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Crohn Disease HELP
Based on 11,571 articles since 2008
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These are the 11571 published articles about Crohn Disease that originated from Worldwide during 2008-2017.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy. 2016

Nguyen, Geoffrey C / Seow, Cynthia H / Maxwell, Cynthia / Huang, Vivian / Leung, Yvette / Jones, Jennifer / Leontiadis, Grigorios I / Tse, Frances / Mahadevan, Uma / van der Woude, C Janneke / Anonymous1790853 / Anonymous1800853. ·Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: geoff.nguyen@utoronto.ca. · Departments of Medicine & Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. · Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada. · Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. · Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada. · Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. · Department of Medicine, McMaster University, Hamilton, Ontario, Canada. · Department of Medicine, University of California, San Francisco, San Francisco, California. · Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands. · ·Gastroenterology · Pubmed #26688268.

ABSTRACT: BACKGROUND & AIMS: The management of inflammatory bowel disease (IBD) poses a particular challenge during pregnancy because the health of both the mother and the fetus must be considered. METHODS: A systematic literature search identified studies on the management of IBD during pregnancy. The quality of evidence and strength of recommendations were rated using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. RESULTS: Consensus was reached on 29 of the 30 recommendations considered. Preconception counseling and access to specialist care are paramount in optimizing disease management. In general, women on 5-ASA, thiopurine, or anti-tumor necrosis factor (TNF) monotherapy for maintenance should continue therapy throughout pregnancy. Discontinuation of anti-TNF therapy or switching from combination therapy to monotherapy may be considered in very select low-risk patients. Women who have a mild to moderate disease flare while on optimized 5-ASA or thiopurine therapy should be managed with systemic corticosteroid or anti-TNF therapy, and those with a corticosteroid-resistant flare should start anti-TNF therapy. Endoscopy or urgent surgery should not be delayed during pregnancy if indicated. Decisions regarding cesarean delivery should be based on obstetric considerations and not the diagnosis of IBD alone, with the exception of women with active perianal Crohn's disease. With the exception of methotrexate, the use of medications for IBD should not influence the decision to breast-feed and vice versa. Live vaccinations are not recommended within the first 6 months of life in the offspring of women who were on anti-TNF therapy during pregnancy. CONCLUSIONS: Optimal management of IBD before and during pregnancy is essential to achieving favorable maternal and neonatal outcomes.

2 Guideline Guideline for wireless capsule endoscopy in children and adolescents: A consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases). 2015

Argüelles-Arias, Federico / Donat, Ester / Fernández-Urien, Ignacio / Alberca, Fernando / Argüelles-Martín, Federico / Martínez, María José / Molina, Manuel / Varea, Vicente / Herrerías-Gutiérrez, Juan Manuel / Ribes-Koninckx, Carmen. ·Digestivo, H. Universitarioa Virgen Macarena, España. · Pediatría, Hospital la Fe, Valencia, España. · Digestivo, Complejo Hospitalario de Navarra, España. · DIGESTIVO/ENDOSCOPIAS, Hospital Universitario Virgen de la Arrixaca. Murcia, España. · Pediatría, Hospital Universitario Virgen Macarena, España. · Pediatría, Hospital Niño Jesús, España. · Pediatría, Hospital La Paz, España. · Pediatría, Hospital San Joan de Deu, España. · Aparato Digestivo, Hospital Universitario Virgen Macarena, España. · Pediatría, Hospital la Fe, España. ·Rev Esp Enferm Dig · Pubmed #26671584.

ABSTRACT: INTRODUCTION: Capsule Endoscopy (CE) in children has limitations based mainly on age. The objective of this consensus was reviewing the scientific evidence. MATERIAL AND METHODS: Some experts from the Spanish Society of Gastroenterology (SEPD) and Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) were invited to answer different issues about CE in children. These sections were: a) Indications, contraindications and limitations; b) efficacy of CE in different clinical scenarios; c) CE performance; d) CE-related complications; e) Patency Capsule; and f) colon capsule endoscopy. They reviewed relevant questions on each topic. RESULTS: The main indication is Crohn's disease (CD). There is no contraindication for the age and in the event that the patient not to swallow it, it should be administered under deep sedation with endoscopy and specific device. The CE is useful in CD, for the management of OGIB in children and in Peutz-Jeghers syndrome (in this indication has the most effectiveness). The main complication is retention, which should be specially taken into account in cases of CD already diagnosed with malnutrition. A preparation regimen based on a low volume of polyethylene glycol (PEG) the day before plus simethicone on the same day is the best one in terms of cleanliness although does not improve the results of the CE procedure. CONCLUSIONS: CE is safe and useful in children. Indications are similar to those of adults, the main one is CD to establish both a diagnosis and disease extension. Moreover, only few limitations are detected in children.

3 Guideline Clinical Practice Guideline for the Surgical Management of Crohn's Disease. 2015

Strong, Scott / Steele, Scott R / Boutrous, Marylise / Bordineau, Liliana / Chun, Jonathan / Stewart, David B / Vogel, Jon / Rafferty, Janice F / Anonymous3570845. · ·Dis Colon Rectum · Pubmed #26445174.

