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Epidemiology of inflammatory bowel disease in racial and ethnic migrant groups

World Journal of Gastroenterology 2018年第3期24卷 424-437页

作者： Ravi Misra Omar Faiz Pia Munkholm johan burisch Naila Arebi Department of Gastroenterology St.Marks Academic Institute Surgical Epidemiology Trials and Outcome CentreSt.Marks Academic Institute Department of Gastroen-terology North Zealand University Hospital

AIM To summarise the current literature and define patterns of disease in migrant and racial *** A structured key word search in Ovid Medline and EMBASE was undertaken in accordance with PRISMA guidelines. Studies on incidence, prevalence and disease phenotype of migrants and races compared with indigenous groups were eligible for inclusion. RESULTS Thirty-three studies met the inclusion criteria. Individual studies showed significant differences in incidence, prevalence and disease phenotype between migrants or race and indigenous groups. Pooled analysis could only be undertaken for incidence studies on South Asians where there was significant heterogeneity between the studies [95% for ulcerative colitis(UC), 83% for Crohn's disease(CD)]. The difference between incidence rates was not significant with a rate ratio South Asian: Caucasian of 0.78(95%CI: 0.22-2.78) for CD and 1.39(95%CI: 0.84-2.32) for UC. South Asians showed consistently higher incidence and more extensive UC than the indigenous population in five countries. A similar pattern was observed for Hispanics in the United States. Bangladeshis and African Americans showed an increased risk of CD with perianal disease. CONCLUSION This review suggests that migration and race influence the risk of developing inflammatory bowel disease. This may be due to different inherent responses upon exposure to an environmental trigger in the adopted country. Further prospective studies on homogenous migrant populations are needed to validate these observations, with a parallel arm for in-depth investigation of putative drivers.

关键词： Epidemiology Ethnicity Migration

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Systematic review of the prevalence and development of osteoporosis or low bone mineral density and its risk factors in patients with inflammatory bowel disease

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World Journal of Gastroenterology 2020年第35期26卷 5362-5374页

作者： Sofia Kärnsund Bobby Lo Flemming Bendtsen Jakob Holm johan burisch Gastrounit Medical DivisionCopenhagen University Hospital HvidovreHvidovre 2650Denmark Department of Endocrinology Copenhagen University Hospital HerlevHerlev 4600Denmark

BACKGROUND The inflammatory bowel diseases(IBD),Crohn’s disease(CD)and ulcerative colitis(UC)are chronic,immune-mediated disorders of the digestive *** is considered to be a risk factor for developing osteoporosis;however current literature on this matter is *** To assess prevalence and development of osteoporosis and low bone mineral density(BMD),and its risk factors,in IBD *** Systematic review of population-based *** were identified by electronic(January 2018)and manual searches(May 2018).Databases searched included EMBASE and PubMed and abstracts from 2014-2018 presented at the United European Gastroenterology Week,the European Crohn’s and Colitis Organisation congress,and Digestive Disease Week were *** were eligible for inclusion if they investigated either the prevalence of osteoporosis or osteopenia and/or risk factors for osteoporosis or low BMD in IBD *** on children under the age of 18 were *** population-based studies were *** risk factors for osteoporosis and low BMD investigated in any included article were *** quality and the possibility of bias were analysed using the Newcastle-Ottawa *** Twelve studies including 3661 IBD patients and 12789 healthy controls were *** of osteoporosis varied between 4%-9%in studies including both CD and UC patients;2%-9% in studies including UC patients, and 7%-15% instudies including CD patients. Among healthy controls, prevalence ofosteoporosis was 3% and 10% in two studies. CD diagnosis, lower body massindex (BMI), and lower body weight were risk factors associated withosteoporosis or low BMD. Findings regarding gender showed inconsistent *** patients had an increased risk for osteoporosis or low BMD over time, whileUC patients did not. Increased age was associated with decreased BMD, and therewas a positive association between weight and BMI and BMD over time. Greatheterogeneity was

关键词： Inflammatory bowel disease Osteoporosis Systematic review Epidemiology Bone mineral density

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Individualized home-monitoring of disease activity in adult patients with inflammatory bowel disease can be recommended in clinical practice: A randomized-clinical trial

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World Journal of Gastroenterology 2019年第40期25卷 6158-6171页

作者： Dorit Vedel Ankersen Petra Weimers Dorte Marker Mette Bennedsen Sanaz Saboori Kristine Paridaens johan burisch Pia Munkholm Department of Gastroenterology North Zealand University HospitalFrederikssund 3600Capital regionDenmark Global Medical Affairs Ferring International Center S.A.Saint-Prex 1162Switzerland

