What is the effect of IBS on quality of life? IBS can have a significant negative effect on health-related quality of life (HR-QOL). However, because IBS is not a life-threatening illness many clinicians underestimate its effect on individuals, family, and friends. Using the standard health-related questionnaire (SF-36), individuals with IBS symptoms report lower scores on …
How common is IBS? Approximately 10% to 15% of the population in Western societies report symptoms consistent with IBS. Younger individuals (25-45 years of age) are more likely to report IBS symptoms as compared with older individuals, although IBS can occur at any age. In some cases, symptoms of IBS date back to childhood. Women …
How are IBS subtypes distinguished? IBS subtypes are differentiated based on stool form and not stool frequency. Using the Rome III definition, subtypes are differentiated based on the percent of bowel movements with hard or lumpy stools versus those with loose or watery stools. It should be noted that patients frequently switch between subtypes. Approximately …
How are adenomatous appearing polyps managed in patients with UC and Crohn’s disease? Adenomatous-appearing polyps should be completely removed by polypectomy, and biopsy specimens should be obtained from the adjacent flat mucosa to determine the presence of dysplasia. If no dysplasia or inflammation is found in the surrounding mucosa, then this can be managed as …
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What is the treatment strategy for dysplasia in patients with UC or Crohn’s disease? If dysplasia is identified during endoscopic screening, it should be confirmed by a second GI pathologist. HGD or multifocal LGD detected during endoscopy in an area of flat mucosa is an indication for colectomy. The management of unifocal LGD is controversial, …
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How should endoscopic surveillance be performed in patients with UC and Crohn’s disease? Surveillance colonoscopy should be performed in patients with UC or extensive Crohn’s disease every 1 to 2 years beginning 8 to 10 years after the clear onset of disease symptoms. During the colonoscopy, four-quadrant biopsy samples should be obtained every 10 cm …
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Which clinical characteristics increase the risk of CRC in patients with UC and Crohn’s disease? In patients with UC and Crohn’s disease, the risk of CRC increases with: Longer duration More extensive or severe colitis (more than one-third colonic involvement) Family history of CRC Young age at onset of disease Presence of backwash ileitis Personal …