ABSTRACT: -- No abstract --

4 Guideline Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. 2015

Pennazio, Marco / Spada, Cristiano / Eliakim, Rami / Keuchel, Martin / May, Andrea / Mulder, Chris J / Rondonotti, Emanuele / Adler, Samuel N / Albert, Joerg / Baltes, Peter / Barbaro, Federico / Cellier, Christophe / Charton, Jean Pierre / Delvaux, Michel / Despott, Edward J / Domagk, Dirk / Klein, Amir / McAlindon, Mark / Rosa, Bruno / Rowse, Georgina / Sanders, David S / Saurin, Jean Christophe / Sidhu, Reena / Dumonceau, Jean-Marc / Hassan, Cesare / Gralnek, Ian M. ·Division of Gastroenterology, San Giovanni Battista University Teaching Hospital, Turin, Italy. · Digestive Endoscopy Unit, Catholic University, Rome, Italy. · Department of Gastroenterology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University Tel-Hashomer, Israel. · Klinik für Innere Medizin, Bethesda Krankenhaus Bergedorf, Hamburg, Germany. · Department of Medicine II, Sana Klinikum, Offenbach, Germany. · Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands. · Gastroenterology Unit, Ospedale Valduce, Como, Italy. · Division of Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel. · Department of Medicine I, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany. · Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service d'Hépato-gastro-entérologie, Paris, France. · Medizinische Klinik, Evangelisches Krankenhaus, Düsseldorf, Germany. · Department of Hepato-Gastroenterology, Nouvel Hôpital Civil, University Hospital of Strasbourg, Strasbourg, France. · Royal Free Unit for Endoscopy and Centre for Gastroenterology, The Royal Free Hospital and University College London, London, UK. · Department of Medicine B, University of Münster, Münster, Germany. · Institute of Gastroenterology and Liver Diseases, Ha'emek Medical Center Afula, Israel, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology Haifa, Israel. · Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. · Gastroenterology Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal. · Clinical Psychology Unit, Department of Psychology, University of Sheffield. · Centre Hospitalier Lyon Sud, Pierre Bénite, Lyon, France. · Gedyt Endoscopy Center, Buenos Aires, Argentina. ·Endoscopy · Pubmed #25826168.

ABSTRACT: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Guideline was also reviewed and endorsed by the British Society of Gastroenterology (BSG). It addresses the roles of small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders. Main recommendations 1 ESGE recommends small-bowel video capsule endoscopy as the first-line investigation in patients with obscure gastrointestinal bleeding (strong recommendation, moderate quality evidence). 2 In patients with overt obscure gastrointestinal bleeding, ESGE recommends performing small-bowel capsule endoscopy as soon as possible after the bleeding episode, optimally within 14 days, in order to maximize the diagnostic yield (strong recommendation, moderate quality evidence). 3 ESGE does not recommend the routine performance of second-look endoscopy prior to small-bowel capsule endoscopy; however whether to perform second-look endoscopy before capsule endoscopy in patients with obscure gastrointestinal bleeding or iron-deficiency anaemia should be decided on a case-by-case basis (strong recommendation, low quality evidence). 4 In patients with positive findings at small-bowel capsule endoscopy, ESGE recommends device-assisted enteroscopy to confirm and possibly treat lesions identified by capsule endoscopy (strong recommendation, high quality evidence). 5 ESGE recommends ileocolonoscopy as the first endoscopic examination for investigating patients with suspected Crohn's disease (strong recommendation, high quality evidence). In patients with suspected Crohn's disease and negative ileocolonoscopy findings, ESGE recommends small-bowel capsule endoscopy as the initial diagnostic modality for investigating the small bowel, in the absence of obstructive symptoms or known stenosis (strong recommendation, moderate quality evidence).ESGE does not recommend routine small-bowel imaging or the use of the PillCam patency capsule prior to capsule endoscopy in these patients (strong recommendation, low quality evidence). In the presence of obstructive symptoms or known stenosis, ESGE recommends that dedicated small bowel cross-sectional imaging modalities such as magnetic resonance enterography/enteroclysis or computed tomography enterography/enteroclysis should be used first (strong recommendation, low quality evidence). 6 In patients with established Crohn's disease, based on ileocolonoscopy findings, ESGE recommends dedicated cross-sectional imaging for small-bowel evaluation since this has the potential to assess extent and location of any Crohn's disease lesions, to identify strictures, and to assess for extraluminal disease (strong recommendation, low quality evidence). In patients with unremarkable or nondiagnostic findings from such cross-sectional imaging of the small bowel, ESGE recommends small-bowel capsule endoscopy as a subsequent investigation, if deemed to influence patient management (strong recommendation, low quality evidence). When capsule endoscopy is indicated, ESGE recommends use of the PillCam patency capsule to confirm functional patency of the small bowel (strong recommendation, low quality evidence). 7 ESGE strongly recommends against the use of small-bowel capsule endoscopy for suspected coeliac disease but suggests that capsule endoscopy could be used in patients unwilling or unable to undergo conventional endoscopy (strong recommendation, low quality evidence).

5 Guideline Guidelines for imaging of Crohn's perianal fistulizing disease. 2015

Ong, Eugene M W / Ghazi, Leyla J / Schwartz, David A / Mortelé, Koenraad J / Anonymous3570823. ·*Department of Radiology, Division of Clinical MRI, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; †Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland; and ‡Department of Gastroenterology and Hepatology, Vanderbilt University, Nashville, Tennessee. · ·Inflamm Bowel Dis · Pubmed #25751067.

ABSTRACT: -- No abstract --

6 Guideline Guidelines for the multidisciplinary management of Crohn's perianal fistulas: summary statement. 2015

Schwartz, David A / Ghazi, Leyla J / Regueiro, Miguel / Fichera, Alessandro / Zoccali, Marco / Ong, Eugene M W / Mortelé, Koenraad J / Anonymous3560823. ·*Department of Gastroenterology and Hepatology, Vanderbilt University, Nashville, Tennessee; †Department of Gastroenterology and Hepatology, University of Maryland Medical Center, Baltimore, Maryland; ‡University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; §Division of General Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington; ‖Department of Surgery, Weill Medical College of Cornell University, New York, New York; and ¶Division of Clinical MRI, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. · ·Inflamm Bowel Dis · Pubmed #25751066.

