Environmental exposure: can we reduce risk?
|
|
|
- Shawn Sharp
- 5 years ago
- Views:
Transcription
1 Oxford Inflammatory Bowel Disease MasterClass Environmental exposure: can we reduce risk? Dr Peter Lakatos, Budapest, Hungary
2 Oxford Inflammatory Bowel Disease MasterClass Environmental exposure: can we reduce risk? Peter Laszlo Lakatos 1st Department of Medicine Semmelweis University Budapest Hungary
3 Objective to discuss the role of environmental factors in IBD in disease susceptibility in predicting disease phenotype During the course of the disease short-long term prognosis and risk for complications?
4 Reducing risk of WHAT? disease susceptibility? disease phenotype? disease course progression? AND if we decrease certain risks will we have to other complications?
5 IBD a complex phenotype
6 Environmental factors in IBD flora stress smoking drugs (OC, NSAID) appendectomy IBD infections (measles, mycobacterium, pharyngitis, tonsillitis,) diet hygiene (refined sugar, fat, fast food, corn flakes, chocolate, cocacola, toothpaste)
7 Disease susceptibility Leone V J Gastroenterol 2013
8 Developed hygiene?
9 Developed hygiene? Urban environment and risk of CD (and UC) IRR CD : 1.42, 95%CI: IRR UC : 1.17, 95%CI: Soon BMC Gastroenterology 2012
10 Developed hygiene? Bernstein CN Am J GE 2006
11 Developed hygiene? Bernstein CN Am J GE 2006
12 Vaccination? Davis RL Arch Ped Adolesc Med 2001 Villumsen Inflamm Bowel Dis 2013
13 Diet? Studies are inconsistent and subject to important methodological limitations. Riordan AM Eur J Clin Nutr 1998;52:
14 Diet: but how to measure? Hou AJG 2011, Ng Gut 2013
15 Diet-fat: CD+ UC- Hou AJG 2011, Ng Gut 2013
16 Fat intake and UC - NHS study yrs at inclusion! Ananthakrishnan Gut 2013 july
17 Diet: fat and the EPIC IBD in the elderly! Tjonneland GUT 2009, de Silva GE 2010
18 Diet- fruit, vegetable, fiber -? Hou AJG 2011, g Gut 2013
19 Fiber intake and CD?! NHS study yrs at inclusion! For each food item, a commonly used portion size was specified and participants were asked how often they consumed the food on an average over the past year.?? Ananthakrishnan Gastro 2013 aug
20 Vitamin D Data are increasing on the immunologic role of vitamin D, particularly on the innate immune system?? Ananthakrishnan Gastroenterology 2012
21 and there is a seasonal variation in vitamin D levels? Bours PH Osteoporosis Int 2011
22 Is it the then sunlight? or vitamin D? CD risk Nerich V Aliment Pharm Ther 2011
23 Season of Birth and risk of IBD? Shaw SY CGH 2013 aug
24 NSAID use? An EPIC IBD in the elderly? BUT: age at inclusion and capture of Aspirin use? Chan SS Aliment Pharm Ther 2011
25 NSAID dose and duration? NHS study yrs at inclusion! + dose +duration of use Anathakrishnan Ann Intern Med 2012
26 Oral contraceptive use OR CD : 1.44, ORCD: 1.51, (14 studies) 95%CI: %CI: NHS study in CD HR: 2.82 (95% CI 1.65 to 4.82) among current users 1.39 (95% CI 1.05 to 1.85) among past users OR UC : 1.29, 95%CI: Godet PG Gut 1995, Cornish JA Am J GE 2008, Khalili GUT 2013
27 Hormone replacement therapy and risk of postmenopausal IBD NHS study yrs at inclusion! Khalili Gastroenterology 2012
28 Appendectomy and risk of UC Rate of appendectomy in UC: 1/174 (0.6%) Rate of appendecytomy in controls: 41/161 (25.4%) OR: 59.1 (95% CI, ) Rutgeerts NEJM 1994 Koutrobakis IBD 2002
29 Appendicits? and risk of UC Frisch M BMJ 2009
30 Life events Lerebours E IBD 2007
31 Smoking
32 current vs never smoking %CI: P<0.001 former vs never smoking %CI: P=0.08 Mahid SS Mayo Clin Proc 2006
33 current vs never smoking %CI: P<0.001 former vs never smoking %CI: P<0.001 Mahid SS Mayo Clin Proc 2006
34 Smoking; is the risk age-dependent? Lakatos IBD 2013
35 Air pollution? Kaplan GG Am J GE 2010
36 Is it infectious? Virus, bacteria or worms?
37 CD: Infections? Antibiotics? Cause or indicator? Halfvarson Inflamm Bowel Dis 2006
38 Antibiotics and CD? Indicator or bystander? Finland Denmark (n=577627) Hviid A Gut 2011 Virta E Am J Epidemiol 2012
39 And, of course there is interaction... Smoking cessation and composition of intestinal microflora cessation non-smoker smoker Biederman PLOS One 2013
