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Medicina
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Inflammatory Bowel Disease: Causes, Symptoms, Diet and Treatment
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Inflammatory Bowel Disease: Causes, Symptoms, Diet and Treatment

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (1 August 2019) | Viewed by 15778

Special Issue Editors

Dr. Atsushi Sakuraba

E-Mail Website
Guest Editor
Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL 60637, USA
Interests: inflammatory bowel disease; Crohn's disease; ulcerative colitis; microscopic colitis; colon cancer; gastrointestinal endoscopy; fecal transplant; clinical trials
Special Issues, Collections and Topics in MDPI journals
Dr. Katsuyoshi Matsuoka

E-Mail Website
Guest Editor
Inflammatory bowel disease center, Toho University Sakura Medical Center, Chiba, Japan
Interests: inflammatory bowel disease; Crohn's disease; ulcerative colitis

Special Issue Information

Dear Colleagues,

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a chronic relapsing and remitting disorder characterized by inflammation of the digestive tract. It causes various intestinal as well as extraintestinal symptoms, which often can be debilitating. With the advancement of basic, translational, and clinical research, our understanding and management of IBD have greatly progressed over the past decades. The exact cause of IBD still remains unknown, but research has shown that genetic, immunological, and environmental factors play a role in the initiation and perpetuation of the disease process. Clinical management has greatly changed in the past decade owing to the evolution of biologic treatments, and treatment goals are now not only to control symptoms but to achieve mucosal healing and alter the natural course of the disease. To promote the basic and clinical research field in IBD, we invite investigators to contribute original research articles as well as review articles that will stimulate the continuing efforts to understand the mechanisms and management of IBD. Topics of interest include, but are not limited to, the following:

  • Genetics
  • Immunology and tolerance
  • Host-microbe interaction and fecal transplantation
  • Novel diagnostic approaches including biomarkers, serology, and imaging modalities
  • Biologic and non-biologic therapies
  • Therapeutic drug monitoring
  • Mucosal healing
  • Disease- and therapy-related complications and surveillance
  • Surgery and related issues

Dr. Atsushi Sakuraba
Dr. Katsuyoshi Matsuoka
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • inflammatory bowel disease
  • Crohn’s disease
  • ulcerative colitis
  • microbiome
  • fecal transplant
  • biologics
  • mucosal healing

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Published Papers (4 papers)