ABSTRACT: -- No abstract --

7 Guideline Guidelines for the surgical treatment of Crohn's perianal fistulas. 2015

Fichera, Alessandro / Zoccali, Marco / Anonymous110823. ·*Section Gastrointestinal Surgery, Division of General Surgery. Department of Surgery, University of Washington Medical Center, Seattle, Washington; and †Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York. · ·Inflamm Bowel Dis · Pubmed #25738380.

ABSTRACT: -- No abstract --

8 Guideline Colonoscopy surveillance for dysplasia and colorectal cancer in patients with inflammatory bowel disease. 2015

Aalykke, Claus / Jensen, Michael Dam / Fallingborg, Jan / Jess, Tine / Langholz, Ebbe / Meisner, Søren / Andersen, Nynne Nyboe / Riis, Lene Buhl / Thomsen, Ole Østergaard / Tøttrup, Anders. ·Department of Medicine, OUH, Svendborg Sygehus, 5700 Svendborg, Denmark. claus.aalykke@rsyd.dk. · ·Dan Med J · Pubmed #25557336.

ABSTRACT: The risk of colorectal cancer (CRC) and dysplasia in patients with inflammatory bowel disease (IBD) has been highly debated as risk estimates from different studies vary greatly. The present national Danish guideline on colonoscopy surveillance for dysplasia and colorectal cancer in patients with IBD is based on a thorough review of existing literature with particular focus on recent studies from Denmark revealing a lower risk of CRC than previously assumed. The overall risk of CRC in the Danish IBD population does not appear to be different from that of the background population; however, in some subgroups of patients the risk is increased. These subgroups of patients, who should be offered colonoscopy surveillance, include patients with ulcerative colitis having extensive disease and a long disease duration (10-13 years); early age at onset (less than 19 years of age) of ulcerative colitis; and patients with ulcerative colitis as well as Crohn's disease with a concomitant diagnosis of primary sclerosing cholangitis. A colonoscopy surveillance program is recommended in these subgroups with intervals ranging from every 3-6 months to every 5 years, using chromoendoscopy with targeted biopsies of the lesion and adjacent mucosa, instead of conventional colonoscopy with random biopsies. Preferably, the colonoscopy should be performed during clinical remission. If a lesion is detected the endoscopical resectability together with the pathology of the lesion and the adjacent mucosa determine how the lesion should be treated.

9 Guideline [Reccomendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on the use of methotrexate in inflammatory bowel disease]. 2015

Gomollón, Fernando / Rubio, Saioa / Charro, Mara / García-López, Santiago / Muñoz, Fernando / Gisbert, Javier P / Domènech, Eugeni / Anonymous1330940. ·Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, IIS Aragón, España Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD). Electronic address: fgomollon@gmail.com. · Servicio de Aparato Digestivo, Hospital de Navarra, PamplonaEspaña. · Servicio de Aparato Digestivo, Hospital Royo Villanova, Zaragoza España. · Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España. · Servicio de Aparato Digestivo, Hospital de León, León España. · Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid España, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD). · Servicio de Aparato Digestivo, Hospital Germans Trías i Pujol, Badalona España, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD). · ·Gastroenterol Hepatol · Pubmed #25454602.

ABSTRACT: Methotrexate is an immunosuppressant that may be useful in several clinical scenarios in inflammatory bowel disease. In this article, we review the available evidence in Crohn's disease and ulcerative colitis and establish general recommendations for its use in clinical practice. Although the available data are limited, it is very likely that methotrexate is underused because its effectiveness is underestimated and its toxicity is overestimated. Both in induction therapy and in maintenance of remission, methotrexate is useful in Crohn's disease. When prescribed in combination with biologic agents, immunogenicity is less frequent and consequently long-term response could potentially be improved. There are few published studies, but several data suggest that methotrexate could also be useful in ulcerative colitis. Although myelotoxicity and liver toxicity are well known risks, methotrexate is a drug that is well tolerated in many patients, even in the long term.

10 Guideline [Updated German clinical practice guideline on "Diagnosis and treatment of Crohn's disease" 2014]. 2014

Preiß, J C / Bokemeyer, B / Buhr, H J / Dignaß, A / Häuser, W / Hartmann, F / Herrlinger, K R / Kaltz, B / Kienle, P / Kruis, W / Kucharzik, T / Langhorst, J / Schreiber, S / Siegmund, B / Stallmach, A / Stange, E F / Stein, J / Hoffmann, J C / Anonymous3780814. ·Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin. · Gastroenterologische Gemeinschaftspraxis Minden. · Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, Berlin. · Medizinische Klinik I, Agaplesion Markus-Krankenhaus, Frankfurt/Main. · Klinik Innere Medizin I, Klinikum Saarbrücken. · Agaplesion MVZ, Frankfurt/Main. · Innere Medizin I, Asklepios Klinik Nord, Hamburg. · Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung (DCCV) e. V., Berlin. · Chirurgische Klinik, Universitätsmedizin Mannheim. · Abteilung für Innere Medizin, Evangelisches Krankenhaus Kalk, Köln. · Klinik für Allgemeine Innere Medizin & Gastroenterologie, Klinikum Lüneburg. · Integrative Gastroenterologie, Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen-Mitte. · Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Campus Kiel. · Klinik für Innere Medizin IV, Universitätsklinikum Jena. · Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart. · Abteilung Gastroenterologie/Ernährungsmedizin, DGD Kliniken Frankfurt Sachsenhausen, Frankfurt/Main. · Medizinische Klinik I, St. Marien- und St. Annastiftskrankenhaus, Ludwigshafen. · ·Z Gastroenterol · Pubmed #25474283.