40 Predicting disease phenotype/disease course?
41 Is diet predicting the relapse rate in UC? Jowett SL Gut 2004
42 Can we modify the disease? Vitamin D In DSS mouse maybe, in human? In vitro, 1,25(OH)2D3 increased TEER, TJ proteins and mrna expressions, decreased the FITC-D permeability, and preserved structural integrity of the TJ in Caco-2 cells Zhao H BMC Gastroenterology 2012
43 Vitamin D level is associated with activity and QoL Ulitsky JPEN J Parenter Enteral Nutr 2011
44 Vitamin D level and hospitlization/surgery predictor or indicator only? Ananthakrishnan IBD 2013
45 Is stress associated with disease course in IBD?
46 Is stress associated with disease course in IBD? Bitton Gut 2008
47 Psychiatric co-morbidity and risk of hospitalization, drug use and surgery? Ananthakrishnan Aliment Pharm Ther 2013
48 Smoking is associated with probability of flares in CD Cosnes J Gastroenterology 2001
49 % without stricture % without complicated disease Smoking and disease phenotype in CD Aldhous M. Am J GE 2007
50 Survival without surgery Association between smoking, azathioprine/biological use and need for surgery in patients with Crohn`s disease 1,0 0,8 no IM / no smoking IM / no smoking no IM / smoking IM / smoking censored censored censored censored 0,6 0,4 0,2 0,0 0,00 50,00 100,00 150,00 200,00 250,00 300,00 follow-up (months) plogrank<0.001, pbreslow<0.001 Szamosi T EJGH2010
51 Association between smoking and colectomy in UC OR: 0.57 (95%CI: ) Cosnes J Best Pract Res Clin GE 2004
52 Survival without colectomy Association between smoking and colectomy in UC 1,0 0,8 0,6 0,4 0,2 0,0 no-smoking smoking censored censored 0,00 100,00 200,00 300,00 400,00 follow-up (months) Szamosi T EJGH2010 plogrank=0.042, pbreslow=0.08
53 Ananthakrishnan IBD 2011 Air pollution and hospitalization? Probably not specific for IBD
54 Summary: Environmental factors Molodecky NA, IBD 2011
55 Modifying evironmental factors? Ananthakrishnan Curr Gastro Rep 2013
56 Environmental factors in IBD There are many methodological limitations Molodecky NA, IBD 2011
57 So, how can we modify the environmental exposure predisposing to IBD? Protective: breastfeeding, vitamin D, fruit/vegetable, fiber, sunshine Avoid: developed hygiene but also early life gastrointestinal infections/antibiotics, air polution, NSAID, sugar?/fat?/red meat, stress-life events, psychiatric co-morbidity, in females: contraceptives- HRT, in males-do not born April-June (if you are Canadian?) Conflictive: Smoke or not? depending whether you are afraid of CD or UC?, have an appendectomy, Ideal but place only to before live! the age of 20 yrs and only for appendicits!
Environmental factors affecting IBD Have we made progress? Peter Laszlo Lakatos 1st Department of Medicine Semmelweis University Budapest Hungary
Environmental factors affecting IBD Have we made progress? Peter Laszlo Lakatos 1st Department of Medicine Semmelweis University Budapest Hungary Environmental factors in IBD Are associated with disease
Is there an anti-inflammatory diet in IBD?
