNF therapy is generally considered to be an effective, well-tolerated treatment option for the management of chronic inflammation in these conditions.\u0000Over the past decade, patents for the original reference anti-TNF agents have expired, permitting the development of anti-TNF products that are biologically similar, termed ‘biosimilar’, to the original reference product. Differences in the approval process mean that biosimilars are often available to healthcare services at a considerably lower cost compared with the reference products, providing an opportunity to improve patient access to the benefits of anti-TNF therapy.\u0000However, despite the spreading use of biosimilars across healthcare services, some clinicians remain reluctant to prescribe them. The gradual accumulation of long-term data on the real-world use of biosimilars, and an improved understanding of the development and approval process for these products, may help to increase clinicians’ confidence to increase usage of biosimilars.\u0000This mini review summarises the current status of anti-TNF biosimilars in clinical practice, including the requirements for regulatory approval, real-word evidence for their equivalence to novel anti-TNFs, guidelines for their use, and challenges to their acceptance by both clinicians and patients.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82289128","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 : 2022-09-25DOI: 10.33590/emjgastroenterol/22-00022
Melissa Kyriakos Saad, W. Dib, G. El Hachem, E. Saikaly
Retrorectal neoplasms is a rare, heterogeneous group of neoplasms developing in the retrorectal space. Its rarity makes its management a challenge to the unaware. Here, the authors present a case of 37-year-old female patient presenting with anal pain, diagnosed with retrorectal teratoma, which was managed surgically by posterior approach, the Kraske procedure.
{"title":"Retrorectal Teratoma: A Case Report","authors":"Melissa Kyriakos Saad, W. Dib, G. El Hachem, E. Saikaly","doi":"10.33590/emjgastroenterol/22-00022","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/22-00022","url":null,"abstract":"Retrorectal neoplasms is a rare, heterogeneous group of neoplasms developing in\u0000the retrorectal space. Its rarity makes its management a challenge to the unaware.\u0000Here, the authors present a case of 37-year-old female patient presenting with\u0000anal pain, diagnosed with retrorectal teratoma, which was managed surgically by\u0000posterior approach, the Kraske procedure.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88724457","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 : 2022-09-02DOI: 10.33590/emjgastroenterol/10075567
Nicola Humphry
The 2022 International Scientific Conference of Probiotics, Prebiotics, Gut Microbiota and Health® took place in Bratislava, Slovakia, from 27th–30th June. A common theme throughout the conference was that, although significant progress has been made, considerable work remains to be done in understanding how probiotics work, aligning definitions of microbiome-modifying agents, and communicating evidence-based recommendations to clinicians and consumers. There was also an overarching concern around the ease with which food supplements receive marketing approval compared to drugs, and where probiotics lie on this spectrum. Arthur Ouwehand, International Flavors & Fragrances, Inc. (IFF), Kantvik, Finland, presented updates to the 2022 International Life Sciences Institute (ILSI) Concise Monograph on probiotics, prebiotics, and the gut microbiota in human health. Hania Szajewska, Medical University of Warsaw, Poland, focused on clinical recommendations for the use of probiotics, suggesting ways to approach the differences between guidelines. Regulatory agencies now recognise probiotics as a new category of medicinal products termed ‘live biotherapeutic products’, and Sin-Hyeog Im, Pohang University of Sciences and Biotechnology, Pohang, South Korea, and ImmunoBiome Inc., Pohang, South Korea, discussed the importance of characterising a new probiotic and understanding its mechanism of action to fulfil regulatory requirements. Benjamin Jensen, Department of Biomedical Sciences, University of Copenhagen, Denmark, stressed the importance of considering the gastrointestinal target and the diet and condition of the patient when developing probiotics, and Martin Haranta, PerBiotiX – Microbiome Solutions, Kysucké Nové Mesto, Slovakia, expanded on this subject, emphasising the promise that personalised and targeted modulation of gut microbiota holds for chronic disease. Sean Gibbons, Institute for Systems Biology, Seattle, Washington, USA, and University of Washington, Seattle, USA, described some of the current and emerging tools to support research into microbiota-based therapies and how these could be harnessed to achieve personalised medicine. Finally, links between the gut microbiome and the liver and central nervous system (CNS), and potential therapies to exploit these connections were illustrated by Peter Konturek, Thuringia-Clinic Saalfeld, Germany, and Gerard Clarke, University College Cork, Ireland.