ABSTRACT: -- No abstract --

11 Guideline [Updated S3 guideline on diagnosis and treatment of Crohn's disease: up to date or new?]. 2014

Stallmach, A / Hoffmann, J / Preiß, J C / Anonymous3760814. ·Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie und Infektiologie), Universitätsklinikum Jena. · Medizinische Klinik I, St. Marien- und St. Annastiftskrankenhaus, Ludwigshafen. · Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin. · ·Z Gastroenterol · Pubmed #25474276.

ABSTRACT: -- No abstract --

12 Guideline Monitoring disease activity and progression in Crohn's disease. A Swiss perspective on the IBD ahead 'optimised monitoring' recommendations. 2014

Sauter, Bernhard / Beglinger, Christoph / Girardin, Marc / Macpherson, Andrew / Michetti, Pierre / Schoepfer, Alain / Seibold, Frank / Vavricka, Stephan R / Rogler, Gerhard. ·GastroZentrum Hirslanden, Zurich, Switzerland. · ·Digestion · Pubmed #25074029.

ABSTRACT: BACKGROUND AND AIMS: The structured IBD Ahead 'Optimised Monitoring' programme was designed to obtain the opinion, insight and advice of gastroenterologists on optimising the monitoring of Crohn's disease activity in four settings: (1) assessment at diagnosis, (2) monitoring in symptomatic patients, (3) monitoring in asymptomatic patients, and (4) the postoperative follow-up. For each of these settings, four monitoring methods were discussed: (a) symptom assessment, (b) endoscopy, (c) laboratory markers, and (d) imaging. Based on literature search and expert opinion compiled during an international consensus meeting, recommendations were given to answer the question 'which diagnostic method, when, and how often'. The International IBD Ahead Expert Panel advised to tailor this guidance to the healthcare system and the special prerequisites of each country. The IBD Ahead Swiss National Steering Committee proposes best-practice recommendations adapted for Switzerland. METHODS: The IBD Ahead Steering Committee identified key questions and provided the Swiss Expert Panel with a structured literature research. The expert panel agreed on a set of statements. During an international expert meeting the consolidated outcome of the national meetings was merged into final statements agreed by the participating International and National Steering Committee members - the IBD Ahead 'Optimized Monitoring' Consensus. RESULTS: A systematic assessment of symptoms, endoscopy findings, and laboratory markers with special emphasis on faecal calprotectin is deemed necessary even in symptom-free patients. The choice of recommended imaging methods is adapted to the specific situation in Switzerland and highlights the importance of ultrasonography and magnetic resonance imaging besides endoscopy. CONCLUSION: The recommendations stress the importance of monitoring disease activity on a regular basis and by objective parameters, such as faecal calprotectin and endoscopy with detailed documentation of findings. Physicians should not rely on symptoms only and adapt the monitoring schedule and choice of options to individual situations.

13 Guideline A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn's disease. 2014

Gecse, Krisztina B / Bemelman, Willem / Kamm, Michael A / Stoker, Jaap / Khanna, Reena / Ng, Siew C / Panés, Julián / van Assche, Gert / Liu, Zhanju / Hart, Ailsa / Levesque, Barrett G / D'Haens, Geert / Anonymous3050798 / Anonymous3060798. ·Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Robarts Research Institute, Amsterdam, The Netherlands. · Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · St. Vincent's Hospital and University of Melbourne, Melbourne, Australia. · Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · Robarts Research Institute, London, Ontario, Canada University of Western Ontario, London, Ontario, Canada. · Department of Medicine and Therapeutics, Institute of Digestive Disease, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong. · Department of Gastroenterology, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain. · Department of Gastroenterology, University of Leuven, Leuven, Belgium. · Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China. · APRG, Imperial College, London, UK IBD Unit, St. Mark's Hospital, London, UK. · Robarts Research Institute, San Diego, CA, USA Division of Gastroenterology, University of California San Diego, La Jolla, California, USA. · ·Gut · Pubmed #24951257.

ABSTRACT: OBJECTIVE: To develop a consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn's disease (pCD), based on best available evidence. METHODS: Based on a systematic literature review, statements were formed, discussed and approved in multiple rounds by the 20 working group participants. Consensus was defined as at least 80% agreement among voters. Evidence was assessed using the modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria. RESULTS: Highest diagnostic accuracy can only be established if a combination of modalities is used. Drainage of sepsis is always first line therapy before initiating immunosuppressive treatment. Mucosal healing is the goal in the presence of proctitis. Whereas antibiotics and thiopurines have a role as adjunctive treatments in pCD, anti-tumour necrosis factor (anti-TNF) is the current gold standard. The efficacy of infliximab is best documented although adalimumab and certolizumab pegol are moderately effective. Oral tacrolimus could be used in patients failing anti-TNF therapy. Definite surgical repair is only of consideration in the absence of luminal inflammation. CONCLUSIONS: Based on a multidisciplinary approach, items relevant for fistula management were identified and algorithms on diagnosis and treatment of pCD were developed.