CCFA North Texas Chapter IBD education symposium December 2, 2017, Dallas, TX Is there an anti-inflammatory diet in IBD? Themos Dassopoulos, MD Director, Baylor Scott and White Center for IBD Baylor University
Page 1. Global trends in diet parallel IBD. Is there an anti-inflammatory diet for IBD? Patients want to know. Challenges in establishing causality
Is there an anti-inflammatory diet for IBD? Why diet? Global trends in diet parallel IBD Ashwin N Ananthakrishnan, MD, MPH Director, Crohn s and Colitis Center Assistant Professor of Medicine Massachusetts
Factsheet - Risk factors for inflammatory bowel disease (IBD)
Key Points Knowledge of the causes or risk factors for Crohn s disease and ulcerative colitis is limited. Many genes have been shown to be associated with the development of IBD. Research is continuing
Dietary Options for Inflammatory Bowel Disease
Dietary Options for Inflammatory Bowel Disease Michael J. Rosen, MD, MSCI Schubert-Martin Inflammatory Bowel Disease Center Learning objectives Worldwide rise in the incidence of IBD The relationship between
Epidemiology of Inflammatory Bowel Disease
Epidemiology of Inflammatory Bowel Disease Edward V. Loftus, Jr., M.D. Professor of Medicine Division of Gastroenterology and Hepatology Mayo Clinic Rochester, Minnesota, U.S.A. 2010 MFMER slide-1 Loftus
Looking for Answers. IBD Research March 9, Dr. Benjamin Click, MD MS Associate Staff Cleveland Clinic
Looking for Answers IBD Research 2019 March 9, 2019 Dr. Benjamin Click, MD MS Associate Staff Cleveland Clinic Disclosures No relevant financial disclosures There is still no cure for IBD Why me? ETIOLOGY
Causes of IBD: The Role of Genetics and Microbes and the Epidemiology of IBD
Causes of IBD: The Role of Genetics and Microbes and the Epidemiology of IBD James D. Lewis, MD, MSCE Professor of Medicine and Epidemiology Perelman School of Medicine at the University of Pennsylvania
Crohn s Disease. Naturopathic Treatment Options
Crohn s Disease Naturopathic Treatment Options by Dr. Gayamali Karunaratna, B.Sc., M.Ed., ND Markham Natural Health Centre 3160 Steeles Avenue East, Suite 204 Markham, Ontario L3R 4G9 http://www.markhamnaturalhealthcentre.com
Gut Microbiota and IBD. Vahedi. H M.D Associate Professor of Medicine DDRI
Gut Microbiota and IBD Vahedi. H M.D Associate Professor of Medicine DDRI 1393.3.1 2 GUT MICROBIOTA 100 Trillion Microbes - 10 times more than cells in our body Collective weight of about 1kg in human
Inflammatory bowel disease (IBD) is a chronic intestinal disease
Environmental Risk Factors for Inflammatory Bowel Disease Ashwin N. Ananthakrishnan, MD, MPH Dr. Ananthakrishnan is an Assistant Professor of Medicine in the Division of Gastroenterology at the Massachusetts
Predicting the natural history of IBD. Séverine Vermeire, MD, PhD Department of Gastroenterology University Hospital Leuven Belgium
Predicting the natural history of IBD Séverine Vermeire, MD, PhD Department of Gastroenterology University Hospital Leuven Belgium Patient 1 Patient 2 Age 22 Frequent cramps and diarrhea for 6 months Weight
Etiology, Assessment and Treatment
Etiology, Assessment and Treatment Andrew Tinsley MD, MS Associate Director of IBD Center Assistant Professor of Medicine Penn State College of Medicine Abbvie Janssen Nestle 1 To review the prevalence
PEDIATRIC INFLAMMATORY BOWEL DISEASE
PEDIATRIC INFLAMMATORY BOWEL DISEASE Alexis Rodriguez, MD Pediatric Gastroenterology Advocate Children s Hospital Disclosers Abbott Nutrition - Speaker Inflammatory Bowel Disease Chronic inflammatory disease
IBD high risk groups
IBD high risk groups Ulcerative colitis Value (95% CI) CRC prevalence (%) 3.7 (3.2-4.2) Overall annual CRC incidence (%) 0.3 (0.2-0.4) Annual CRC incidence in first decade of UC (%) 0.2 (0.1-0.2) Annual
Inflammatory Bowel Diseases (IBD) Clinical aspects Nitsan Maharshak M.D., IBD Center, Department of Gastroenterology and Liver Diseases Tel Aviv Soura
Inflammatory Bowel Diseases (IBD) Clinical aspects Nitsan Maharshak M.D., IBD Center, Department of Gastroenterology and Liver Diseases Tel Aviv Sourasky Medical Center Tel Aviv, Israel IBD- clinical features
What is IBD and Why Me?