{"title":"Updates in the Role of Pre- and Probiotics in Health and Disease: Where Do We Stand Today?","authors":"Nicola Humphry","doi":"10.33590/emjgastroenterol/10075567","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10075567","url":null,"abstract":"The 2022 International Scientific Conference of Probiotics, Prebiotics, Gut Microbiota and Health® took place in Bratislava, Slovakia, from 27th–30th June. A common theme throughout the conference was that, although significant progress has been made, considerable work remains to be done in understanding how probiotics work, aligning definitions of microbiome-modifying agents, and communicating evidence-based recommendations to clinicians and consumers. There was also an overarching concern around the ease with which food supplements receive marketing approval compared to drugs, and where probiotics lie on this spectrum.\u0000\u0000Arthur Ouwehand, International Flavors & Fragrances, Inc. (IFF), Kantvik, Finland, presented updates to the 2022 International Life Sciences Institute (ILSI) Concise Monograph on probiotics, prebiotics, and the gut microbiota in human health. Hania Szajewska, Medical University of Warsaw, Poland, focused on clinical recommendations for the use of probiotics, suggesting ways to approach the differences between guidelines. Regulatory agencies now recognise probiotics as a new category of medicinal products termed ‘live biotherapeutic products’, and Sin-Hyeog Im, Pohang University of Sciences and Biotechnology, Pohang, South Korea, and ImmunoBiome Inc., Pohang, South Korea, discussed the importance of characterising a new probiotic and understanding its mechanism of action to fulfil regulatory requirements. Benjamin Jensen, Department of Biomedical Sciences, University of Copenhagen, Denmark, stressed the importance of considering the gastrointestinal target and the diet and condition of the patient when developing probiotics, and Martin Haranta, PerBiotiX – Microbiome Solutions, Kysucké Nové Mesto, Slovakia, expanded on this subject, emphasising the promise that personalised and targeted modulation of gut microbiota holds for chronic disease. Sean Gibbons, Institute for Systems Biology, Seattle, Washington, USA, and University of Washington, Seattle, USA, described some of the current and emerging tools to support research into microbiota-based therapies and how these could be harnessed to achieve personalised medicine. Finally, links between the gut microbiome and the liver and central nervous system (CNS), and potential therapies to exploit these connections were illustrated by Peter Konturek, Thuringia-Clinic Saalfeld, Germany, and Gerard Clarke, University College Cork, Ireland.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74488718","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 : 2022-08-22DOI: 10.33590/emjgastroenterol/21-00227
Abhijith Bale, Irshad Ali, Ajay Bale, V. Ramappa, U. Jalihal
Self-expanding metal stents (SEMS) have been established beyond doubt as an effective tool in the palliative management of malignant gastrointestinal tract strictures. The advent of fully covered retrievable SEMS has allowed its use in benign oesophageal strictures and gastric outlet obstruction, which are traditionally treated with balloon or bougie dilation. Although balloon and bougie dilations are effective, strictures may be refractory, requiring repeated sessions of dilation or complex surgeries. Endoluminal stenting spares the patient from complex surgical procedures and their associated complications. Here, the authors present four cases wherein fully covered SEMS were used as an effective therapy for the restoration of the gastrointestinal lumen in non-malignant conditions.