14 Guideline Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease. 2014

Ruemmele, F M / Veres, G / Kolho, K L / Griffiths, A / Levine, A / Escher, J C / Amil Dias, J / Barabino, A / Braegger, C P / Bronsky, J / Buderus, S / Martín-de-Carpi, J / De Ridder, L / Fagerberg, U L / Hugot, J P / Kierkus, J / Kolacek, S / Koletzko, S / Lionetti, P / Miele, E / Navas López, V M / Paerregaard, A / Russell, R K / Serban, D E / Shaoul, R / Van Rheenen, P / Veereman, G / Weiss, B / Wilson, D / Dignass, A / Eliakim, A / Winter, H / Turner, D / Anonymous230797 / Anonymous240797. ·Department of Paediatric Gastroenterology, APHP Hôpital Necker Enfants Malades, 149 Rue de Sèvres 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 2 Rue de l'École de Médecine, 75006 Paris, France; INSERM U989, Institut IMAGINE, 24 Bd Montparnasse, 75015 Paris, France. Electronic address: frank.ruemmele@nck.aphp.fr. · Department of Paediatrics I, Semmelweis University, Bókay János str. 53, 1083 Budapest, Hungary. · Department of Gastroenterology, Helsinki University Hospital for Children and Adolescents, Stenbäckinkatu 11, P.O. Box 281, 00290 Helsinki, Finland. · Department of Paediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8 Toronto, ON, Canada. · Paediatric Gastroenterology and Nutrition Unit, Tel Aviv University, Edith Wolfson Medical Center, 62 HaLohamim Street, 58100 Holon, Israel. · Department of Paediatric Gastroenterology, Erasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, Netherlands. · Unit of Paediatric Gastroenterology, Hospital S. João, A Hernani Monteiro, 4202-451, Porto, Portugal. · Gastroenterology and Endoscopy Unit, Istituto G. Gaslini, Via G. Gaslini 5, 16148 Genoa, Italy. · Division of Gastroenterology and Nutrition, and Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland. · Department of Pediatrics, University Hospital Motol, Uvalu 84, 150 06 Prague, Czech Republic. · Department of Paediatrics, St. Marien Hospital, Robert-Koch-Str.1, 53115 Bonn, Germany. · Department of Paediatric Gastroenterolgoy, Hepatology and Nutrition, Hospital Sant Joan de Déu, Paseo Sant Joan de Déu 2, 08950 Barcelona, Spain. · Department of Pediatrics, Centre for Clinical Research, Entrance 29, Västmanland Hospital, 72189 Västerås/Karolinska Institutet, Stockholm, Sweden. · Department of Gastroenterology and Nutrition, Hopital Robert Debré, 48 Bd Sérurier, APHP, 75019 Paris, France; Université Paris-Diderot Sorbonne Paris-Cité, 75018 Paris France. · Department of Gastroenterology, Hepatology and Feeding Disorders, Instytut Pomnik Centrum Zdrowia Dziecka, Ul. Dzieci Polskich 20, 04-730 Warsaw, Poland. · Department of Paediatric Gastroenterology, Children's Hospital, University of Zagreb Medical School, Klaićeva 16, 10000 Zagreb, Croatia. · Department of Paediatric Gastroenterology, Dr. von Hauner Children's Hospital, Lindwurmstr. 4, 80337 Munich, Germany. · Department of Gastroenterology and Nutrition, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy. · Department of Translational Medical Science, Section of Paediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131 Naples, Italy. · Paediatric Gastroenterology and Nutrition Unit, Hospital Materno Infantil, Avda. Arroyo de los Ángeles s/n, 29009 Málaga, Spain. · Department of Paediatrics 460, Hvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark. · Department of Paediatric Gastroenterology, Yorkhill Hospital, Dalnair Street, Glasgow G3 8SJ, United Kingdom. · 2nd Department of Paediatrics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Emergency Children's Hospital, Crisan nr. 5, 400177 Cluj-Napoca, Romania. · Department of Pediatric Gastroenterology and Nutrition, Rambam Health Care Campus Rappaport Faculty Of Medicine, 6 Ha'alya Street, P.O. Box 9602, 31096 Haifa, Israel. · Department of Paediatric Gastroenterology, Hepatology and Nutrition, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, Netherlands. · Department of Paediatric Gastroenterology and Nutrition, Children's University Hospital, Laarbeeklaan 101, 1090 Brussels, Belgium. · Paediatric Gastroenterology and Nutrition Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52625 Tel Hashomer, Israel. · Child Life and Health, Paediatric Gastroenterology, Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh EH9 1LF, United Kingdom. · Department of Medicine I, Agaplesion Markus Hospital, Wilhelm-Epstein-Str. 4, 60431 Frankfurt/Main, Gemany. · 33-Gastroenterology, Sheba Medical Center, 52621 Tel Hashomer, Israel. · Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Mass General Hospital for Children, 175 Cambridge Street, 02114 Boston, United States. · Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel. · ·J Crohns Colitis · Pubmed #24909831.

ABSTRACT: Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn's and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutrition (EEN) is the induction therapy of first choice due to its excellent safety profile, preferable over corticosteroids, which are equipotential to induce remission. The majority of patients with pediatric-onset CD require immunomodulator based maintenance therapy. The experts discuss several factors potentially predictive for poor disease outcome (such as severe perianal fistulizing disease, severe stricturing/penetrating disease, severe growth retardation, panenteric disease, persistent severe disease despite adequate induction therapy), which may incite to an anti-TNF-based top down approach. These guidelines are intended to give practical (whenever possible evidence-based) answers to (pediatric) gastroenterologists who take care of children and adolescents with CD; they are not meant to be a rule or legal standard, since many different clinical scenario exist requiring treatment strategies not covered by or different from these guidelines.

