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Ferreira AO, Reves JB, Nascimento C, Frias-Gomes C, Costa-Santos MP, Ramos LR, Palmela C, Gloria L, Cravo M, Dinis-Ribeiro M, Canena J. Narrow Band Imaging versus White Light for the Detection of Sessile Serrated Colorectal Lesions: A Randomized Clinical Trial. GE Port J Gastroenterol 2023; 30:368-374. [PMID: 37868631 PMCID: PMC10586213 DOI: 10.1159/000526606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/14/2022] [Indexed: 10/24/2023]
Abstract
Background Colorectal cancer (CRC) is a leading cause of cancer. The detection of pre-malignant lesions by colonoscopy is associated with reduced CRC incidence and mortality. Narrow band imaging has shown promising but conflicting results for the detection of serrated lesions. Methods We performed a randomized clinical trial to compare the mean detection of serrated lesions and hyperplastic polyps ≥10 mm with NBI or high-definition white light (HD-WL) withdrawal. We also compared all sessile serrated lesions (SSLs), adenoma, and polyp prevalence and rates. Results Overall, 782 patients were randomized (WL group 392 patients; NBI group 390 patients). The average number of serrated lesions and hyperplastic polyps ≥10 mm detected per colonoscopy (primary endpoint) was similar between the HD-WL and NBI group (0.118 vs. 0.156, p = 0.44). Likewise, the adenoma detection rate (55.2% vs. 53.2%, p = 0.58) and SSL detection rate (6.8% vs. 7.5%, p = 0.502) were not different between the two study groups. Withdrawal time was higher in the NBI group (10.88 vs. 9.47 min, p = 0.004), with a statistically nonsignificant higher total procedure time (20.97 vs. 19.30 min, p = 0.052). Conclusions The routine utilization of narrow band imaging does not improve the detection of serrated class lesions or any pre-malignant lesion and increases the withdrawal time.
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Affiliation(s)
- Alexandre Oliveira Ferreira
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Joana Branco Reves
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
| | | | | | - Maria Pia Costa-Santos
- Department of Gastroenterology, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - Lídia Roque Ramos
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Carolina Palmela
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Luísa Gloria
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Marília Cravo
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Mário Dinis-Ribeiro
- Department of Gastroenterology, Instituto Português de Oncologia, Porto, Portugal
- Cintesis, Center for Health Technology and Services Research, Porto, Portugal
| | - Jorge Canena
- Cintesis, Center for Health Technology and Services Research, Porto, Portugal
- Department of Gastroenterology, Nova Medical School/Faculty of Medical Sciences, Lisboa, Portugal
- University Center of Gastroenterology, Hospital Cuf Tejo, Lisbon, Portugal
- Department of Gastroenterology, Professor Doutor Fernando Fonseca Hospital, Amadora, Portugal
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Kral J, Nakov R, Lanska V, Barberio B, Benech N, Blesl A, Brunet E, Capela T, Derikx L, Dragoni G, Eek A, Frias-Gomes C, Gîlcă-Blanariu GE, Gilroy L, Harvey P, Kagramanova A, Kani H, Konikoff T, Lessing M, Madsen G, Maksimaityte V, Miasnikova M, Mikolašević I, Milivojevic V, Noviello D, Oliinyk D, Patai A, Pisani A, Protopapas A, Rodríguez-Lago I, Schreiner P, Skuja V, Tran F, Truyens M, Włodarczyk M, Zatorski H, Verstockt B, Segal JP. Significant differences in IBD care and education across Europe: results of the pan-European VIPER survey. Dig Dis 2022; 41:387-395. [PMID: 36412565 DOI: 10.1159/000528070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) care and education might differ around Europe. Therefore, we conducted this European Variation In IBD PracticE suRvey (VIPER) to investigate potential differences between countries. METHODS This trainee-initiated survey, run through SurveyMonkey®, consisted of 47 questions inquiring basic demographics, IBD training, and clinical care. Results were compared according to gross domestic product (GDP) per capita, for which countries were divided into 2 groups (low/high income, according to the World Bank). RESULTS The online survey was completed by 1285 participants from 40 European countries, with a majority of specialists (65.3%) working in academic institutions (50.4%). Significant differences in IBD-specific training (55.9% vs. 38.4%), as well as availability of IBD units (58.4% vs. 39.7%) and multidisciplinary meetings (73.2% vs. 40.1%) were observed between respondees from high and low GDP countries (p<0.0001). In high GDP countries, IBD nurses are more common (85.9% vs. 36.0%), also mirrored by more nurse-led IBD clinics (40.6% vs. 13.7%; p<0.0001). IBD dieticians (33.4% vs. 16.5%) and psychologists (16.8% vs. 7.5%) are mainly present in high GDP countries (p<0.0001). In the current COVID era, telemedicine is available in 73.2% vs. 54.1% of the high/low GDP countries respectively (p<0.0001). Treat-to-target approaches are implemented everywhere (85.0%), though access to biologicals and small molecules differs significantly. CONCLUSION Much variability in IBD practice exists across Europe, with marked differences between high vs. low GDP countries. Further work is required to help address some of these inequalities, aiming to improve and standardize IBD care and training across Europe.