{"title":"Innovative Upper Gastrointestinal Stenting: Reboring the Blocked Path","authors":"Abhijith Bale, Irshad Ali, Ajay Bale, V. Ramappa, U. Jalihal","doi":"10.33590/emjgastroenterol/21-00227","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/21-00227","url":null,"abstract":"Self-expanding metal stents (SEMS) have been established beyond doubt as an effective tool in the palliative management of malignant gastrointestinal tract strictures. The advent of fully covered retrievable SEMS has allowed its use in benign oesophageal strictures and gastric outlet obstruction, which are traditionally treated with balloon or bougie dilation. Although balloon and bougie dilations are effective, strictures may be refractory, requiring repeated sessions of dilation or complex surgeries. Endoluminal stenting spares the patient from complex surgical procedures and their associated complications. Here, the authors present four cases wherein fully covered SEMS were used as an effective therapy for the restoration of the gastrointestinal lumen in non-malignant conditions.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84021665","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 : 2022-08-19DOI: 10.33590/emjgastroenterol/10102824
Nicola Humphry
TNF-α is produced in high concentrations in chronic inflammatory disease, resulting in excessive inflammation which eventually leads to organ damage. The advent of anti-TNF therapy in clinical practice 20 years ago represented a significant change in the management of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis (RA), axial spondylarthritis (SpA), psoriasis, and inflammatory bowel disease (IBD). There are five anti-TNFs approved for use in IMIDs: infliximab, adalimumab, golimumab, etanercept, and certolizumab pegol. The structural and pharmacological differences between these agents mean that they can have differential efficacy across IMIDs, and therefore the indications for which they are approved vary. This mini-review aims to summarise the current understanding of anti-TNF efficacy in those IMIDs for which they are approved, focussing on data from meta-analyses of randomised clinical trials (RCTs), and real-world studies.
{"title":"The Efficacy of Anti-TNFs in Immune-Mediated Disease","authors":"Nicola Humphry","doi":"10.33590/emjgastroenterol/10102824","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10102824","url":null,"abstract":"TNF-α is produced in high concentrations in chronic inflammatory disease, resulting in excessive inflammation which eventually leads to organ damage. The advent of anti-TNF therapy in clinical practice 20 years ago represented a significant change in the management of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis (RA), axial spondylarthritis (SpA), psoriasis, and inflammatory bowel disease (IBD).\u0000\u0000There are five anti-TNFs approved for use in IMIDs: infliximab, adalimumab, golimumab, etanercept, and certolizumab pegol. The structural and pharmacological differences between these agents mean that they can have differential efficacy across IMIDs, and therefore the indications for which they are approved vary. This mini-review aims to summarise the current understanding of anti-TNF efficacy in those IMIDs for which they are approved, focussing on data from meta-analyses of randomised clinical trials (RCTs), and real-world studies.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83637077","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 : 2022-07-01DOI: 10.33590/emjgastroenterol/22c8071
Nicola Humphry
In chronic inflammatory disease, TNF-α is produced in high concentrations, leading to excessive inflammation and eventually organ damage. The advent of anti-TNF therapy in clinical practice 20 years ago represented a significant change in the management of immune-mediated inflammatory diseases (IMID). Common concerns regarding the safety profile of anti-TNFs include increased infection rates, associations with cancer, and safety in pregnancy. Regulatory authority guidelines to reduce risk include vaccination and screening for latent infections prior to treatment initiation. In general, pharmacovigilance and tailored medicine are the best methods for optimising anti-TNF therapy while minimising side effects. This mini review aims to summarise the current understanding of the safety profile of this drug class.
{"title":"Safety of Anti-TNFs in Patients with Immune-Mediated Disease","authors":"Nicola Humphry","doi":"10.33590/emjgastroenterol/22c8071","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/22c8071","url":null,"abstract":"In chronic inflammatory disease, TNF-α is produced in high concentrations, leading to excessive inflammation and eventually organ damage. The advent of anti-TNF therapy in clinical practice 20 years ago represented a significant change in the management of immune-mediated inflammatory diseases (IMID). Common concerns regarding the safety profile of anti-TNFs include increased infection rates, associations with cancer, and safety in pregnancy. Regulatory authority guidelines to reduce risk include vaccination and screening for latent infections prior to treatment initiation. In general, pharmacovigilance and tailored medicine are the best methods for optimising anti-TNF therapy while minimising side effects. This mini review aims to summarise the current understanding of the safety profile of this drug class.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86186016","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 : 2022-04-17DOI: 10.33590/emjgastroenterol/21-00140
Melissa Kyriakos Saad, E. Triantafyllou, Domenico Papaleo, V. Cahn, E. Saikaly, Yann Martin Proske
Medullary carcinoma of the pancreas is an extremely rare malignant tumour. To the best of the authors’ knowledge, only 26 cases have been reported in the medical literature. A case of medullary carcinoma of the pancreas treated surgically by distal splenopancreatectomy is reported here.
