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  1. Article ; Online: Lifestyle Factors and Silent Inflammatory Bowel Disease.

    Coates, Matthew D / Dalessio, Shannon / Stuart, August / Walter, Vonn / Tinsley, Andrew / Clarke, Kofi / Williams, Emmanuelle D

    Inflammatory intestinal diseases

    2023  Volume 8, Issue 4, Page(s) 153–160

    Abstract: Introduction: Hypoalgesic or silent inflammatory bowel disease (IBD) is a poorly understood condition that has been associated with poor clinical outcomes. There is evidence that lifestyle factors, including diet, exercise, and substance use can ... ...

    Abstract Introduction: Hypoalgesic or silent inflammatory bowel disease (IBD) is a poorly understood condition that has been associated with poor clinical outcomes. There is evidence that lifestyle factors, including diet, exercise, and substance use can influence inflammatory activity and symptoms in IBD. It is unclear, though, whether these issues impact pain experience in IBD. We performed this study to evaluate the potential relationship between several key lifestyle factors and silent IBD.
    Methods: We performed a retrospective analysis using an IBD natural history registry based in a single tertiary care referral center. We compared demographic and clinical features in 2 patient cohorts defined using data from simultaneous pain surveys and ileocolonoscopy: (a) active IBD without pain (silent IBD) and (b) active IBD with pain. We also evaluated the relative incidence of characteristics related to diet, exercise, sexual activity, and substance abuse.
    Results: One hundred and eighty IBD patients had active disease and 69 (38.3%) exhibited silent IBD. Silent IBD patients exhibited incidences of disease type, location, and severity as pain-perceiving IBD patients. Silent IBD patients were more likely to be male and less likely to exhibit anxiety and/or depression or to use cannabis, analgesic medication, or corticosteroids. There were no significant differences in dietary, exercise-related, or sexual activities between silent and pain-perceiving IBD patients.
    Conclusions: Silent IBD was associated with reduced incidence of substance and analgesic medication use. No relationships were found between silent IBD and diet, exercise, or sexual activity, though specific elements of each require further dedicated study.
    Language English
    Publishing date 2023-10-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2817967-5
    ISSN 2296-9365 ; 2296-9365
    ISSN (online) 2296-9365
    ISSN 2296-9365
    DOI 10.1159/000534413
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  2. Article ; Online: Lifestyle Factors Associated with Abdominal Pain in Quiescent Inflammatory Bowel Disease.

    Coates, Matthew D / Dalessio, Shannon / Walter, Vonn / Stuart, August / Tinsley, Andrew / Williams, Emmanuelle D / Clarke, Kofi

    Digestive diseases and sciences

    2023  Volume 68, Issue 11, Page(s) 4156–4165

    Abstract: Background: Lifestyle factors, including diet, exercise, substance use, and sexual activity, have been shown to influence risk of inflammation and complications in inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis ( ... ...

    Abstract Background: Lifestyle factors, including diet, exercise, substance use, and sexual activity, have been shown to influence risk of inflammation and complications in inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). Little is known about their potential role in abdominal pain generation in IBD.
    Aims: We performed this study to evaluate for relationships between lifestyle factors and abdominal pain in quiescent IBD (QP-IBD).
    Methods: We performed a retrospective analysis utilizing data from our institution's IBD Natural History Registry (January 1, 2017-December 31, 2022). Endoscopic evaluation, concurrent laboratory studies and surveys were completed by participants. Demographic and clinical data were also abstracted.
    Results: We identified 177 consecutive patients with quiescent disease (105 females:72 males; 121 with CD:56 with UC) for participation in this study, 93 (52.5%) had QP-IBD. Compared to patients with quiescent IBD without pain (QNP-IBD, patients with QP-IBD exhibited no significant differences in IBD type, location, severity or complication rate. Patients with QP-IBD were more likely to have anxiety/depression (55.9% vs. 32.1%, p = 0.002) and to use antidepressants/anxiolytics (49.5% vs. 21.4%, p < 0.001). They were also less likely to engage in exercise at least three times per week (39.8% vs. 54.8%, p = 0.05) or participate in sexual activity at least monthly (53.8% vs. 69.1%, p = 0.04). On logistic regression analysis, antidepressant and/or anxiolytic use was independently associated with QP-IBD [2.72(1.32-5.62)], while monthly sexual activity was inversely associated [0.48(0.24-0.96)].
    Conclusion: Lifestyle factors, including the lack of sexual activity and exercise, are significantly associated with QP-IBD. Further study is warranted to clarify the relationships between these factors and the development of abdominal pain in quiescent IBD.
    Language English
    Publishing date 2023-09-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-023-08075-0
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  3. Article: Polysubstance use in inflammatory bowel disease is associated with increased risk of emergency department visits: a longitudinal study.