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Bravo A, Nascimento C, Abreu B, Revés J, Morão B, Frias-Gomes C, Canhoto M, Glória L, Fidalgo C. 1278P How do hospitalized patients with chronic liver disease, with and without hepatocellular carcinoma, die? End-of-life quality analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Frias-Gomes C, Sousa AC, Rolim I, Henriques AR, Branco F, Janeiro A, Malveiro S, Dário AR, Oliveira MH, Borralho P, Teixeira JA, Faria A, Maio R, Fonseca I, Cravo M. Phenotype-Genotype Correlation in Colorectal Cancer: A Real-Life Study. GE Port J Gastroenterol 2022; 29:13-21. [PMID: 35111960 PMCID: PMC8787526 DOI: 10.1159/000516009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/06/2021] [Indexed: 09/26/2023]
Abstract
BACKGROUND AND AIMS Colorectal cancer (CRC) is a heterogeneous disease with distinctive genetic pathways, such as chromosomal instability, microsatellite instability and methylator pathway. Our aim was to correlate clinical and genetic characteristics of CRC patients in order to understand clinical implications of tumour genotype. METHODS Single-institution retrospective cohort of patients who underwent curative surgery for CRC, from 2012 to 2014. RAS and BRAF mutations were evaluated with the real-time PCR technique Idylla®. Mismatch repair deficiency (dMMR) was characterized by absence of MLH1, MSH6, MSH2 and/or PMS2 expression, evaluated by tissue microarrays. Overall survival (OS) and disease-free survival (DFS) were assessed using survival analysis. RESULTS Overall, 242 patients were included (males 57.4%, age 69.3 ± 12.9 years; median follow-up 49 months). RAS-mutated tumours were associated with reduced DFS (p = 0.02) and OS (p = 0.045) in stage I-III CRC. BRAF-mutated tumours were more predominant in females and in the right colon, similarly to dMMR tumours. BRAF status did not influence OS (4 years)/DFS (3.5 years) in stage I-III disease. However, after relapse, length of survival was 3.5 months in BRAF-mutated tumours in contrast to 18.6 months in BRAF wild-type tumours (p = NS). No germline mutations in mismatch repair genes were so far identified in the patients with dMMR tumours. Molecular phenotype (RAS, BRAF and MMR) did not influence OS in metastatic patients. Our small sample size may be a limitation of the study. CONCLUSION In our cohort, RAS-mutated tumours were associated with worse DFS and OS in early-stage CRC, whereas the remaining molecular variables had no prognostic influence.