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Research

14 pages, 323 KiB  
Article
The Effect of Enteral Nutrition Support Rich in TGF-β in the Treatment of Inflammatory Bowel Disease in Childhood
by Mehmet Agin, Aylin Yucel, Meltem Gumus, Hasan Ali Yuksekkaya and Gokhan Tumgor
Medicina 2019, 55(10), 620; https://doi.org/10.3390/medicina55100620 - 22 Sep 2019
Cited by 14 | Viewed by 3226
Abstract
Background and Objective: Malnutrition is a major complication of inflammatory bowel disease (IBD). Our aim of the study was to examine the effects of Modulen IBD supplementation, which was administered to IBD patients without limiting their daily diet in addition to medical treatment, [...] Read more.
Background and Objective: Malnutrition is a major complication of inflammatory bowel disease (IBD). Our aim of the study was to examine the effects of Modulen IBD supplementation, which was administered to IBD patients without limiting their daily diet in addition to medical treatment, on the clinical, laboratory, anthropometric values, and disease activities of these patients. Materials and Methods: Seventy three children with IBD were evaluated retrospectively. The cases were classified as those who had Crohn disease receiving (CD-M; n = 16) or not receiving Modulen IBD (CD; n = 19) and those who had ulcerative colitis receiving (UC-M; n = 13) or not receiving Modulen IBD (UC; n = 25). Disease activities, laboratory values, remission rates, and anthropometric measurements of the groups were compared. In addition to IBD treatment, Modulen IBD in which half of the daily calorie requirement was provided was given for eight weeks. Results: In the third month of treatment, 14 (88%) patients were in remission in CD-M group and eight (42%) patients were in remission in CD group. The height and weight z scores, which were low at the time of diagnosis, improved in the first week in CD-M group. Inflammatory parameters (UC) were significantly lower in the UC-M group compared to the UC group in first and third months. In the third month, eight (62%) patients in the UC-M group and four (16%) in the UC group were remitted clinically and in terms of laboratory values. Conclusions: TGF-β-rich enteral nutrition support in children with IBD is an easy, effective, and reliable approach. It was shown that TGF-β-rich enteral nutritional supplementation enabled the disease to enter the remission earlier, and contributed to the early recovery of weight and height scores. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease: Causes, Symptoms, Diet and Treatment)
13 pages, 777 KiB  
Article
Self-Prescribed Dietary Restrictions are Common in Inflammatory Bowel Disease Patients and Are Associated with Low Bone Mineralization
by Tiziana Larussa, Evelina Suraci, Raffaella Marasco, Maria Imeneo, Ludovico Abenavoli and Francesco Luzza
Medicina 2019, 55(8), 507; https://doi.org/10.3390/medicina55080507 - 20 Aug 2019
Cited by 34 | Viewed by 3911
Abstract
Background and objectives: Despite the serious concerns of patients about the role of food in triggering or ameliorating their intestinal disease, there are few studies dealing with patients’ beliefs and practices regarding diet in inflammatory bowel disease (IBD). The aim of this study [...] Read more.
Background and objectives: Despite the serious concerns of patients about the role of food in triggering or ameliorating their intestinal disease, there are few studies dealing with patients’ beliefs and practices regarding diet in inflammatory bowel disease (IBD). The aim of this study was to investigate how the disease affected the dietary habits of patients with IBD, and to assess if patients’ food restrictions were responsible for low bone mineralization. Materials and Methods: For this study, 90 consecutive patients referred for IBD were interviewed regarding their dietary habits. Demographic features and clinical characteristics potentially associated with the dietary habits were collected. A validated and self-administered survey questionnaire dealing with dietary habits and patients’ beliefs and perceptions regarding food was analyzed. Multivariate logistic regression analysis was performed in order to identify risk factors for dietary restrictions among participants and to evaluate the relationship between dietary restrictions and low bone mineral density (BMD). Results: Among the 63 (70%) patients who claimed a self-prescribed dietary restriction, 84% avoided dairy products. Significant risk factors (adjusted odds ratio (OR), 95% confidence interval (CI)) for the dietary restrictions were a younger age (p = 0.02), a higher level of education (p = 0.007), and a higher visceral sensitivity index (p = 0.009). Most (80%) of the patients displayed an inadequate calcium intake, and an abnormal result at dual-energy X-ray absorptiometry (DXA) scan accounting for low BMD was reported in 46 (51%) of them. Dietary restrictions (p = 0.03), and in particular avoiding dairy products (p = 0.001), were significant risk factors for a low BMD, along with female gender (p = 0.001), smoking (p = 0.04), and steroid abuse (p = 0.03). Almost all (86%) patients changed their diet after IBD diagnosis, as 8% believed that foods could have been a trigger for IBD and 37% that a proper diet was more important than drugs in controlling disease. Although 61% of the patients claimed to have received nutritional advice, 78% of the participants showed interest in receiving more. Conclusions: Dietary habits of IBD patients should be investigated by healthcare professionals as part of the routine visit. Clinicians are invited to provide nutritional recommendations to these patients in order to avoid unnecessary self-prescribed dietary restrictions. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease: Causes, Symptoms, Diet and Treatment)
