Search

Inflammatory bowel disease (IBD) poses significant challenges in its management, encompassing a spectrum of conditions from Crohn's disease to ulcerative colitis. Dietary interventions have emerged as integral components of the multidisciplinary approach to IBD management, with implications ranging from disease prevention to treatment of active manifestations and addressing complications such as malnutrition. While dietary interventions show promise in improving outcomes for some patients with IBD, there is no consensus in the existing literature regarding remission maintenance in those patients. Furthermore, many patients explore dietary modifications often guided by anecdotal evidence or personal experiences and this could lead to malnutrition and decreased quality of life. This comprehensive review synthesizes existing literature to elucidate the complex interplay between diet and IBD, offering insights into the efficacy and safety of various dietary modalities in maintaining disease remission. It also highlights the importance of patient education in navigating dietary choices and potential risks associated with food avoidance, including the heightened risk of micronutrient deficiencies. Furthermore, it emphasizes the pivotal role of a multidisciplinary care team comprising clinicians and dietitians in providing personalized dietary guidance tailored to individual patient needs and goals. By synthesizing the latest evidence and providing insights into both the potential benefits and risks of dietary interventions, this review could be used as a resource for healthcare professionals and patients alike in navigating the complex landscape of dietary management in IBD. [ABSTRACT FROM AUTHOR]

Despite the decreased rates in inflammatory bowel disease (IBD) colectomies due to high advances in therapeutic options, a significant number of patients still require proctocolectomy with ileal pouch-anal anastomosis (IPPA) for ulcerative colitis (UC). Pouchitis is the most common complication in these patients, where up to 60% develop one episode of pouchitis in the first two years after UC surgery with IPAA with severe negative impact on their quality of life. Acute cases usually respond well to antibiotics, but 15% of patients will still develop a refractory disease that requires the initiation of advanced immunosuppressive therapies. For chronic idiopathic pouchitis, current recommendations suggest using the same therapeutic options as for IBD in terms of biologics and small molecules. However, the available data are limited regarding the effectiveness of different biologics or small molecules for the management of this condition, and all evidences arise from case series and small studies. Vedolizumab is the only biologic agent that has received approval for the treatment of adult patients with moderately to severely active chronic refractory pouchitis. Despite the fact that IBD treatment is rapidly evolving with the development of novel molecules, the presence of pouchitis represents an exclusion criterion in these trials. Recommendations for the approach of these conditions range from low to very low certainty of evidence, resulting from small randomized controlled trials and case series studies. The current review focuses on the therapeutic management of idiopathic pouchitis. [ABSTRACT FROM AUTHOR]

Background & Aims: Recent research has shown that Western-style diets have been associated with an increased risk of inflammatory bowel diseases (IBD). Our aim was to examine the link between an antiinflammatory diet and the maintenance of IBD remission, as well as to assess the potential therapeutic advantages of this dietary approach in preserving IBD remission. Methods: The inclusion and exclusion criteria were applied to a total of 189 individuals with IBD, with 21 individuals not meeting the criteria. Therefore, 168 eligible patients were enrolled in the study and allocated to either an anti-inflammatory diet or a regular diet, based on their personal preference. Results: A cohort of 168 IBD adult patients was recruited for the study: 88 patients with ulcerative colitis and 80 with Crohn‘s disease. The intervention group received an anti-inflammatory diet consisting of the removal of red and processed meat, fried foods, high-lactose foods, fast food, white bread, sugar, and vegetable oils rich in omega-6 for a period of 1 year. The clinical response was maintained in 80 patients (95.2%) in the intervention group and in 72 patients (85.7%) in the control group (p-value=0.036). Although not statistically significant, fecal calprotectin was higher in the control group than in the intervention group at follow-up. Conclusions: Patients who adhered to an anti-inflammatory diet exhibited a higher rate of maintenance of clinical remission. Furthermore, improvement in inflammation tests was observed in the intervention group, reinforcing the proposition that IBD is a lifestyle-related disease. [ABSTRACT FROM AUTHOR]

Background and aims. For the 8-week OPrD regimen, real world data are insufficient. This study aims to compare the efficacy of the two types of regimens (12-week versus 8-week) in a real world cohort of patients with genotype 1b. Material and methods. We analysed a multicentric retrospective cohort enrolling 1436 patients who started HCV therapy in 2018-2019. Liver fibrosis was staged in all subjects by Fibromax. Efficacy was assessed by the percentage of patients achieving SVR 12 weeks post-treatment (SVR12). Results. Out of the 1436 analysed patients, 112 received 8 weeks therapy and 1324 received 12 weeks. In this cohort the proportion of male patients was 25.2%, the median age 61 years, 28.2% were interferon pre-treated, and the rate of co-morbidities was 47%. 42% of the subjects had F2 fibrosis, 29% F1 fibrosis, 16% F3 and 12% F4. The SVR rate was comparable in both groups of patients (97% in those treated with OPrD 12 weeks vs 96.4% in those that received OPrD 8 weeks) (by intention-to-treat). In the 12 weeks arm, the drop-out rate was 0.8% and the rate of severe adverse events was 1%, while in the arm of 8 weeks therapy there were no severe adverse events reported and no drop-out (p = 0.25). The only predictive factor for non-response in both treatment arms was the male sex. Conclusions. OPrD 8 weeks proved to be highly efficient in our patients with a 96.4% SVR. No serious adverse events and no drop out were reported. [ABSTRACT FROM AUTHOR]