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Affiliation(s)
- Catarina Frias-Gomes
- Serviço de Gastrenterologia, Departamento de Cirurgia, Hospital Beatriz Ângelo, Loures, Portugal
| | | | - Inês Rolim
- Serviço de Anatomia Patológica, Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
- Instituto de Anatomia Patológica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Raquel Henriques
- Instituto de Anatomia Patológica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Francisco Branco
- Serviço de Oncologia Médica, Departamento de Oncologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - André Janeiro
- Genomed, Instituto de Medicina Molecular, Lisboa, Portugal
| | - Sara Malveiro
- Genomed, Instituto de Medicina Molecular, Lisboa, Portugal
| | - Ana Rita Dário
- Genomed, Instituto de Medicina Molecular, Lisboa, Portugal
| | | | - Paula Borralho
- Instituto de Anatomia Patológica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Serviço de Anatomia Patológica, Hospital CUF Descobertas, Lisboa, Portugal
| | - José Alberto Teixeira
- Serviço de Oncologia Médica, Departamento de Oncologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - Ana Faria
- Serviço de Oncologia Médica, Departamento de Oncologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - Rui Maio
- Serviço de Cirurgia Geral, Departamento de Cirurgia, Hospital Beatriz Ângelo, Loures, Portugal
| | - Isabel Fonseca
- Serviço de Anatomia Patológica, Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
- Instituto de Anatomia Patológica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Marília Cravo
- Serviço de Gastrenterologia, Departamento de Cirurgia, Hospital Beatriz Ângelo, Loures, Portugal
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Frias-Gomes C, Torres J, Palmela C. Intestinal Ultrasound in Inflammatory Bowel Disease: A Valuable and Increasingly Important Tool. GE Port J Gastroenterol 2021; 29:223-239. [PMID: 35979252 PMCID: PMC9275009 DOI: 10.1159/000520212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/08/2021] [Indexed: 11/19/2022]
Abstract
Background Intestinal ultrasound is emerging as a non-invasive tool for monitoring disease activity in inflammatory bowel disease patients due to its low cost, excellent safety profile, and availability. Herein, we comprehensively review the role of intestinal ultrasound in the management of these patients. Summary Intestinal ultrasound has a good accuracy in the diagnosis of Crohn's disease, as well as in the assessment of disease activity, extent, and evaluating disease-related complications, namely strictures, fistulae, and abscesses. Even though not fully validated, several scores have been developed to assess disease activity using ultrasound. Importantly, intestinal ultrasound can also be used to assess response to treatment. Changes in ultrasonographic parameters are observed as early as 4 weeks after treatment initiation and persist during short- and long-term follow-up. Additionally, Crohn's disease patients with no ultrasound improvement seem to be at a higher risk of therapy intensification, need for steroids, hospitalisation, or even surgery. Similarly to Crohn's disease, intestinal ultrasound has a good performance in the diagnosis, activity, and disease extent assessment in ulcerative colitis patients. In fact, in patients with severe acute colitis, higher bowel wall thickness at admission is associated with the need for salvage therapy and the absence of a significant decrease in this parameter may predict the need for colectomy. Short-term data also evidence the role of intestinal ultrasound in evaluating therapy response, with ultrasound changes observed after 2 weeks of treatment and significant improvement after 12 weeks of follow-up in ulcerative colitis. Key Messages Intestinal ultrasound is a valuable tool to assess disease activity and complications, and to monitor response to therapy. Even though longer prospective data are warranted, intestinal ultrasound may lead to a change in the paradigm of inflammatory bowel disease management as it can be used in a point-of-care setting, enabling earlier intervention if needed.
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Affiliation(s)
- Catarina Frias-Gomes
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Joana Torres
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Carolina Palmela
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
- *Carolina Palmela,
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Revés JB, Frias-Gomes C, Morão B, Nascimento C, Palmela C, Fidalgo C, Roque Ramos L, Sampaio A, Glória L, Cravo M, Torres J. Inflammatory Bowel Disease Patients' Perspectives during COVID-19 Pandemic: Results from a Portuguese Survey. GE Port J Gastroenterol 2021; 5:1-9. [PMID: 34934777 PMCID: PMC8678223 DOI: 10.1159/000518945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/03/2021] [Indexed: 11/19/2022]
Abstract