15 Guideline British Dietetic Association evidence-based guidelines for the dietary management of Crohn's disease in adults. 2014

Lee, J / Allen, R / Ashley, S / Becker, S / Cummins, P / Gbadamosi, A / Gooding, O / Huston, J / Le Couteur, J / O'Sullivan, D / Wilson, S / Lomer, M C E / Anonymous2350778. ·Department of Nutrition and Dietetics, Addenbrookes, Cambridge, UK. · ·J Hum Nutr Diet · Pubmed #24313460.

ABSTRACT: BACKGROUND: Crohn's disease is a debilitating chronic inflammatory bowel disease. Appropriate use of diet and nutritional therapy is integral to the overall management strategy of Crohn's disease. The aim was to develop evidence-based guidelines on the dietary management of Crohn's disease in adults. METHODS: Questions relating to the dietary management of Crohn's disease were developed. These included the roles of enteral nutrition to induce remission, food re-introduction diets to structure food re-introduction and maintain remission, and dietary management of stricturing disease, as well as whether probiotics or prebiotics induce or maintain remission. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines CINAHL, Cochrane Library, EMBASE, MEDLINE, Scopus and Web of Science. Evidence statements, recommendations, practical considerations and research recommendations were developed. RESULTS: Fifteen research papers were critically appraised and the evidence formed the basis of these guidelines. Although corticosteroids appear to be more effective, enteral nutrition (elemental or non-elemental) can be offered as an alternative option to induce disease remission. After a course of enteral nutrition, food re-introduction diets may be useful to structure food re-introduction and help maintain disease remission. Dietary fibre is contraindicated in the presence of strictures as a result of the risk of mechanical obstruction. The use of probiotics and prebiotics is not currently supported. CONCLUSIONS: As an alternative to corticosteroids, evidence supports enteral nutrition to induce disease remission. Food re-introduction diets provide structure to food re-introduction and help maintain disease remission. These guidelines aim to reduce variation in clinical practice.

16 Guideline ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. 2014

Levine, Arie / Koletzko, Sibylle / Turner, Dan / Escher, Johanna C / Cucchiara, Salvatore / de Ridder, Lissy / Kolho, Kaija-Leena / Veres, Gabor / Russell, Richard K / Paerregaard, Anders / Buderus, Stephan / Greer, Mary-Louise C / Dias, Jorge A / Veereman-Wauters, Gigi / Lionetti, Paolo / Sladek, Malgorzata / Martin de Carpi, Javier / Staiano, Annamaria / Ruemmele, Frank M / Wilson, David C / Anonymous5200775. ·*Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel †Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel §Pediatric Gastroenterology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands ||Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy ¶Children's Hospital, University of Helsinki, Helsinki, Finland #Semmelweis University, Budapest, Hungary **Department of Paediatric Gastroenterology and Nutrition, Yorkhill Children's Hospital, Glasgow, UK ††Department of Paediatrics, Hvidovre University Hospital, Copenhagen, Denmark ‡‡St.-Marien-Hospital, Department of Pediatrics, Bonn, Germany §§Department of Diagnostic Imaging, The Hospital for Sick Children ||||Department of Medical Imaging, University of Toronto, Toronto Canada ¶¶Hospital S. João, Porto, Portugal ##Pediatric Gastroenterology and Nutrition, UZ Brussels, Brussels, Belgium ***Departement Neurofarba, University of Florence, Meyer Children Hospital, Florence, Italy †††Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College, Cracow, Poland ‡‡‡Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, Barcelona, Spain §§§Department of Translational Medical Sciences, Section of Pediatrics, University of Naples "Federico II," Naples, Italy ||||||Université Sorbonne Paris Cité, Université Paris Descartes, INSERM U989, AP-HP, Hôpital Necker Enfants Malades, Service de Gastroentérologie Pédiatrique, Paris, France ¶¶¶Child Life and Health, University of Edinburgh, Edinburgh, UK. · ·J Pediatr Gastroenterol Nutr · Pubmed #24231644.

ABSTRACT: BACKGROUND: The diagnosis of pediatric-onset inflammatory bowel disease (PIBD) can be challenging in choosing the most informative diagnostic tests and correctly classifying PIBD into its different subtypes. Recent advances in our understanding of the natural history and phenotype of PIBD, increasing availability of serological and fecal biomarkers, and the emergence of novel endoscopic and imaging technologies taken together have made the previous Porto criteria for the diagnosis of PIBD obsolete. METHODS: We aimed to revise the original Porto criteria using an evidence-based approach and consensus process to yield specific practice recommendations for the diagnosis of PIBD. These revised criteria are based on the Paris classification of PIBD and the original Porto criteria while incorporating novel data, such as for serum and fecal biomarkers. A consensus of at least 80% of participants was achieved for all recommendations and the summary algorithm. RESULTS: The revised criteria depart from existing criteria by defining 2 categories of ulcerative colitis (UC, typical and atypical); atypical phenotypes of UC should be treated as UC. A novel approach based on multiple criteria for diagnosing IBD-unclassified (IBD-U) is proposed. Specifically, these revised criteria recommend upper gastrointestinal endoscopy and ileocolonscopy for all suspected patients with PIBD, with small bowel imaging (unless typical UC after endoscopy and histology) by magnetic resonance enterography or wireless capsule endoscopy. CONCLUSIONS: These revised Porto criteria for the diagnosis of PIBD have been developed to meet present challenges and developments in PIBD and provide up-to-date guidelines for the definition and diagnosis of the IBD spectrum.