Johns Hopkins Symposium: An Integrative Medicine Approach to Inflammatory Bowel Disease (IBD) What is IBD and Why Me? Steven R. Brant, M.D. Associate Professor of Medicine Director, Meyerhoff Inflammatory
Anti-TNF and cyclosporine are identical choices for severe ulcerative colitis refractory to steroid therapy CON Peter Laszlo LAKATOS Semmelweis
Anti-TNF and cyclosporine are identical choices for severe ulcerative colitis refractory to steroid therapy CON Peter Laszlo LAKATOS Semmelweis University, 1st Department of Medicine Budapest June 13-15,
What to Eat For a Healthy Gut
What to Eat For a Healthy Gut CHOP IBD Education Day 2018 LINDSEY ALBENBERG, DO NATALIE L. ADLER, RD, CSP, LDN Does diet play a role in the development of IBD? Hou JK et al. American Journal of Gastro
Nutritional Requirements for Inflammatory Bowel Disease. Dale Lee, MD, MSCE Assistant Professor of Pediatrics University of Washington
Nutritional Requirements for Inflammatory Bowel Disease Dale Lee, MD, MSCE Assistant Professor of Pediatrics University of Washington No disclosures Objectives 1) Review the biological mechanisms disturbed
Genetic and Environmental Risks for IBD
Genetic and Environmental Risks for IBD CCFA April 26, 2014 Presented by: Name goes here April 30, 2014 TheoTheodore 1 Genetic and Environmental Risks for IBD Theodore M. Bayless, M.D. Director Emeritus
Microbiome GI Disorders
Microbiome GI Disorders Prof. Ram Dickman Neurogastroenterology Unit Rabin Medical Center Israel 1 Key Points Our gut microbiota Were to find them? Symbiosis or Why do we need them? Dysbiosis or when things
EPIDEMIOLOGY OF INFLAMMATORY BOWEL DISEASE IN PEDIATRIC PATIENTS
EPIDEMIOLOGY OF INFLAMMATORY BOWEL DISEASE IN PEDIATRIC PATIENTS ERIC BENCHIMOL, MD, PhD, FRCPC Associate Professor of Pediatrics and Epidemiology, University of Ottawa Pediatric Gastroenterologist, CHEO
Guided by Dr. Michal Amitai Head of Abdominal Imaging Department of Diagnostic Imaging Sheba Medical Center Sackler School of Medicine, Tel Aviv
Guided by Dr. Michal Amitai Head of Abdominal Imaging Department of Diagnostic Imaging Sheba Medical Center Sackler School of Medicine, Tel Aviv University 1 SHARE study My year Collaboration between gastroenterology
Epidemiology of Inflammatory Bowel Disease and Overview of Pathogenesis
Epidemiology of Inflammatory Bowel Disease and Overview of Pathogenesis Crohn s disease (CD) and ulcerative colitis (UC) are believed to affect approximately 1.4 million people in the United States (US).
Communicating with the IBD Patient: How to convey risks and benefits
Communicating with the IBD Patient: How to convey risks and benefits October 30, 2011 ACG Postgraduate Course National Harbor, Maryland Corey A. Siegel, MD Assistant Professor of Medicine Dartmouth Medical
Slide 1. Slide 2. Slide 3. Inflammatory Bowel Disease in the Elderly. IBD and aging. IBD and aging
Slide 1 Inflammatory Bowel Disease in the Elderly Steven N. Fine, MD Chief of GI, MetroWest Med Cntr Med Director, Boston Endo Cntr Slide 2 IBD and aging Are there differences between older and younger
Speaker Introduction
Speaker Introduction Stephen B. Hanauer, MD Professor of Medicine and Clinical Pharmacology University of Chicago Pritzker School of Medicine Chief of Gastroenterology, Hepatology, and Nutrition University
Addressing Risks and Benefits In IBD
Addressing Risks and Benefits In IBD Gil Y. Melmed, MD, MS Assistant Professor of Medicine, Cedars-Sinai Medical Center David Geffen School of Medicine at UCLA www.nomorecrohnsdisease.com "Jaw Dropping
Personalized Medicine in IBD
Personalized Medicine in IBD Anita Afzali MD, MPH Assistant Professor of Medicine Director, Inflammatory Bowel Diseases Program University of Washington Harborview Medical Center CCFA April 2 nd, 2016
Maintaining Good Health
Pediatric Inflammatory Bowel Disease Maintaining Good Health Ghassan Wahbeh MD Professor Pediatric Gastroenterology Seattle Children s Hospital Director IBD Center University of Washington 1. IBD treatment
Can We Predict the Natural History of Ulcerative Colitis? Edward V Loftus, Jr, MD Professor of Medicine Mayo Clinic Rochester, Minnesota, USA
Can We Predict the Natural History of Ulcerative Colitis? Edward V Loftus, Jr, MD Professor of Medicine Mayo Clinic Rochester, Minnesota, USA Endpoints Overview Hospitalization Surgery Colorectal cancer
Cancer Risk with IBD Therapies How to Discuss with your Patients?
Cancer Risk with IBD Therapies How to Discuss with your Patients? Douglas L Nguyen, MD Assistant Clinical Professor of Medicine University of California, Irvine Medical Center H.H. Chao Comprehensive Digestive
Accepted Manuscript. Correlation or Causation: Sex Hormones and Microscopic Colitis. Baldeep Pabla, Reid M. Ness
Accepted Manuscript Correlation or Causation: Sex Hormones and Microscopic Colitis Baldeep Pabla, Reid M. Ness PII: S0016-5085(18)35216-8 DOI: https://doi.org/10.1053/j.gastro.2018.11.007 Reference: YGAST
Gut Lung Axis Implication of the Gut Microbiota beyond its niche
Gut Lung Axis Implication of the Gut Microbiota beyond its niche Reema Subramanian PhD Candidate (4 th year) Supervisor: Prof. Margaret Ip Department of Microbiology, CUHK Joint Graduate Student Seminar
Page 1. Is the Risk This High? Dysplasia in the IBD Patient. Dysplasia in the Non IBD Patient. Increased Risk of CRC in Ulcerative Colitis
Screening for Colorectal Neoplasia in Inflammatory Bowel Disease Francis A. Farraye MD, MSc Clinical Director, Section of Gastroenterology Co-Director, Center for Digestive Disorders Boston Medical Center
ESPEN Congress Lisbon 2015 NUTRITIONAL ISSUES IN CROHN'S DISEASE. The clash of generations: children are not small adults S.