BACKGROUND The optimal way to home-monitor patients with inflammatory bowel disease(IBD)for disease progression or relapse remains to be *** To determine whether an electronic health(eHealth)screening procedure for disease activity in IBD should be implemented in clinical practice,scheduled every third month(3M)or according to patient own decision,on demand(OD).METHODS Adult IBD patients were consecutively randomized to 1-year open-label eHealth interventions(3M vs OD).Both intervention arms were screening for disease activity,quality of life and fatigue and were measuring medical compliance with the constant care web-application according to the screening interventions OD or *** activity was assessed using home measured fecal calprotectin(FC)and a disease activity *** In total,102 patients were randomized(n=52/503M/OD)at baseline,and 88 patients completed the 1-year study(n=433M;n=45 OD).No difference in the two screening procedures could be found regarding medical compliance(P=0.58),fatigue(P=0.86),quality of life(P=0.17),mean time spent in remission(P>0.32),overall FC relapse rates(P=0.49),FC disease courses(P=0.61),FC time to a severe relapse(P=0.69)and remission(P=0.88)during 1 ***(interquartile range)numbers of FC home-monitoring test-kits used per patient were significantly different,3M:6.0(5.0-8.0)and OD:4.0(2.0-9.0),P=*** The two eHealth screening procedures are equally good in capturing a relapse and bringing about ***,the OD group used fewer FC home testkits per *** screening procedures can be recommended for adult IBD patients in clinical web-practice.

关键词： Inflammatory bowel disease Electronic health Screening Disease activity

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Artificial intelligence assisted assessment of endoscopic disease activity in inflammatory bowel disease

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Artificial Intelligence in Gastrointestinal Endoscopy 2021年第4期2卷 95-102页

作者： Bobby Lo johan burisch Gastrounit Medical SectionCopenhagen University Hospital HvidovreHvidovre 2650Denmark Copenhagen Centre for Inflammatory Bowel Disease in Children Adolescents and AdultsCopenhagen University Hospital HvidovreHvidovre 2650Denmark

Assessment of endoscopic disease activity can be difficult in patients with inflammatory bowel disease(IBD)[comprises Crohn's disease(CD)and ulcerative colitis(UC)].Endoscopic assessment is currently the foundation of disease evaluation and the grading is pivotal for the initiation of certain ***,disharmony is found among experts;even when reassessed by the same *** studies have demonstrated that the evaluation is no better than flipping a *** UC,the greatest achieved consensus between physicians when assessing endoscopic disease activity only reached a Kappa value of 0.77(or 77%agreement adjustment for chance/accident).This is unsatisfactory when dealing with patients at risk of surgery or disease progression without proper ***,across all medical specialities,computer assistance has become increasingly *** after the emanation of machine learning–colloquially referred to as artificial intelligence(AI).Compared to other data analysis methods,the strengths of AI lie in its capability to derive complex models from a relatively small dataset and its ability to learn and optimise its predictions from new *** is therefore evident that with such a model,one hopes to be able to remove inconsistency among humans and standardise the results across educational levels,nationalities and *** has manifested in a handful of studies where AI is mainly applied to capsule endoscopy in CD and colonoscopy in ***,due to its recent place in IBD,there is a great inconsistency between the results,as well as the reporting of the *** this opinion review,we will explore and evaluate the method and results of the published studies utilising AI within IBD(with examples),and discuss the future possibilities AI can offer within IBD.

关键词： Inflammatory bowel disease Artificial intelligence Deep learning Endoscopy Disease severity Machine learning

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Ehealth monitoring in irritable bowel syndrome patients treated with low fermentable oligo-, di-, mono-saccharides and polyols diet

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World Journal of Gastroenterology 2014年第21期20卷 6680-6684页

作者： Natalia Pedersen Zsuzsanna Vegh johan burisch Lisbeth Jensen Dorit Vedel Ankersen Maria Felding Nynne Nyboe Andersen Pia Munkholm Digestive Disease Centre Medical SectionHerlev University HospitalCopenhagen 2730Denmark Department of Medicine Veszprém Megyei Csolnoky Ferenc KórházVeszprém 8200Hungary Clinical Nutrition Faculty of ScienceUniversity of Copenhagen 1870Denmark Department of Epidemiology Research Statens Serum InstitutCopenhagen 2300Denmark

In the present study we report on changes in irritable bowel syndrome-severity scoring system (IBS-SSS) and irritable bowel syndrome-quality of life (IBS-QoL) in 19 IBS patients, aged 18 to 74 years (F/M: 14/5), during 12 wk registering their symptoms on the web-application (***). During a control period of the first 6-wk patients were asked to register their IBS-SSS and IBS-QoL on the web-application weekly without receiving any intervention. Thereafter, low fermentable oligo-, di-, mono-saccharides and polyols (FODMAP) diet (LFD) was introduced for the next 6 wk while continuing the registration. Though a small sample size a significant improvement in disease activity (IBS-SSS) was observed during both the control period, median: 278 (range: 122-377), P = 0.02, and subsequently during the LFD period, median: 151 (range: 29-334), P < 0.01. The IBS-QoL solely changed significantly during the LFD period, median: 67 (37-120), P < 0.01. The significant reduction in disease activity during the control period shows a positive effect of the web-application on IBS symptoms when presented as a “traffic light”. However adding the diet reduced IBS-SSS to < 150, inactive to mild symptoms. In the future results from larger scale trials are awaited.