17 Guideline American Gastroenterological Association Institute guideline on the use of thiopurines, methotrexate, and anti-TNF-α biologic drugs for the induction and maintenance of remission in inflammatory Crohn's disease. 2013

Terdiman, Jonathan P / Gruss, Claudia B / Heidelbaugh, Joel J / Sultan, Shahnaz / Falck-Ytter, Yngve T / Anonymous5300776. ·Division of Gastroenterology, University of California, San Francisco School of Medicine, San Francisco, California. · ·Gastroenterology · Pubmed #24267474.

ABSTRACT: -- No abstract --

18 Guideline Endoscopy in inflammatory bowel disease: recommendations from the IBD Committee of the French Society of Digestive Endoscopy (SFED). 2013

Peyrin-Biroulet, Laurent / Bonnaud, Guillaume / Bourreille, Arnaud / Chevaux, Jean-Baptiste / Faure, Patrick / Filippi, Jérôme / Laharie, David / Vuitton, Lucine / Bulois, Philippe / Gonzalez, Florent / Trang, Caroline / Koch, Stéphane / Bernardini, David / Cellier, Christophe / Anonymous5740773. ·Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy-Brabois, Université Henri Poincaré 1, 54511 Vandoeuvre-lès-Nancy. · ·Endoscopy · Pubmed #24165822.

ABSTRACT: -- No abstract --

19 Guideline European consensus on the histopathology of inflammatory bowel disease. 2013

Magro, F / Langner, C / Driessen, A / Ensari, A / Geboes, K / Mantzaris, G J / Villanacci, V / Becheanu, G / Borralho Nunes, P / Cathomas, G / Fries, W / Jouret-Mourin, A / Mescoli, C / de Petris, G / Rubio, C A / Shepherd, N A / Vieth, M / Eliakim, R / Anonymous4850764 / Anonymous4860764. ·Department of Pharmacology & Therapeutics, Institute for Molecular and Cell Biology, Faculty of Medicine University of Porto, Department of Gastroenterology, Hospital de Sao Joao, Porto, Portugal. Electronic address: fm@med.up.pt. · ·J Crohns Colitis · Pubmed #23870728.

ABSTRACT: The histologic examination of endoscopic biopsies or resection specimens remains a key step in the work-up of affected inflammatory bowel disease (IBD) patients and can be used for diagnosis and differential diagnosis, particularly in the differentiation of UC from CD and other non-IBD related colitides. The introduction of new treatment strategies in inflammatory bowel disease (IBD) interfering with the patients' immune system may result in mucosal healing, making the pathologists aware of the impact of treatment upon diagnostic features. The European Crohn's and Colitis Organisation (ECCO) and the European Society of Pathology (ESP) jointly elaborated a consensus to establish standards for histopathology diagnosis in IBD. The consensus endeavors to address: (i) procedures required for a proper diagnosis, (ii) features which can be used for the analysis of endoscopic biopsies, (iii) features which can be used for the analysis of surgical samples, (iv) criteria for diagnosis and differential diagnosis, and (v) special situations including those inherent to therapy. Questions that were addressed include: how many features should be present for a firm diagnosis? What is the role of histology in patient management, including search for dysplasia? Which features if any, can be used for assessment of disease activity? The statements and general recommendations of this consensus are based on the highest level of evidence available, but significant gaps remain in certain areas.

20 Guideline [Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis on the use of anti-tumor necrosis factor drugs in inflammatory bowel disease]. 2013

Cabriada, José Luis / Vera, Isabel / Domènech, Eugeni / Barreiro-de Acosta, Manuel / Esteve, María / Gisbert, Javier P / Panés, Julia / Gomollón, Fernando / Anonymous1130751. ·Servicio de Aparato Digestivo, Hospital Galdakao-Usansolo, Galdakao, Vizcaya, España. jcabriada@gmail.com · ·Gastroenterol Hepatol · Pubmed #23433780.

ABSTRACT: -- No abstract --

21 Guideline NICE clinical guideline (CG152): the management of Crohn's disease in adults, children and young people. 2013

Mayberry, J F / Lobo, A / Ford, A C / Thomas, A. ·Department of Digestive Diseases, University Hospitals of Leicester NHS Trust, Leicester, UK. johnfmayberry@yahoo.co.uk · ·Aliment Pharmacol Ther · Pubmed #23151246.

ABSTRACT: BACKGROUND: The guideline offers best practice advice on the care of adults, children and young people with Crohn's disease. AIM: To provide clinically effective and cost-effective evidence-based recommendations to guide clinical practice in a clinical guideline commissioned by the National Institute for Health and Clinical Excellence (NICE). METHODS: A systematic review of the evidence including critical appraisal, meta-analysis and cost-effectiveness modelling. RESULTS: Thirty-one evidence-based recommendations covering induction and maintenance therapy are available. Five key priorities for implementation are identified together with nine future research recommendations. Three guideline versions are available: short (containing just the recommendations), full (containing the full evidence base) and an Understanding NICE guidance for patients and carers. Algorithms have been produced together with a NICE pathway and implementation tools. CONCLUSION: These are the first evidence-based clinical and cost-effectiveness guidelines for Crohn's disease in the United Kingdom.

22 Guideline Evidence-based clinical practice guidelines for Crohn's disease, integrated with formal consensus of experts in Japan. 2013

Ueno, Fumiaki / Matsui, Toshiyuki / Matsumoto, Takayuki / Matsuoka, Katsuyoshi / Watanabe, Mamoru / Hibi, Toshifumi / Anonymous3390740. ·Ofuna Chuo Hospital, Kanagawa, Japan. · ·J Gastroenterol · Pubmed #23090001.