ESPEN Congress Lisbon 2015 NUTRITIONAL ISSUES IN CROHN'S DISEASE The clash of generations: children are not small adults S. Kolacek (HR) Role of Nutrition in Children with CD Child is NOT a Little Adult
Diet and breast cancer risk: fibre and meat
Diet and breast cancer risk: fibre and meat UK Women s Cohort Study Janet Cade General diet and cancer issues: Alcohol consumption increases cancer risk, particularly among smokers In England 47% of men
Bacteriology. Mycology. Patient: SAMPLE PATIENT DOB: Sex: MRN: Rare. Rare. Positive. Brown. Negative *NG. Negative
Patient: SAMPLE PATIENT DOB: Sex: MRN: 3.2 0.9-26.8 U/g 1.2 0.2-3.3 mg/g 2.2 1.3-8.6 micromol/g 1.1 1.3-23.7 mg/g 1.1 0.2-3.5 mg/g Rare 1.0 0.2-8.8 mg/g Rare 4.4 2.6-32.4 mg/g 64.6 >= 13.6 micromol/g Bacteriology
Mucosal healing: does it really matter?
Oxford Inflammatory Bowel Disease MasterClass Mucosal healing: does it really matter? Professor Jean-Frédéric Colombel, New York, USA Oxford Inflammatory Bowel Disease MasterClass Mucosal healing: does
My Child Has Inflammatory Bowel Disease : Why? What now? What s next?
My Child Has Inflammatory Bowel Disease : Why? What now? What s next? George M. Zacur, M.D., M.S. Clinical Assistant Professor Department of Pediatrics and Communicable Diseases Division of Gastroenterology
Diagnostic and Therapeutic Approaches to Dysplasia in Inflammatory Bowel Diseases
Diagnostic and Therapeutic Approaches to Dysplasia in Inflammatory Bowel Diseases Parakkal Deepak, M.B.B.S., M.S. Assistant Professor of Medicine Division of Gastroenterology John T. Milliken Department
IBD Understanding Your Medications. Thomas V. Aguirre, MD Santa Barbara GI Consultants
IBD Understanding Your Medications Thomas V. Aguirre, MD Santa Barbara GI Consultants IBD Understanding Your Medications (& Your Doctor) Thomas V. Aguirre, MD Santa Barbara GI Consultants Disclosure I
Running head: CHRON'S DISEASE GENE-ENVIRONMENTAL INTERACTION 1
Running head: CHRON'S DISEASE GENE-ENVIRONMENTAL INTERACTION 1 A review of Crohn's Disease Gene-Environmental Interaction A study of gene-environment interaction between genetic susceptibility variants
Nutrition and gastrointestinal cancer: An update of the epidemiological evidence
Nutrition and gastrointestinal cancer: An update of the epidemiological evidence Krasimira Aleksandrova, PhD MPH Nutrition, Immunity and Metabolsim Start-up Lab Department of Epidemiology German Institute
A healthy Nordic food index
A healthy Nordic food index Anja Olsen Danish Cancer Society Research Center Health effects of the Nordic diet November 13 th 2013 Outline Why study Nordic diet? How to construct a healthy Nordic food
Understanding Inflammatory Bowel Diseases (IBD):
Understanding Inflammatory Bowel Diseases (IBD): What Every Patient Needs to Know William H Holderman, MD Digestive Health Specialists Tacoma, WA Today s Objectives Define IBD, its potential causes and
How to help your patient quit smoking. Christopher M. Johnson MD, PhD
How to help your patient quit smoking Christopher M. Johnson MD, PhD Outline Smoking and its effects on IBD CD UC Clinical interventions Pharmacotherapy Resources Outline Smoking and its effects on IBD
Issues at Hand. Inflammatory Bowel Disease Paradigm. Diet changes the fecal microbiome. Experience with diet in IBD
Diet s Role in IBD David Suskind M.D. Professor of Pediatrics Director of Clinical Gastroenterology Division of Gastroenterology University of Washington Seattle Children s Hospital Issues at Hand Inflammatory
Ali Keshavarzian MD Rush University Medical Center
Treatment: Step Up or Top Down? Ali Keshavarzian MD Rush University Medical Center Questions What medication should IBD be treated with? Can we predict which patients with IBD are high risk? Is starting
Positioning Biologics in Ulcerative Colitis
Positioning Biologics in Ulcerative Colitis Bruce E. Sands, MD, MS Acting Chief, Gastrointestinal Unit Massachusetts General Hospital Associate Professor of Medicine Harvard Medical School Sequential Therapies
Disease behavior in adult patients- are there predictors for stricture or fistula formation?