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15 pages, 854 KiB  
Article
Analysis of Association between Dietary Intake and Red Blood Cell Count Results in Remission Ulcerative Colitis Individuals
by Dominika Głąbska, Dominika Guzek, Barbara Kanarek and Gustaw Lech
Medicina 2019, 55(4), 96; https://doi.org/10.3390/medicina55040096 - 8 Apr 2019
Cited by 5 | Viewed by 4473
Abstract
Background and objectives: The anemia is the most common extra-intestinal manifestation of the ulcerative colitis. Taking into account, that meat products are perceived as factor, that may promote relapses, the crucial is to indicate the dietary recommendations to prevent anemia development but without [...] Read more.
Background and objectives: The anemia is the most common extra-intestinal manifestation of the ulcerative colitis. Taking into account, that meat products are perceived as factor, that may promote relapses, the crucial is to indicate the dietary recommendations to prevent anemia development but without high animal products intake. Aim of the study was to analyze the influence of animal products intake on the red blood cell count results in remission ulcerative colitis individuals and pair-matched control group, during 6 weeks of observation. Materials and Methods: The intake of nutrients associated with anemia development (iron, vitamin B12, protein, animal protein, calcium) and the products being their sources (meat, meat products, dairy beverages, cottage cheese, rennet cheese) were analyzed. Results: In spite of the higher meat products intake in the group of ulcerative colitis individuals, the iron intake did not differ between groups. The positive correlations between intakes of meat, meat products, total protein, animal protein, iron, vitamin B12 and red blood cell count results were stated for ulcerative colitis individuals, while in control group were not observed, that may have resulted from higher susceptibility for the diet-influenced changes. Conclusions: The positive correlation between red blood cell count results and energy value of diet, and daily iron intake observed in ulcerative colitis individuals, accompanied by negative correlation for iron intake per 1000 kcal of diet, may indicate, that higher iron intake may be beneficial, but only while accompanied by high energy value of diet. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease: Causes, Symptoms, Diet and Treatment)
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14 pages, 3076 KiB  
Article
Nonenzymatic Serum Antioxidant Capacity in IBD and Its Association with the Severity of Bowel Inflammation and Corticosteroids Treatment
by Katarzyna Neubauer, Radoslaw Kempinski, Malgorzata Matusiewicz, Iwona Bednarz-Misa and Malgorzata Krzystek-Korpacka
Medicina 2019, 55(4), 88; https://doi.org/10.3390/medicina55040088 - 2 Apr 2019
Cited by 21 | Viewed by 3237
Abstract
Background and objectives: Oxidative stress signalling plays a monumental role in inflammatory bowel disease (IBD). Reduction of oxidative stress might control inflammation, block tissue damage, and reverse natural history of IBD. We assessed the serum concentrations of free thiols (FT) and uric [...] Read more.
Background and objectives: Oxidative stress signalling plays a monumental role in inflammatory bowel disease (IBD). Reduction of oxidative stress might control inflammation, block tissue damage, and reverse natural history of IBD. We assessed the serum concentrations of free thiols (FT) and uric acid (SUA), together constituting a large part of nonenzymatic serum antioxidant capacity, as well as total antioxidant status (TAS) with reference to IBD phenotype, activity, co-occurrence of anemia, and treatment with azathioprine (AZA) and corticosteroids (CS). Additionally, we appraised the potential of uric acid, thiol stress, and TAS as mucosal healing (MH) markers in ulcerative colitis. Materials and methods: SUA, FT, and TAS were measured colorimetrically using, respectively, uricase, Ellman’s and 2,2′-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) methods. Results: The study group consisted of 175 individuals: 57 controls, 71 ulcerative colitis (UC), and 47 Crohn’s disease (CD) patients. When compared to controls, SUA levels were significantly lower in patients with CD, and FT and TAS levels were significantly lower in patients with CD and UC. In UC patients, SUA, FT, and TAS inversely correlated with the severity of bowel inflammation. As MH markers, SUA displayed better overall accuracy and higher specificity than FT. In active CD, FT, and SUA were significantly lower in patients with anemia. FT was significantly lower in patients treated with corticosteroids. Conclusions: IBD patients, regardless the disease phenotype, have systemic thiol stress, depleted total antioxidant capacity, and reduced concentrations of uric acid, reflecting, to various degrees, clinical and local disease activity as well as presence of anaemia, the most common extraintestinal manifestation of IBD. Evaluation of systemic total antioxidant status may be useful in noninvasive assessment of mucosal healing. Our findings on thiol stress provide an additional aspect on adverse effects of corticosteroids therapy. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease: Causes, Symptoms, Diet and Treatment)
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