Introduction Patients with inflammatory bowel disease (IBD) do not seem to be at increased risk of infection by SARS-CoV-2, but there is a concern whether immunosuppressive therapy may be associated with more severe disease. Several clinical practice recommendations have been published to help guide IBD care during the COVID-19 pandemic. Nonetheless, few studies have addressed patients' perspectives and fears. We aimed to evaluate Portuguese IBD patients' perspectives on the clinical management of their disease during the SARS-CoV-2 pandemic as well as the impact on their professional life. Methods An anonymous electronic survey was created using REDCap and was distributed by the Portuguese Association of Inflammatory Bowel Disease (APDI) between May and August 2020. Patients' perspectives on immunosuppressive therapy, disease management, interaction with gastroenterology departments, and the impact of the pandemic in their professional life were assessed. Patients' proposals to improve medical care were also evaluated. Descriptive analysis and logistic regression were performed. Results A total of 137 participants answered the survey (79.6% females, mean age 41.7 ± 12.1 years). Although having IBD and receiving treatment with immunosuppressors (thiopurines, steroids, or biologics) were considered promotors of anxiety, most patients (85.4%) agreed that disease remission was a priority and only a minority of patients interrupted their treatment during the pandemic. In multivariate analysis, active disease, biologic treatment, and use of corticosteroids in the last 3 months were perceived by the patients as high-risk features for increased risk of SARS-Cov-2 infection and more severe disease. Fifty-nine patients (44%) believed that their follow-up was influenced by the pandemic and only 58.8% felt that they had the opportunity to discuss their therapeutic options with their doctor. Sixty-three patients (46.0%) were working from home during the pandemic, although this decision was related to IBD and immunosuppressive therapy in only 36.5 and 39.7% of the cases, respectively. Areas where care could have been improved during the pandemic were identified by patients, namely enhancement of the communication with IBD professionals, conciliation of telemedicine with face-to-face appointments, and facilitation of the interaction between patients and employers. Conclusion Most patients agreed that maintaining IBD remission is crucial, and only a minority of the patients stopped their treatment as per their own initiative. IBD status only had a small influence on patients' professional activity during the COVID-19 outbreak, with most changes being related to the pandemic itself.
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Affiliation(s)
- Joana Branco Revés
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Catarina Frias-Gomes
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Bárbara Morão
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Catarina Nascimento
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Carolina Palmela
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Catarina Fidalgo
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Lídia Roque Ramos
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Ana Sampaio
- Associação Portuguesa da Doença Inflamatória do Intestino (APDI), Matosinhos, Portugal
| | - Luísa Glória
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Marília Cravo
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joana Torres
- Gastroenterology Division, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Agrawal M, Sabino J, Frias-Gomes C, Hillenbrand CM, Soudant C, Axelrad JE, Shah SC, Ribeiro-Mourão F, Lambin T, Peter I, Colombel JF, Narula N, Torres J. Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses. EClinicalMedicine 2021; 36:100884. [PMID: 34308303 PMCID: PMC8257976 DOI: 10.1016/j.eclinm.2021.100884] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Early life exposures impact immune system development and therefore the risk of immune-mediated diseases, including inflammatory bowel disease (IBD). We systematically reviewed the impact of pre-, peri‑, and postnatal exposures up to the age of five years on subsequent IBD diagnosis. METHODS We identified case-control and cohort studies reporting on the association between early life environmental factors and Crohn's disease (CD), ulcerative colitis (UC), or IBD overall. Databases were search from their inception until May 24th, 2019 until July 14th, 2020. We conducted meta-analyses for quantitative review of relevant risk factors that were comparable across studies and qualitative synthesis of the literature for a wide range of early life exposures, including maternal health and exposures during pregnancy, perinatal factors, birth month and related-factors, breastfeeding, hygiene-related factors and social factors, immigration, antibiotics, offspring health, including infections, and passive smoking. PROSPERO registration: CRD42019134980. FINDINGS Prenatal exposure to antibiotics (OR 1.8; 95% CI 1.2-2.5) and tobacco smoke (OR 1.5; 95% CI 1.2-1.9), and early life otitis media (OR 2.1; 95% CI 1.2-3.6) were associated with IBD. There was a trend towards an association between exposure to antibiotics in infancy and IBD (OR: 1.7, 95% CI 0.97, 2.9), supported by positive data on population-based data. Breastfeeding was protective against IBD. Other early life risk factors had no association with IBD, but data were limited and heterogenous. INTERPRETATION Early life is an important period of susceptibility for IBD development later in life. Tobacco smoke, infections and antibiotics were associated positively, and breastfeeding was associated negatively with IBD. Our findings offer an opportunity to develop primary prevention strategies. FUNDING This study did not receive any funding.
