Evaluation of Inflammatory Bowel Disease, An Issue of Gastroenterology Clinicsby Samir Shah, Edward Feller, Adam Harris
The Guest Editors have focused on methods of diagnosing and evaluating IBD to help guide optimal treatment to maximize clinical outcomes and minimize risks. Authors have provided state-of-the-art updates with practical information/guidelines/algorithms and cutting-edge data for incorporation into practice. The first set of articles deals with endoscopy: its role in diagnosis and monitoring IBD; the growing importance of chromoendoscopy in IBD surveillance exams; assessment of post-operative recurrence; and finally the emerging role of capsule endoscopy. The second section focuses on specific scenarios that IBD physicians encounter frequently: health maintenance in IBD focusing on proper vaccinations; the growing problem of Clostridium difficile in IBD; assessment of pouch problems; optimal evaluation of perianal disease; the state of the art in using thiopurines including use of allopurinol to optimize metabolites and optimizing the use of infliximab by measuring levels and antibodies to infliximab; factors to consider in choosing monotherapy versus combination therapy and communication of risk/benefit to patients; and finally disability assessment in IBD. The third and final section highlights noninvasive methods to evaluate IBD: clinical predictors of aggressive or disabling disease; the evolving role of specific antibodies in diagnosing, subtyping and most recently prognosticating in IBD; stool markers (calproctectin and lactoferrin) for evaluating and monitoring IBD; the growing role of imaging modalities with emphasis on MR enterography and CT enterography; and finally, the genetics of IBD and the potential role of genetic testing in the diagnosis/prognosis and tailoring of therapy.
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