ABSTRACT: Crohn's disease is a disorder of unknown etiology and complicated pathogenesis. A substantial amount of evidence has accumulated recently and has been applied to clinical practice. The present guidelines were developed based on recent evidence and the formal consensus of experts relevant to this disease. Here we provide an overview of these guidelines, as follows. Target disease: Crohn's disease Users: Clinical practitioners in internal medicine, surgery, gastroenterology, and general practice Purpose: To provide appropriate clinical indicators to practitioners Scope of clinical indicators: Concept of Crohn's disease, epidemiology, classifications, diagnosis, treatment, follow up, and special situations Intervention: Diagnosis (interview, physical examination, clinical laboratory tests, imaging, and pathology) and treatment (lifestyle guidance, drug therapy, nutritional therapy, surgery, etc.) Outcome assessment: Attenuation of symptoms, induction and maintenance of remission, imaging findings, quality of life (QOL), prevention of complications and harm of therapy Methods for developing these guidelines: Described in the text Basis of recommendations: Integration of evidence level and consensus of experts Cost-benefit analysis: Not implemented Evaluation of effectiveness: Yet to be confirmed Status of guidelines: Updated version of the first Guidelines published in 2010 Publication sources: Printed publication available and electronic information in preparation Patient information: Not available Date of publication: October 2011 These guidelines were intended primarily to be used by practitioners in Japan, and the goal of these guidelines is to improve the outcomes of patients with Crohn's disease.

23 Guideline [Guidelines for the management of Crohn's disease]. 2012

Ye, Byong Duk / Yang, Suk-Kyun / Shin, Sung Jae / Lee, Kang Moon / Jang, Byung Ik / Cheon, Jae Hee / Choi, Chang Hwan / Kim, Young-Ho / Lee, Heeyoung / Anonymous431078. ·Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea. · ·Korean J Gastroenterol · Pubmed #22387837.

ABSTRACT: Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with uncertain etiopathogenesis. CD can involve any site of gastrointestinal tract from the mouth to anus and is associated with serious complications such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies are currently applied for diverse clinical situations of CD. However, a lot of decisions on the management of CD are made depending on the personal experiences and choices of physicians. To suggest preferable approaches to diverse problems of CD and to minimize the variations according to physicians, guidelines for the management of CD are needed. Therefore, IBD Study Group of the Korean Association for the Study of the Intestinal Diseases has set out to develop the guidelines for the management of CD in Korea. These guidelines were developed using the adaptation methods and encompass the treatment of inflammatory disease, stricturing disease, and penetrating disease. The guidelines also cover the indication of surgery, prevention of recurrence after surgery, and CD in pregnancy and lactation. These are the first Korean guidelines for the management of CD and the update with further scientific data and evidences is needed.

24 Guideline Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. 2012

Critch, Jeff / Day, Andrew S / Otley, Anthony / King-Moore, Cynthia / Teitelbaum, Jonathan E / Shashidhar, Harohalli / Anonymous430708. ·Division of Gastroenterology, Janeway Children's Health Center, Memorial University, St John's, Newfoundland and Labrador, Canada. jeff.critch@easternhealth.ca · ·J Pediatr Gastroenterol Nutr · Pubmed #22002478.

ABSTRACT: Exclusive enteral nutrition is an effective yet often underused therapy for the induction of remission in pediatric Crohn disease. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition formed the Enteral Nutrition Working Group to review the use of enteral nutrition therapy in pediatric Crohn disease. The group was composed of 5 pediatric gastroenterologists and 1 pediatric nutritionist, all with an interest and/or expertise in exclusive enteral nutrition. Specific attention was placed upon review of the evidence for efficacy of therapy, assessment of the variations in care, identification of barriers to its widespread use, and compilation of the necessary components for a successful program. The present guideline is intended to aid physicians in developing an enteral nutrition therapy program and potentially promote its use.

25 Guideline [Surveillance of patients with inflammatory bowel diseases]. 2011

Moshkowitz, Menachem / Kariv, Revital / Half, Betsei / Vilkin, Alex / Levi, Zohar / Niv, Yaron / Dotan, Iris / Anonymous640713. ·The Section of Gastrointestinal Oncology, the Israeli Gastroenterology Association. · ·Harefuah · Pubmed #22164923.

ABSTRACT: This position paper of the Section of Gastrointestinal Oncology of the Israeli Gastroenterological Association recommends specific guidelines for colorectal cancer surveillance in patients with inflammatory bowel disease. Colorectal cancer (CRC) is a severe complication of inflammatory bowel disease (IBD), generally developing into a longstanding disease. The Lifetime prevalence of CRC in ulcerative colitis (UC) patients is estimated to be 2% after 10 years, 8% after 20 years, and even 18% after 30 years of extensive disease. Screening colonoscopy should be initiated 8-10 years after onset of symptoms in extensive UC patients (pancolitis), and after 15 years in patients with left-sided colitis (UC or Crohn's). Surveillance should continue periodically at an interval of every 1 to 2 years. Surveillance colonoscopies should be performed in combination with an extensive biopsy protocol. High-grade dysplasia (HGD) in flat mucosa or a dysplasia associated Lesion or mass (DALM) is considered an indication for colectomy when the pathological findings are confirmed by a second experienced pathologist. Further research is directed toward improving detection of dysplasia during colonoscopy through the use of novel endoscopic imaging techniques which are hoped to impact the approach to cancer prevention in patients with IBD.

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