关键词： Irritable bowel syndrome Low fermentable oligo- di- mono-saccharides and polyols diet Self-management Disease-specific quality of life Disease activity

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Ehealth:Low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome

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World Journal of Gastroenterology 2014年第43期20卷 16215-16226页

作者： Natalia Pedersen Nynne Nyboe Andersen Zsuzsanna Végh Lisbeth Jensen Dorit Vedel Ankersen Maria Felding Mette Hestetun Simonsen johan burisch Pia Munkholm Digestive Disease Centre Medical SectionHerlev University Hospital2730 CopenhagenDenmark Department of Epidemiology Research Statens Serum Institut2300 CopenhagenDenmark Department of Medicine Veszprém Megyei Csolnoky Ferenc Kórház8200 VeszprémHungary Nutrition Department Herlev University Hospital2730 CopenhagenDenmark Clinical Nutrition Faculty of ScienceUniversity of Copenhagen1870 CopenhagenDenmark

AIM: To investigate the effects of a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet (LFD) and the probiotic Lactobacillus rhamnosus GG (LGG) in irritable bowel syndrome (IBS).

关键词： Irritable bowel syndrome Web-based management Low FODMAP diet Lactobacillus rhamnosus GG Disease severity Irritable bowel syndrome-quality of life

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Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

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World Journal of Gastroenterology 2017年第18期23卷 3356-3366页

作者： Natalia Pedersen Dorit Vedel Ankersen Maria Felding Henrik Wachmann Zsuzsanna Végh Line Molzen johan burisch Jens Rikardt Andersen Pia Munkholm Department of Gastroenterology Slagelse Hospital Gastroenterology Unit North Zealand Hospital Department of Nutrition Exercise and SportsUniversity of Copenhagen Department of Statistics First Department of Medicine Semmelweis University

To investigate the effect of a low-FODMAP diet on irritable bowel syndrome (IBS)-like symptoms in patients with inflammatory bowel disease (IBD).METHODSThis was a randomised controlled open-label trial of patients with IBD in remission or with mild-to-moderate disease and coexisting IBS-like symptoms (Rome III) randomly assigned to a Low-FODMAP diet (LFD) or a normal diet (ND) for 6 wk between June 2012 and December 2013. Patients completed the IBS symptom severity system (IBS-SSS) and short IBD quality of life questionnaire (SIBDQ) at weeks 0 and 6. The primary end-point was response rates (at least 50-point reduction) in IBS-SSS at week 6 between groups; secondary end-point was the impact on quality of ***-nine patients, 67 (75%) women, median age 40, range 20-70 years were randomised: 44 to LFD group and 45 to ND, from which 78 patients completed the study period and were included in the final analysis (37 LFD and 41 ND). There was a significantly larger proportion of responders in the LFD group (n = 30, 81%) than in the ND group (n = 19, 46%); (OR = 5.30; 95%CI: 1.81-15.55, P < 0.01). At week 6, the LFD group showed a significantly lower median IBS-SSS (median 115; inter-quartile range [IQR] 33-169) than ND group (median 170, IQR 91-288), P = 0.02. Furthermore, the LFD group had a significantly greater increase in SIBDQ (median 60, IQR 51-65) than the ND group (median 50, IQR 39-60), P < *** a prospective study, a low-FODMAP diet reduced IBS-like symptoms and increased quality of life in patients with IBD in remission.

关键词： Inflammatory bowel disease Web-based management Irritable bowel syndrome Low-FODMAP diet

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Ethnic differences in inflammatory bowel disease: Results from the United Kingdom inception cohort epidemiology study

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World Journal of Gastroenterology 2019年第40期25卷 6145-6157页