{"title":"Medullary Carcinoma of the Pancreas: Report of a Rare Pancreatic Malignancy and Review of Literature","authors":"Melissa Kyriakos Saad, E. Triantafyllou, Domenico Papaleo, V. Cahn, E. Saikaly, Yann Martin Proske","doi":"10.33590/emjgastroenterol/21-00140","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/21-00140","url":null,"abstract":"Medullary carcinoma of the pancreas is an extremely rare malignant tumour. To the best of the authors’ knowledge, only 26 cases have been reported in the medical literature. A case of medullary carcinoma of the pancreas treated surgically by distal splenopancreatectomy is reported here.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78064366","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 : 2022-03-21DOI: 10.33590/emjgastroenterol/21-00104
P. Pal, Joyce Wing Yan Mak, S. Ng, R. Banerjee
The COVID-19 pandemic has overwhelmed the already limited healthcare systems of low resource Asian countries. It has had a profound impact on inflammatory bowel disease (IBD) patient care in this region, where the disease is emerging. Fear of increased risk of COVID-19 due to disease or drugs, lack of access to medications, laboratory testing, endoscopy, surgery, infusion centres, and even remote medical consultation have made the lives of patients with IBD in this region more difficult than before. Similarly, physicians faced challenges due to limited testing facilities and therapeutic armamentarium for IBD management in the face of the COVID-19 pandemic. There was also the fear of potential spread of COVID-19 during colonoscopy or physical consultation, with the shortage of protective equipment, and unfamiliarity with teleconsultation and the remote monitoring of IBD. Most of the healthcare systems in these countries faced similar challenges in disease containment and management due to overwhelmed healthcare facilities in the face of crisis, inadequate vaccination drive in highly populous regions, and the unequal distribution of healthcare facilities centred in urban areas. COVID-19-specific safety norms, proper psychological support, and IBD-focused COVID-19 information can help alleviate patient concerns. Widespread adaptation of telemedicine, being up to date with current evidence, and performing endoscopy in high-priority cases, with precautions, can help physicians treat patients with IBD optimally. Additionally, the restructuring of the public health system, widespread vaccine rollout, and, ultimately, containment of the pandemic, can improve healthcare outcomes of patients with IBD in low resource countries.
{"title":"Implications of the COVID-19 Pandemic on the Management of Inflammatory Bowel Disease in the Low Resource Countries of Asia","authors":"P. Pal, Joyce Wing Yan Mak, S. Ng, R. Banerjee","doi":"10.33590/emjgastroenterol/21-00104","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/21-00104","url":null,"abstract":"The COVID-19 pandemic has overwhelmed the already limited healthcare systems of low resource Asian countries. It has had a profound impact on inflammatory bowel disease (IBD) patient care in this region, where the disease is emerging. Fear of increased risk of COVID-19 due to disease or drugs, lack of access to medications, laboratory testing, endoscopy, surgery, infusion centres, and even remote medical consultation have made the lives of patients with IBD in this region more difficult than before. Similarly, physicians faced challenges due to limited testing facilities and therapeutic armamentarium for IBD management in the face of the COVID-19 pandemic. There was also the fear of potential spread of COVID-19 during colonoscopy or physical consultation, with the shortage of protective equipment, and unfamiliarity with teleconsultation and the remote monitoring of IBD. Most of the healthcare systems in these countries faced similar challenges in disease containment and management due to overwhelmed healthcare facilities in the face of crisis, inadequate vaccination drive in highly populous regions, and the unequal distribution of healthcare facilities centred in urban areas. COVID-19-specific safety norms, proper psychological support, and IBD-focused COVID-19 information can help alleviate patient concerns. Widespread adaptation of telemedicine, being up to date with current evidence, and performing endoscopy in high-priority cases, with precautions, can help physicians treat patients with IBD optimally. Additionally, the restructuring of the public health system, widespread vaccine rollout, and, ultimately, containment of the pandemic, can improve healthcare outcomes of patients with IBD in low resource countries.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81522613","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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