Disease behavior in adult patients- are there predictors for stricture or fistula formation? Falk Symposium 168, Madrid, Spain Iris Dotan, M.D., Head, IBD Center, Department of Gastroenterology and Liver
Accepted Manuscript. Does eradication of Helicobacter pylori cause inflammatory bowel disease? Johan Burisch, Tine Jess
Accepted Manuscript Does eradication of Helicobacter pylori cause inflammatory bowel disease? Johan Burisch, Tine Jess PII: S1542-3565(19)30153-3 DOI: https://doi.org/10.1016/j.cgh.2019.02.013 Reference:
Personalized Medicine in IBD: Where Are We in 2013
Personalized Medicine in IBD: Where Are We in 2013 David A. Schwartz, MD Director, Inflammatory Bowel Disease Center Associate Professor of Medicine Vanderbilt University Medical Center What is Personalized
Selby Inflamm Bowel Dis. 2008:14:
Medical Management of Inflammatory Bowel Disease Freddy Caldera D.O. Assistant Professor Division of Gastroenterology Objectives Discuss Crohn s disease and Ulcerative Colitis Discuss Medications for Inflammatory
Laboratory Testing: Medication Dependent. The Newly Diagnosed Patient. Why Talk about This? Lack of Primary Care
Why Talk about This? Lack of Primary Care Health Care Maintenance in the IBD Patient Sunanda Kane, MD MSPH FACG FACP AGAF Mayo Clinic Rochester Many patients with IBD are young and do not have co-morbid
CCFA. Crohns Disease vs UC: What is the best treatment for me? November
CCFA Crohns Disease vs UC: What is the best treatment for me? November 8 2009 Ellen J. Scherl,, MD, FACP,AGAF Roberts Inflammatory Bowel Disease Center Weill Medical College Cornell University New York
Achieving Wellness through a whole foods based diet
Achieving Wellness through a whole foods based diet By: Aziza Amarshi, BSc, RPh, RHN aziza@kingcitypharmacy.ca King City Guardian Pharmacy In the business of keeping you healthy Today s discussion What
Preventing post-operative recurrence
Oxford Inflammatory Bowel Disease MasterClass Preventing post-operative recurrence Dr Oliver Brain Oxford Disclosures Presented at IEE, Oxford 2013 AbbVie sponsored meeting Talk Outline Risk factors for
Apples to Zucchini: The Scoop On Fruits & Veggies. Edwin Cox, M.D.
Apples to Zucchini: The Scoop On Fruits & Veggies Edwin Cox, M.D. What We Mean by F&V Includes: Green leafy vegetables: lettuce, cabbage, spinach, kale Cruciferous vegetables: Broccoli Fruits fresh, dried,
Therapeutic Manipulation of the Gut Microbiota in Patients with IBD
Therapeutic Manipulation of the Gut Microbiota in Patients with IBD Karen Madsen, PhD Director of Center of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR) Disclosure of Commercial
Influence of environmental factors on the onset and course of inflammatory bowel disease
Submit a Manuscript: http://www.wjgnet.com/esps/ Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx DOI: 10.3748/wjg.v22.i3.1088 World J Gastroenterol 2016 January 21; 22(3): 1088-1100 ISSN 1007-9327
The role of geriatricians in management of dementia - from the viewpoint of life style modification -
Global Dementia Legacy Event Japan Roppongi Hills, Tokyo 2014.11.6 The role of geriatricians in management of dementia - from the viewpoint of life style modification - President, Federation of National
Practical Risk Management Tools for Patients with IBD. Garth Swanson MD Rush University Medical Center
Practical Risk Management Tools for Patients with IBD Garth Swanson MD Rush University Medical Center IBD Therapy Severity Tysabri Surgery Infliximab, i Adalimumab, Certilizumab Corticosteroids, Immunomodulators
Dietary advice for people with Inflammatory Bowel Disease
Dietary advice for people with Inflammatory Bowel Disease Crohn s disease and Ulcerative colitis Information for patients Name Your Dietitian Dietitian contact number: 0118 322 7116 What is Inflammatory
Primary and Secondary Prevention of Diverticular Disease
Primary and Secondary Prevention of Diverticular Disease Walid.H. Aldoori Wyeth Consumer Healthcare Inc. CANADA Falk Symposium Diverticular Disease: Emerging Evidence in a Common Condition Munich, June
Optimizing Immunomodulators and
Optimizing Immunomodulators and Biologics i in Inflammatory Bowel Disease Sunanda Kane, MD, MSPH, FACG Professor of Medicine Division of Gastroenterology and Hepatology Mayo Clinic Rochester, Minnesota,
Treatment of Pediatric IBD: What is Different?
