rome and Colitis--Ulcerative

Despite advances in ulcerative colitis (UC) therapies, a relatively undefined proportion of patients experience faecal incontinence (FI) in the absence of active inflammation. For this group, there remains a significant unmet need with a limited evidence base.. We aimed to estimate the prevalence and impact of FI in UC.. In a prospective cross-sectional study, patients with UC completed a series of validated questionnaires, including Rome IV FI criteria, an inflammatory bowel disease (IBD)-specific FI questionnaire (ICIQ-IBD), Hospital Anxiety and Depression Scale and IBD-Control. UC remission was defined as faecal calprotectin (FCP) ≤250 μg/g, or IBD-control 8 score ≥13 and IBD-Control-VAS ≥ 85.. Of 255 patients with UC, overall, 20.4% fulfilled Rome IV criteria for FI. Rome IV FI prevalence did not differ between active and quiescent UC regardless of whether disease activity was defined by IBD-Control scores ± FCP (p = 0.25), or objectively with FCP thresholds of 250 μg/g (p = 0.86) and 100 μg/g (p = 0.95). Most patients (75.2%) reported FI when in 'remission' and during 'relapse' (90.6%) according to ICIQ-IBD. Those who reported FI according to both ICIQ-IBD and Rome IV definitions had higher anxiety, depression and worse quality-of-life (QoL) scores (p < 0.05). In those with Rome IV FI, there was a strong correlation between FI symptom severity and impaired QoL (r = 0.809, p < 0.001).. The prevalence of FI in UC is high, even in remission, and associated with significant psychological distress, symptom burden and impaired QoL. These findings highlight the urgent need for further research and development of evidence-based treatments for FI in UC.

Topics: Colitis, Ulcerative; Cross-Sectional Studies; Fecal Incontinence; Humans; Inflammatory Bowel Diseases; Prevalence; Prospective Studies; Quality of Life; Rome; Severity of Illness Index

Several randomised clinical trials (RCTs) performing faecal microbiota transplantation (FMT) for the management of inflammatory bowel disease (IBD), particularly for ulcerative colitis, have recently been published, but with major variations in study design. These include differences in administered dose, route and frequency of delivery, type of placebo and evaluated endpoints. Although the overall outcomes appear to be promising, they are highly dependent on both donor and recipient factors.. To develop concensus-based statements and recommendations for the evaluation, management and potential treatment of IBD using FMT in order to move towards standardised practices.. An international panel of experts convened several times to generate evidence-based guidelines by performing a deep evaluation of currently available and/or published data. Twenty-five experts in IBD, immunology and microbiology collaborated in different working groups to provide statements on the following key issues related to FMT in IBD: (A) pathogenesis and rationale, (B) donor selection and biobanking, (C) FMT practices and (D) consideration of future studies and perspectives. Statements were evaluated and voted on by all members using an electronic Delphi process, culminating in a plenary consensus conference and generation of proposed guidelines.. Our group has provided specific statements and recommendations, based on best available evidence, with the end goal of providing guidance and general criteria required to promote FMT as a recognised strategy for the treatment of IBD.

Topics: Colitis, Ulcerative; Fecal Microbiota Transplantation; Gastrointestinal Microbiome; Humans; Inflammatory Bowel Diseases; Rome; Treatment Outcome

Topics: Biomarkers; Colitis, Ulcerative; Crohn Disease; Cross-Sectional Studies; gamma-Globulins; Humans; Hypergammaglobulinemia; Prevalence; Retrospective Studies; Risk Factors; Rome; Seroepidemiologic Studies; Serologic Tests

The phenotype of cytosolic Low Molecular Weight Protein Tyrosine Phosphatase (cLMWPTP or ACP1), an enzyme involved in signal transduction of insulin, PDGF and T-cell receptors, has been determined in 71 patients with Crohn's Disease (CD: 37 males and 34 females), 49 patients with Ulcerative Colitis (UC: 27 males and 22 females) and 358 consecutive newborns (194 males and 164 females). cLMWPTP phenotypes showing a high concentration of F isoforms are associated with CD in females and with UC in males. Since PTPases counteract the effects of protein tyrosines kinases, a high concentration of F isoform of cLMWPTP may influence the mucosal response to pathogenic factors, increasing susceptibility to CD in females and to UC in males.

Topics: Colitis, Ulcerative; Crohn Disease; Female; Genetic Predisposition to Disease; Genomic Imprinting; Genotype; Humans; Infant, Newborn; Inflammatory Bowel Diseases; Isoenzymes; Male; Phenotype; Phosphorylation; Protein Processing, Post-Translational; Protein Tyrosine Phosphatases; Proto-Oncogene Proteins; Receptors, Growth Factor; Rome; Sex Characteristics; Signal Transduction

The aim of this study was to analyze the pattern of mortality among patients with ulcerative colitis (UC) and compare it with mortality in the general population of the same age and sex. All patients with UC admitted to one of the Inflammatory Bowel Disease Clinics in Rome, from January 1970 to December 31, 1989 were enrolled. Vital status was ascertained through the Registry Office of the last municipality of residence as of July 1, 1990. Cause of death was ascertained through record linkage with the national or regional mortality file and coded using the ninth revision of the International Classification of Diseases. Standardized Mortality Ratios (SMRs) were computed to compare mortality among UC patients with mortality in the general population of the same age and sex. Out of a total of 508 UC patients admitted during the study period, 27 deaths were observed, compared with 27.6 expected (SMR = 98). After excluding prevalent cases, an excess risk of death was observed among newly diagnosed cases in the first year after diagnosis (SMR = 644; p < 0.001); ulcerative colitis was the main reason for this excess mortality. Mortality for other diseases was close to that expected. In conclusion, ulcerative colitis impairs life expectancy in the first year after diagnosis, while no excess mortality seems to be present afterwards.

Topics: Adult; Case-Control Studies; Cause of Death; Colitis, Ulcerative; Confidence Intervals; Female; Follow-Up Studies; Humans; Male; Odds Ratio; Prospective Studies; Rome; Sex Distribution; Time Factors