The Burden of Vaccine-preventable Diseases in Patients With Inflammatory Bowel Disease.

Background: Patients with inflammatory bowel disease (IBD) are at an increased risk of infections, including vaccine-preventable diseases (VPDs). The aim of this study was to explore the inpatient prevalence of VPD in patients with IBD, as well as inpatient outcomes.

Methods: Retrospective study using the 2013-2017 Nationwide Inpatient Sample databases.

Decreased Risk of Colorectal Cancer after Colonoscopy in Patients 76-85 Years Old in the United States.

Background/aims: The benefits of colonoscopy in reducing colorectal cancer (CRC) risk for patients over 75 years are controversial. We aimed to determine whether colonoscopy use is associated with a decreased risk of CRC in patients 76-85 years old in the United States (US).

Patients And Methods: All patients in the Medicare 5% random sample of the Surveillance, Epidemiology and End Results-Medicare linked database 76-85 years old at outpatient colonoscopy between January 1, 1998 and December 31, 2002 were identified.

Double-balloon enteroscopy and outcomes in patients older than 80.

Background: double-balloon enteroscopy (DBE) is becoming more commonly used for investigation of small bowel pathology. Currently, there are limited data to describe its safety and efficacy in the population over age 65.

Aim: to investigate the indications, findings and outcomes of DBE performed in patients older than 80, as well as the correlation between DBE and prior capsule endoscopy (CE) findings.

Use of surveillance colonoscopy in medicare patients with inflammatory bowel disease prior to colorectal cancer diagnosis.

Background: Patients with longstanding inflammatory bowel disease (IBD) involving large intestine proximal to rectum are considered to be at increased risk for colorectal cancer (CRC). One prior study showed low utilization of surveillance colonoscopy in patients with ≥ 8 years of ulcerative colitis (UC) in the USA.

Aims: To study use of surveillance colonoscopy among Medicare beneficiaries with IBD in the 2-year period prior to CRC diagnosis.

Intussusception of a small bowel large B-cell lymphoma.

Gastrointestinal tumors can rarely cause intestinal intussusception. Herein, we describe a 74 year-old male with a presumed diagnosis of Crohn's disease who presented with persistent symptoms refractory to medical management. Radiography demonstrated small bowel intussusception into the cecum.

Racial/Ethnic and regional differences in the prevalence of inflammatory bowel disease in the United States.

Background: The magnitude of racial/ethnic and regional differences in the prevalence of inflammatory bowel disease (IBD) in the United States remains largely unknown.

Aims: To estimate differences in the prevalence of IBD by race/ethnicity and region.

Methods: The Medical Expenditure Panel Survey, a nationally representative survey of US households and medical conditions, was used.

Increased odds of interval left-sided colorectal cancer after flexible sigmoidoscopy compared with colonoscopy in older patients in the United States: a population-based analysis of the SEER-Medicare linked database, 2001-2005.

Objectives: To compare the proportion of interval left-sided colorectal cancers (CRCs) after flexible sigmoidoscopy vs colonoscopy in older patients and to identify factors associated with interval CRC.

Patients And Methods: Using the Surveillance, Epidemiology, and End Results-Medicare-linked database, we studied patients 67 years or older with left-sided CRC who had at least one lower endoscopy performed within the previous 36 months between July 1, 2001, and December 31, 2005. The CRCs diagnosed within 6 months of lower endoscopy were defined as detected CRCs; CRCs diagnosed 6 to 36 months after lower endoscopy were defined as interval CRCs.

Risk of colorectal cancer after colonoscopy compared with flexible sigmoidoscopy or no lower endoscopy among older patients in the United States, 1998-2005.

Objective: To determine whether the risk of colorectal cancer (CRC) decreases after colonoscopy compared with sigmoidoscopy or no lower endoscopy.

Patients And Methods: Patients 67 to 80 years old in the 5% random Medicare sample of the Surveillance, Epidemiology and End Results and Medicare-linked database were grouped into those who underwent colonoscopy or flexible sigmoidoscopy from January 1, 1998, through December 31, 2002, and those who did not undergo lower endoscopy. We excluded patients with inflammatory bowel disease, history of colon polyps, or family history of CRC.