Treatment of Pediatric IBD: What is Different? January 13, 2017 Michael Kappelman MD, MPH University of North Carolina at Chapel Hill Overview Is Pediatric IBD the same disease? Treatment considerations
Nutrition for the Gastroenterologist
Nutrition for the Gastroenterologist Octavia Pickett-Blakely, MD, MHS September 25, 2016 None Disclosures 1 Nutrition: Who Cares? Nutrition: Why we should care Divisions of Gastroenterology, Hepatology
Leaky gut? This CANNOT be a good thing.
Leaky gut? This CANNOT be a good thing. It was almost a decade ago that I came across the term leaky gut, whilst scavenging the internet to try and self-diagnose my symptoms (prior to studying nutritional
Update in Pediatric IBD: 2018
Update in Pediatric IBD: 2018 Jeffrey S. Hyams, MD Head, Division of Digestive Diseases, Hepatology and Nutrition Mandell-Braunstein Family Endowed Chair in Pediatric Inflammatory Bowel Disease Connecticut
Ulcerative colitis (UC) and Crohn s disease (CD),
GASTROENTEROLOGY 2012;142:482 489 Higher Predicted Vitamin D Status Is Associated With Reduced Risk of Crohn s Disease ASHWIN N. ANANTHAKRISHNAN,* HAMED KHALILI,* LESLIE M. HIGUCHI, YING BAO, JOSHUA R.
Microbiome, Inflammation and Cancer
Microbiome, Inflammation and Cancer Anita Afzali MD, MPH, FACG Medical Director, OSU Inflammatory Bowel Disease Center Abercrombie & Fitch Endowed Chair in Inflammatory Bowel Disease 4 th Annual Cancer
Physical activity, Obesity, Diet and Colorectal Cancer Prognosis. Jeffrey Meyerhardt, MD, MPH Dana-Farber Cancer Institute Boston, MA
Physical activity, Obesity, Diet and Colorectal Cancer Prognosis Jeffrey Meyerhardt, MD, MPH Dana-Farber Cancer Institute Boston, MA Colorectal Cancer Incidence ~148,000 cases in US annually and ~50,000
Epidemiology of diverticulosis and diverticular disease. Alfredo Papa U.O.C. Medicina Interna e Gastroenterologia, C.I. Columbus
Epidemiology of diverticulosis and diverticular disease Alfredo Papa U.O.C. Medicina Interna e Gastroenterologia, C.I. Columbus Summary Burden of disease on health care resources (outpatients visits, admissions,
Which is the Safest Strategy to Treat Moderate to Severe IBD?
Which is the Safest Strategy to Treat Moderate to Severe IBD? David G. Binion, M.D. Co-Director, Inflammatory Bowel Disease Center Director, Translational Inflammatory Bowel Disease Research Visiting Professor
MICROBIOM AND OBESITY HEINZ GYAKY 2018 BUDAPEST
MICROBIOM AND OBESITY HEINZ GYAKY 2018 BUDAPEST HUMAN MICROBIOM 10 Billion bacterias are building a 1,5 2 kg heavy human microbiom It is located mainly in the human gut There is a intestinal controlled
There is no single IBD diet
Nutrition and IBD There is no single IBD diet Nutrition plays an important role in health, during times of IBD disease activity as well as during remission. Although diet does not cause or cure IBD, the
Fibrotic complications of inflammatory bowel disease
January 27th 2017, 8th Gastro Foundation Weekend for Fellows; Spier Hotel & Conference Centre, Stellenbosch Fibrotic complications of inflammatory bowel disease Gerhard Rogler, Department of Gastroenterology
Risk = probability x consequence
Explaining Risks of IBD Therapy to Parents and Patients December 4, 2009 CCFA Advances in IBD Hollywood, FL Corey A. Siegel Assistant Professor of Medicine, Dartmouth Medical School Director, Dartmouth-Hitchcock
Treating Crohn s disease with Diet
Treating Crohn s disease with Diet Dr Alan Desmond Consultant Gastroenterologist Torbay & South Devon NHS Foundation Trust.com Crohn s Disease: A type of Inflammatory Bowel Disease (IBD) Damaging inflammation
Signal Transduction in Inflammatory Bowel Disease
E v e n t s 0 6 4 Signal Transduction in Inflammatory Bowel Disease 0 1 2 3 4 1 0 1 0 1 0 1 0 1 0 F L 2 - H e ig h t Vineeta Khare Ph.D Overview Inflammatory Bowel Diseases 1. Epidemiology, Symptoms and
Personalized Medicine. Selecting the Right First-line Biologic Agent. Gene Expression Profiles Crohn s Disease. The Right Treatment
Personalized Medicine Selecting the Right First-line Biologic Agent William Tremaine, M.D. Maxine and Jack Zarrow Professor Mayo Clinic Rochester, MN, USA The Right Treatment Pretreatment Genomic Analysis
Disclosures. Nutrition & Menopause. What changes? Mindless Eating 10/6/2017. I have no disclosures