作者： Ravi Misra Jimmy Limdi Rachel Cooney Samia Sakuma Matthew Brookes Edward Fogden Sanjeev Pattni Naveen Sharma Tariq Iqbal Pia Munkholm johan burisch Naila Arebi Gastroenterology St.Mark’s Hospital and Academic InstituteLondon HA13UJUnited Kingdom The Pennine Acute Hospitals NHS Trust Institute of Inflammation and RepairUniversity of ManchesterManchester BL97TDUnited Kingdom Gastroenterology University Hospitals BirminghamBirmingham B122THUnited Kingdom Gastroenterology Royal Wolverhampton NHS TrustLondon WV100QPUnited Kingdom Gastroenterology Sandwell and West Birmingham HospitalsBirmingham B714HJUnited Kingdom Gastroenterology University Leicester HospitalsLeicester LE15WWUnited Kingdom Gastroenterology Heartlands HospitalBirmingham B95SSUnited Kingdom Department of Gastroenterology North Zealand University HospitalFrederikssund 3600Denmark

BACKGROUND The current epidemiology of inflammatory bowel disease(IBD)in the multiethnic United Kingdom is *** last incidence study in the United Kingdom was carried out over 20 years *** To describe the incidence and phenotype of IBD and distribution within ethnic *** Adult patients(>16 years)with newly diagnosed IBD(fulfilling Copenhagen diagnostic criteria)were prospectively recruited over one year in 5 urban catchment areas with high South Asian *** demographics,ethnic codes,disease phenotype(Montreal classification),disease activity and treatment within 3 months of diagnosis were recorded onto the Epicom *** Across a population of 2271406 adults,339 adult patients were diagnosed with IBD over one year:218 with ulcerative colitis(UC,64.3%),115 with Crohn's disease(CD,33.9%)and 6 with IBD unclassified(1.8%).The crude incidence of IBD,UC and CD was 17.0/100000,11.3/100000 and 5.3/100000 *** age adjusted incidence of IBD and UC were significantly higher in the Indian group(25.2/100000 and 20.5/100000)compared to White European(14.9/100000,P=0.009 and 8.2/100000,P<0.001)and Pakistani groups(14.9/100000,P=0.001 and 11.2/100000,P=0.007).The Indian group were significantly more likely to have extensive disease than White Europeans(52.7%vs 41.7%,P=0.031).There was no significant difference in time to diagnosis,disease activity and *** This is the only prospective study to report the incidence of IBD in an ethnically diverse United Kingdom *** Indian ethnic group showed the highest age-adjusted incidence of UC(20.5/100000).Further studies on dietary,microbial and metabolic factors that might explain these findings in UC are underway.

关键词： Inflammatory bowel disease Ethnicity Epidemiology Incidence Phenotype

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Follow-up of patients with functional bowel symptoms treated with a low FODMAP diet

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World Journal of Gastroenterology 2016年第15期22卷 4009-4019页

作者： Louise Maagaard Dorit V Ankersen Zsuzsanna Végh johan burisch Lisbeth Jensen Natalia Pedersen Pia Munkholm Department of Gastroenterology North Zealand University Hospital First Department of Medicine Semmelweis University Department of Gastroenterology Hvidovre University Hospital Department of Gastroenterology Herlev University Hospital Department of Gastroenterology Slagelse University Hospital

AIM: To investigate patient-reported outcomes from, and adherence to, a low FODMAP diet among patients suffering from irritable bowel syndrome and inflammatory bowel ***: Consecutive patients with irritable bowel syndrome(IBS) or inflammatory bowel disease(IBD) and co-existing IBS fulfilling the ROME Ⅲ criteria, who previously attended an outpatient clinic for low FODMAP diet(LFD) dietary management and assessment by a gastroenterologist, were invited to participate in a retrospective questionnaire analysis. The questionnaires were sent and returned by regular mail and gathered information on recall of dietarytreatment, efficacy, symptoms, adherence, satisfaction, change in disease course and stool type, and quality of life. Before study enrolment all patients had to sign an informed written ***: One hundred and eighty patients were included, 131(73%) IBS and 49(27%) IBD patients. Median age was 43 years(range: 18-85) and 147(82%) were females. Median follow-up time was 16 mo(range: 2-80). Eighty-six percent reported either partial(54%) or full(32%) efficacy with greatest improvement of bloating(82%) and abdominal pain(71%). The proportion of patients with full efficacy tended to be greater in the IBD group than in the IBS group(42% vs 29%, P = 0.08). There was a significant reduction in patients with a chronic continuous disease course in both the IBS group(25%, P < 0.001) and IBD group(23%, P = 0.002) along with a significant increase in patients with a mild indolent disease course of 37%(P < 0.001) and 23%(P = 0.002), respectively. The proportion of patients having normal stools increased with 41% in the IBS group(P < 0.001) and 66% in the IBD group(P < 0.001). One-third of patients adhered to the diet and high adherence was associated with longer duration of dietary course(P < 0.001). Satisfaction with dietary management was seen in 83(70%) IBS patients and 24(55%) IBD patients. Eightyfour percent of patients lived on a modified LFD, wher

关键词： Low FODMAP Irritable bowel syndrome Inflammatory bowel disease Adherence Disease course

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