Create New Share
Please enter the email address below of the person you would like to share this article with.
An email will be sent to the recipient with a link to this chosen article.
A source for healthcare professionals to access the latest data and information on the diagnosis, treatment and management of patients with gut related disorders
Dr Jordi Guardiola
Head of the Department of Digestive Diseases, Bellvitge University Hospital, Barcelona, Spain
We do not know exactly why patients with inflammatory bowel disease (IBD) have clinical symptoms. There is no correlation between endoscopic lesions and the clinical manifestations assessed by the Crohn’s disease activity index.1
This lack of correlation has been confirmed in a post hoc analysis of patients in the Study of Biologic and Immunomodulator Naive Patients in Crohn’s Disease trial. The study analysed the probability of presenting intestinal lesions in patients with symptoms. In all cases, a positive predictive value of 65% was observed which indicated that symptoms have limited use in determining whether a patient has endoscopic activity.2 It has therefore been postulated that patients with IBD could have post-inflammatory irritable bowel syndrome (IBS). In fact, a number of systematic reviews have indicated that more than a third of patients in remission from inflammatory disease have symptoms that meet the Rome criteria.3
A study was published in 1994 that primarily investigated patients with Crohn’s disease with long-standing diarrhoea who did not respond to conventional treatment. The study observed that all patients with a history of ileal resection presented with bile acid diarrhoea (BAD), as well as a third of the patients without resection.4 There is a need to confirm the presence of BAD in symptomatic patients with Crohn’s disease in whom there is no clear evidence of inflammatory activity. Treatment success with bile acid binders will depend, in part, on the patient understanding their disease and treatment, and on the conviction of the physician in prescribing the therapy.
Job number: JB57410GBk Date of Preparation: June 2019
You must be registered to GutNews.org
to view or download these files
Brief report: length of ileal resection correlates with severity of bile acid malabsorption in Crohn’s disease
In patients with Crohn’s disease who had a prior surgical resection there was a modest correlation between the length of ileal resection and the severity of bile acid malabsorption (BAM), as defined by tauroselcholic (75selenium) acid (SeHCAT) retention values. Response to bile salt sequestrant therapy was not dependent on SeHCAT retention values.
Are you a healthcare professional?
This educational website is developed by GE Healthcare for educational purposes. The information contained within this website is intended for healthcare professionals. By entering this website you are confirming that you are a healthcare professional.
This link opens another website that is not under the review or control of GE Healthcare Ltd and, as such, the company does not endorse the content, its accuracy, or any practices or standards contained within it.