I have no disclosures Disclosures Nutrition & Menopause Making changes when you can t eat like a 25 year old, and get away with it.. What changes? Social situation Family and family meals Activity levels
The role of gut microbiome in IBS
The role of gut microbiome in IBS Chung Owyang, MD H. Marvin Pollard Professor of Internal Medicine Professor of Molecular and Integrative Physiology Chief, Division of Gastroenterology Director, Pollard
Predictors of DEXA Use and Guideline Performance for the Detection of Low Bone Mineral Density in Inflammatory Bowel Disease
Predictors of DEXA Use and Guideline Performance for the Detection of Low Bone Mineral Density in Inflammatory Bowel Disease Jason Etzel Resident Research Forum Seattle VAMC 6/13/08 Background Increased
NON INVASIVE MONITORING OF MUCOSAL HEALING IN IBD. THE ROLE OF BOWEL ULTRASOUND. Fabrizio Parente
NON INVASIVE MONITORING OF MUCOSAL HEALING IN IBD. THE ROLE OF BOWEL ULTRASOUND Fabrizio Parente Gastrointestinal Unit, A.Manzoni Hospital, Lecco & L.Sacco School of Medicine,University of Milan - Italy
Patho Basic Chronic Inflammatory Bowel Diseases. Jürg Vosbeck Pathology
Patho Basic Chronic Inflammatory Bowel Diseases Jürg Vosbeck Pathology General Group of chronic relapsing diseases with chronic bloody or watery diarrhea Usually ulcerative colitis (UC) or Crohn s disease
P A T I E N T H A N D B O O K
PATIENT HANDBOOK Heal Your Gut, Heal Your Body The gastrointestinal (GI) tract is one of the most sophisticated systems of the human body. We often think of the GI tract for its primary role in digesting
Beyond the Scope: The Microbiome & The Future of Gastroenterology
Beyond the Scope: The Microbiome & The Future of Gastroenterology Robynne Chutkan, MD, FASGE Digestive Center for Wellness, LLC MedStar Georgetown University Hospital Rapid Identification of Microbes
Nutrition as primary therapy in IBD. Dr Clare Donnellan Leeds General Infirmary
Nutrition as primary therapy in IBD Dr Clare Donnellan Leeds General Infirmary Case GB 34 year old female Diagnosed with Crohn s in 2002? Extent Offered steroids or surgery Declined both GB Represented
Hits and Myths of Diverticulosis. JR Gray Gastoenterology UBC
Hits and Myths of Diverticulosis JR Gray Gastoenterology UBC Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form
East west gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort
East west gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort diseasespictures.com Balazs Radnai and Martin Eigler Statistik II. Course 27.01.2014. Introduction
Primer On Personalized Medicine
Primer On Personalized Medicine Sandeep Gupta MD FACG FASGE AGAF Prashanth Porayette MD PhD Pediatric Gastroenterology, Hepatology, Nutrition, Riley Hospital for Children, Indianapolis, IN 46202 Disclosures:
/Webpages/zhang/chinese-full full- program.htm
http://www.ph.ucla.edu/epi/faculty/zhang /Webpages/zhang/chinese-full full- program.htm Cancer Incidence and Mortality and Risk Factors in the World Zuo-Feng Zhang, M.D., Ph.D. Fogarty International Training
Digestion: Small and Large Intestines Pathology
Digestion: Small and Large Intestines Pathology Dr. Ritamarie Loscalzo Medical Disclaimer: The information in this presentation is not intended to replace a one onone relationship with a qualified health
Research Update: Looking for the Answers
Research Update: Looking for the Answers Ted Denson, M.D. Schubert-Martin Inflammatory Bowel Disease Center Research Support: NIH/NIDDK, CCFA, BMRP Figure 2 Approach to Improve Outcomes for our IBD Patients
Complementary and Alternative Therapies in IBD
Complementary and Alternative Therapies in IBD Ross M. Maltz, MD August 19, 2018 IBD Education Day Objectives Define complementary/alternative medicine (CAM) What are patient s perception of CAM Definitions
Treatment Goals. Current Therapeutic Pyramids Crohn s Disease Ulcerative Colitis 11/14/10
Current Management of IBD: From Conventional Agents to Biologics Stephen B. Hanauer, M.D. University of Chicago Treatment Goals Induce and maintain response/ remission Prevent complications Improve quality
Hot Topics In Nutrition & IBD January 6, Kate Vance, RD Wael N. Sayej, MD
Hot Topics In Nutrition & IBD January 6, 2018 Kate Vance, RD Wael N. Sayej, MD Nutrients of Focus Calories Calcium Vitamin D Iron Nutritional Treatment in IBD Improve nutritional status As primary therapy