Ulcerative Colitis: Shifting Sands View Full Text


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Article Info

DATE

2019-03-02

AUTHORS

Geert R. A. M. D’Haens, James O. Lindsay, Remo Panaccione, Stefan Schreiber

ABSTRACT

Ulcerative colitis (UC) is a chronic inflammatory bowel disease associated with considerable disease burden. We review some current misconceptions about UC in adults with the aim of optimizing care for patients. Although UC and Crohn's disease (CD) are considered discrete diseases, distinctions between them are not always clear-cut and phenotypes may change over time. Patient management should take into account disease manifestations, disease severity and extent, and response to prior treatments. Although disease extent often defines severity, distal UC is not always less disabling than extensive disease as patients can progress to more extensive disease. In addition, severe proctitis can give rise to severe and debilitating symptoms, with a substantial impact on health-related quality of life. UC carries an increased risk of colorectal cancer (CRC) compared with CD; however, more recent data indicate a similar risk of CRC in CD with colonic involvement as with UC. Corticosteroids are widely used to induce remission in UC, and prolonged use of steroids in patients with UC is common, but corticosteroid-free maintenance of remission is an important therapeutic goal. Although biologic therapies provide a valuable treatment option in UC, they are not clinically effective in all patients and are also associated with secondary loss of response. More... »

PAGES

227-234

References to SciGraph publications

  • 2016-10-03. Recent trends and future directions for the medical treatment of ulcerative colitis in CLINICAL JOURNAL OF GASTROENTEROLOGY
  • 2015-02-05. Randomized trial of tofacitinib in active ulcerative colitis: analysis of efficacy based on patient-reported outcomes in BMC GASTROENTEROLOGY
  • 2009-01-27. Loss of Response and Requirement of Infliximab Dose Intensification in Crohn's Disease: A Review in THE AMERICAN JOURNAL OF GASTROENTEROLOGY
  • 2015-12-02. Immunopathogenesis of IBD: current state of the art in NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
  • 2016-11-10. Emerging biologics in inflammatory bowel disease in JOURNAL OF GASTROENTEROLOGY
  • 2011-02-06. Meta-analysis identifies 29 additional ulcerative colitis risk loci, increasing the number of confirmed associations to 47 in NATURE GENETICS
  • 2010-01-12. Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee in THE AMERICAN JOURNAL OF GASTROENTEROLOGY
  • 2011-03-15. Loss of Response and Need for Adalimumab Dose Intensification in Crohn's Disease: A Systematic Review in THE AMERICAN JOURNAL OF GASTROENTEROLOGY
  • 2012-11-13. Impact of Antibodies to Infliximab on Clinical Outcomes and Serum Infliximab Levels in Patients With Inflammatory Bowel Disease (IBD): A Meta-Analysis in THE AMERICAN JOURNAL OF GASTROENTEROLOGY
  • 2016-08-10. Gastroenterologists’ Perceptions Regarding Ulcerative Colitis and Its Management: Results from a Large-Scale Survey in ADVANCES IN THERAPY
  • 2011-06-15. Genetics and pathogenesis of inflammatory bowel disease in NATURE
  • 2015-07-19. Optimizing Biologic Agents in Ulcerative Colitis and Crohn’s Disease in CURRENT GASTROENTEROLOGY REPORTS
  • 2010-03-09. Surgery for ulcerative colitis in 1,000 patients in INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s40268-019-0263-2

    DOI

    http://dx.doi.org/10.1007/s40268-019-0263-2

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30827006


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