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Affiliation(s)
- Manasi Agrawal
- The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - João Sabino
- Gastroenterology Division, University Hospital of Leuven, Leuven, Belgium
| | - Catarina Frias-Gomes
- Division of Gastroenterology, Hospital Beatriz Ângelo, Loures 2674-514, Portugal
| | - Christen M. Hillenbrand
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Celine Soudant
- Levy Library, The Mount Sinai Medical Center, New York, NY, United States
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jordan E. Axelrad
- Division of Gastroenterology, New York University Grossman School of Medicine, New York, NY, United States
| | - Shailja C. Shah
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, United States
- Section of Gastroenterology, Veterans Affairs Tennessee Valley Healthcare System, Nashville campus, Nashville, TN, United States
| | - Francisco Ribeiro-Mourão
- Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
- Pediatrics Department, Centro Materno Infantil do Norte – Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Thomas Lambin
- Department of Gastroenterology, Claude Huriez Hospital, University of Lille, Lille, France
| | - Inga Peter
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jean-Frederic Colombel
- The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Neeraj Narula
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive, Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Joana Torres
- The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Division of Gastroenterology, Hospital Beatriz Ângelo, Loures 2674-514, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Portugal
- Corresponding author.
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Costa-Santos MP, Frias-Gomes C, Oliveira A, Sabino J, Mañosa M, Ellul P, Sampaio A, Avedano L, Leone S, Colombel JF, Torres J. Conjugal inflammatory bowel disease: a systematic review and European survey. Ann Gastroenterol 2021; 34:361-369. [PMID: 33948061 PMCID: PMC8079879 DOI: 10.20524/aog.2021.0598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background The frequency of inflammatory bowel disease (IBD) is increased after marriage to an individual with the disease. Importantly, the offspring of these couples have a significant risk for developing the disease. Herein, we aimed to better characterize conjugal IBD. Methods A systematic literature search was conducted with predetermined search criteria. Relevant manuscripts reporting on couples with IBD and their offspring were selected. Concomitantly, a cross-sectional survey was conducted of couples where both members were affected with IBD, as well as their offspring, and electronically distributed by patients’ associations. Results We identified 20 reports of IBD in couples, for a total of 68 couples. Of these, 66% were concordant regarding IBD type and 66% were diagnosed after cohabitation. The overall prevalence of IBD in the offspring of these couples was 29%. Our survey identified 58 couples with IBD, with 62% being concordant regarding IBD type; 42.9% were diagnosed prior to cohabitation, in 12.5% one spouse was diagnosed before and the other after cohabitation, and in 44.6% the onset of disease occurred after cohabitation for both. The prevalence of IBD in children born from these couples was 10%. The probability of developing disease in the progeny was 2% at 10 years, 12% at 15 years, and 16% at 20 years of age. Conclusions IBD in couples occurs mostly after marriage to an individual with disease or after many years of cohabitation. In a modern cohort, the risk for the progeny was around 16% by the age of 20, lower than previously reported.
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Affiliation(s)
- Maria Pia Costa-Santos
- Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal (Maria Pia Costa-Santos, Catarina Frias-Gomes, António Oliveira, Joana Torres)
| | - Catarina Frias-Gomes
- Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal (Maria Pia Costa-Santos, Catarina Frias-Gomes, António Oliveira, Joana Torres)
| | - António Oliveira
- Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal (Maria Pia Costa-Santos, Catarina Frias-Gomes, António Oliveira, Joana Torres)
| | - João Sabino
- Division of Gastroenterology, University Hospital of Leuven, Leuven, Belgium (João Sabino)
| | - Miriam Mañosa
- Division of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain (Miriam Mañosa)
| | - Pierre Ellul
- Division of Gastroenterology, Mater Dei Hospital, Malta (Pierre Ellul)
| | - Ana Sampaio
- Portuguese Association of Inflammatory Bowel Disease (APDI) (Ana Sampaio)
| | - Luisa Avedano
- European Federation of Crohn's & Ulcerative Colitis Associations (EFCCA) (Luisa Avedano, Salvo Leone)
| | - Salvo Leone
- European Federation of Crohn's & Ulcerative Colitis Associations (EFCCA) (Luisa Avedano, Salvo Leone)
| | - Jean-Frédéric Colombel
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA (Jean-Frédéric Colombel)
| | - Joana Torres
- Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal (Maria Pia Costa-Santos, Catarina Frias-Gomes, António Oliveira, Joana Torres)
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