Small bowel tumors discovered during double-balloon enteroscopy: analysis of a large prospectively collected single-center database.

Background: The emergence of capsule endoscopy and double-balloon enteroscopy (DBE) has greatly enhanced the management of small bowel tumors (SBTs). DBE is particularly useful as a diagnostic modality because it allows for direct investigation of the gastrointestinal lumen, yet little data exist regarding its clinical efficacy.

Aim: : To determine the diagnostic yield of DBE in detection of SBTs.

Rate of early/missed colorectal cancers after colonoscopy in older patients with or without inflammatory bowel disease in the United States.

Objectives: Patients with inflammatory bowel disease (IBD) have an increased risk for colorectal cancer (CRC). Previous studies on early/missed CRCs after colonoscopy excluded IBD patients. The aim of this study was to compare the rate of early/missed CRCs after colonoscopy among IBD and non-IBD patients, and identify factors associated with early/missed CRCs.

Food poisoning and diarrhea: small intestine effects.

Transmission of foodborne pathogens remains a growing concern despite increasing public awareness and heightened federal measures to control infection. Over 76 million cases of acute diarrhea secondary to ingestion of contaminated food occur annually in the United States. Fortunately, most are self-limited and resolve without therapy, but up to 6000 deaths occur on an annual basis.

Intestinal ischemia in the elderly.

Mesenteric ischemia in the elderly is an uncommon but often fatal disorder for which the prognosis depends entirely on the speed and accuracy of the diagnosis. A high index of suspicion is required as the early signs and symptoms, at a time when ischemic changes are reversible, are typically nonspecific or absent. This article reviews the clinical spectrum of mesenteric ischemia in the elderly with particular emphasis on the varied presentations, evaluation, and management of ischemic disorders of the intestines.

Inflammatory bowel disease in the elderly.

This article reviews the epidemiology, clinical manifestations, diagnosis, prognosis, and treatment of inflammatory bowel disease (IBD), which will grow in prevalence as the population ages. Prognosis of late-onset ulcerative colitis (UC) is generally similar to that of early-onset UC, whereas in Crohn disease it is probably better because of a tendency for colonic involvement. Disease complications are related more to the duration of the inflammatory bowel disease than the subject's current age.

Immunomodulators are associated with a lower risk of first surgery among patients with non-penetrating non-stricturing Crohn's disease.

Objectives: Early immunomodulator therapy may alter the natural history of Crohn's disease in certain patients. We determined whether immunomodulator use was associated with a lower risk of first surgery among patients with non-stricturing non-penetrating Crohn's disease.

Methods: A total of 159 consecutive patients with non-penetrating non-stricturing Crohn's disease from 1994 to 2005 were retrospectively identified and followed from diagnosis to either first surgery (surgery group) or last clinic follow-up (medication group) in a historical cohort analysis.

Celiac disease.

As many as one in every 100 to 200 persons in the United States has celiac disease, a condition resulting from an inappropriate immune response to the dietary protein gluten. The manifestations of celiac disease range from no symptoms to overt malabsorption with involvement of multiple organ systems and an increased risk of some malignancies. When celiac disease is suspected, initial testing for serum immunoglobulin A (IgA) tissue transglutaminase (tTG) antibodies is useful because it offers adequate sensitivity and specificity at a reasonable cost.

Oral mesalamine and clinical remission are associated with a decrease in the extent of long-standing ulcerative colitis.

Objective: To compare colonoscopy alone with surveillance biopsy for the determination of anatomic extent in long-standing ulcerative colitis (UC). To assess the influences of mesalamine use and clinical disease activity on the change of histologic extent with time.

Materials And Methods: Disease extent (proctosigmoiditis, left-sided colitis, or pancolitis) measured by colonoscopy and surveillance biopsy was compared among 212 consecutive patients with long-standing UC.

Diagnosis and treatment of postprandial nausea, allergy, and eosinophilia.

We report a case of a 16-year-old male patient who presented with postprandial fullness and nausea. He had a history of seasonal allergies, asthma, and peripheral eosinophilia. Endoscopy of the stomach with mucosal biopsies revealed predominate eosinophils.