Background and aim. Recent research has shown that there is considerable interest in studying inflammatory bowel diseases (IBD) due to the potential for dietary interventions to be used as a therapeutic approach for their onset and progression. Evidence suggests that Western-style diets, with high intake of processed foods, food additives, red meat, and animal fat, have been associated with an increased risk of IBD. Thus, the purpose of this study is to evaluate the link between an anti-inflammatory exclusion diet and the maintenance of IBD remission, as well as to assess the potential therapeutic advantages of this dietary approach in preserving IBD remission. Methods. The inclusion and exclusion criteria were applied to a total of 189 individuals with IBD, with 21 individuals not meeting the criteria. Therefore, 168 eligible patients were enrolled in the study and allocated to either an exclusion diet or a regular diet, based on their personal preference. Results. A cohort of 84 adult patients with inflammatory bowel disease (IBD) was recruited for the study. The cohort included 47.6% males, with 44 patients having ulcerative colitis (UC) and 40 having Crohn's disease (CD). The intervention group received an exclusion diet consisting of the removal of red and processed meat, fried foods, high-lactose foods, fast food, white bread, sweetened drinks, and vegetable oils rich in omega-6 for a period of 1 year. An equivalent number of IBD patients with similar demographics and disease types formed the control group. The exclusion diet was well tolerated, with 90% of participants adhering to it frequently or always. The study demonstrated that the clinical response was maintained in 80 patients (95.2%) in the intervention group, which was significantly higher than the 72 patients (85.7%) in the control group (p-value=0.036). Although not statistically significant, fecal calprotectin was higher in the control group than in the intervention group at the one-year follow-up interval. Conclusions. Patients who adhered to an exclusion diet have the chance of a significantly higher rate of maintenance of clinical remission (95% versus 86% in the control group). A trend toward improvement in inflammation tests was observed in the intervention group, confirming once again that Western-style diet is an important etiological factor in IBD. The exclusion, anti-inflammatory diet should be discussed with each patient with IBD. [ABSTRACT FROM AUTHOR]

Study's objectives. Helicobacter pylori (H.P) is the most common chronic bacterial infection in humans. Conservative estimates suggest that 50% of the world's population is affected. Infection is more frequent and acquired at an earlier age in resourcelimited countries compared with industrialized nations. Once acquired, infection persists and may or may not produce gastroduodenal diseases: antral gastritis, peptic ulcer disease and various gastrointestinal neoplasms. The latest studies highlight the benefit of eradicating H.P infection, but also the intestinal dysbiosis following therapy. Material and method. We present a prospective study, carried out within IC Fundeni, Bucharest for a period of 4 weeks after Helicobacter pylori (H.P) eradication therapy (proton pump inhibitor 40mg x2/day+ amoxicillin 1000mg x 2/day+ levofloxacin 500mg/day + bismuth 120mg x 4/day, 14 days), which included a number of 66 patients divided into 2 groups: 33 in the control group and 33 patients in the probiotic group: Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus, Lactobacillus sporogenes: 1 capsule x 2/day, during 4 weeks, after HP eradication therapy (BIOSUN), in order to assess the effects of Helicobacter pylori eradication therapy on intestinal dysbiosis, regarding the general state of health and the impact of probiotic therapy on improving the functional capacity. Patients were evaluated at the end of H.P eradication therapy - visit 1 and after 4 weeks from HP eradication therapy - visit 2, concerning the following aspects: self-assessment of general health state, the ability to perform physical/workplace-related activities, presence of pain (of any kind) with impact on daily/other activities, energy level, presence of melancholy or discouragement feeling, social activities impairment due to emotional or physical issues. Results. At visit 1, among the 66 patients included in our study, 36% patients (15 patients included in the probiotic group and 9 patients included in the control group) confirmed a good/very good/excellent general condition. A good general status proved to be consistent with the absence of: painful symptoms/abdominal discomfort, depressive/anxiety states and with an adequate energy level. 39% patients (12 patients included in the probiotic group and 14 patients in the control group) reported a moderately altered general status and 24% patients (6 patients included in the probiotic group and 10 patients in the control group) a severely altered general status. The altered general condition index was directly correlated with: limitation of physical/work-related activities, presence of pain/abdominal discomfort, frequency of depressive episodes and reduced energy levels. The evaluation carried out 4 weeks from HP infection eradication therapy confirms the improvement of the general condition in 10% of the 33 patients included in the probiotic group. The improvement of the general condition was associated with an increase in functional capacity and energy level, without changing the frequency of depressive episodes. Among the 33 patients included in the control group, 9% confirmed the improvement of general condition, with a directly proportional increase in functional capacity and energy level, also without changing the frequency of depressive episodes. Conclusions. The primary results, assessed shortly after the second visit, demonstrate insignificant differences between the two groups regarding the improvement of the general state, ability to perform physical / workplace-related activities and energy level. No changes were documented regarding the frequency of depressive episodes, possibly associated with the functional nature of the reported symptomatology. No adverse effects were reported during probiotic therapy based on Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus, Lactobacillus sporogenes. The obtained results will also be analyzed according to individual characteristics (age, sex, duration of symptoms, stress level at work); The long-term effects of probiotic therapy after HP eradication therapy remain to be assessed (possible using intestinal microbiota analysis before and after probiotic therapy). [ABSTRACT FROM AUTHOR]