    Bogale, Kaleb / Zubrzycka, Izabela / Stuart, August / Cesaire, Melissa / Walter, Vonn / Tinsley, Andrew / Williams, Emmanuelle / Clarke, Kofi / Coates, Matthew D

    Annals of gastroenterology

    2023  Volume 36, Issue 6, Page(s) 630–636

    Abstract: Background: Polysubstance use (PSU), the simultaneous use of 2 or more substances of abuse, is common in inflammatory bowel disease (IBD). Preliminary studies suggest it may be associated with poor outcomes. This prospective study evaluated the impact ... ...

    Abstract Background: Polysubstance use (PSU), the simultaneous use of 2 or more substances of abuse, is common in inflammatory bowel disease (IBD). Preliminary studies suggest it may be associated with poor outcomes. This prospective study evaluated the impact of PSU on disease activity and healthcare resource utilization in IBD.
    Methods: This study was conducted in a tertiary IBD center between October 29, 2015, and December 31, 2019. Participants were assessed over 2 time points (index and follow-up outpatient appointments) separated by a minimum of 6 months. Demographics, endoscopic disease activity, and surveys assessing symptoms, healthcare resource utilization and substance use (tobacco, alcohol, marijuana, cocaine, methamphetamine, heroin, opioid, or benzodiazepine) were abstracted. We identified PSU during the index appointment and computed descriptive statistics and contingency table analyses, and multivariate logistic regression models at follow up to evaluate outcomes.
    Results: 162 consecutively enrolled IBD patients were included. Seventy-five patients (46%) were polysubstance users at the index appointment. The most common cohorts were utilizing tobacco and alcohol (n=40) or tobacco and opioids (n=13). On bivariate and multivariate analyses, PSU during the index visit was positively associated with emergency department (ED) visits (odds ratio [OR] 2.51, 95% confidence interval [CI] 1.24-5.07; P=0.01) and negatively associated with extraintestinal manifestations (OR 0.37, 95%CI 0.18-0.74; P=0.005). Age, sex, disease activity, disease subtype and IBD-related symptoms were not associated with PSU.
    Conclusions: IBD patients exhibiting PSU had increased risk of future ED visits. This study highlights the risks of PSU and reinforces the importance of appropriate substance use screening.
    Language English
    Publishing date 2023-10-30
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2032850-3
    ISSN 1108-7471
    ISSN 1108-7471
    DOI 10.20524/aog.2023.0835
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  4. Article ; Online: Abdominal Pain in Inflammatory Bowel Disease: An Evidence-Based, Multidisciplinary Review.

    Coates, Matthew D / Clarke, Kofi / Williams, Emmanuelle / Jeganathan, Nimalan / Yadav, Sanjay / Giampetro, David / Gordin, Vitaly / Smith, Sadie / Vrana, Kent / Bobb, Anne / Gazzio, Thu Thi / Tressler, Heather / Dalessio, Shannon

    Crohn's & colitis 360

    2023  Volume 5, Issue 4, Page(s) otad055

    Abstract: Abdominal pain is one of the most common and impactful symptoms associated with inflammatory bowel disease (IBD), including both Crohn's disease and ulcerative colitis. A great deal of research has been undertaken over the past several years to improve ... ...

    Abstract Abdominal pain is one of the most common and impactful symptoms associated with inflammatory bowel disease (IBD), including both Crohn's disease and ulcerative colitis. A great deal of research has been undertaken over the past several years to improve our understanding and to optimize management of this issue. Unfortunately, there is still significant confusion about the underlying pathophysiology of abdominal pain in these conditions and the evidence underlying treatment options in this context. There is also a relative paucity of comprehensive reviews on this topic, including those that simultaneously evaluate pharmacological and nonpharmacological therapeutic options. In this review, our multidisciplinary team examines evidence for various currently available medical, surgical, and other analgesic options to manage abdominal pain in IBD.
    Language English
    Publishing date 2023-09-26
    Publishing country England
    Document type Journal Article
    ISSN 2631-827X
    ISSN (online) 2631-827X
    DOI 10.1093/crocol/otad055
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  5. Article ; Online: COVID-19 Vaccine Hesitancy in Patients with Inflammatory Bowel Disease.

    Clarke, Kofi / Pelton, Matthew / Stuart, August / Tinsley, Andrew / Dalessio, Shannon / Bernasko, Nana / Williams, Emmanuelle D / Coates, Matthew

    Digestive diseases and sciences

    2022  Volume 67, Issue 10, Page(s) 4671–4677

    Abstract: Background and aims: COVID-19 vaccine hesitancy varies across the USA. Data on COVID-19 vaccine hesitancy in patients with inflammatory bowel disease (IBD) are lacking. We assessed COVID-19 vaccine hesitancy and its associated variables in patients with ...

    Abstract Background and aims: COVID-19 vaccine hesitancy varies across the USA. Data on COVID-19 vaccine hesitancy in patients with inflammatory bowel disease (IBD) are lacking. We assessed COVID-19 vaccine hesitancy and its associated variables in patients with IBD.
    Methods: We evaluated voluntary patient survey responses during routine clinical visits to our IBD center. Data collected included demographic and clinical characteristics. Descriptive statistics, univariate and multivariate analyses were performed to evaluate significant associations with COVID-19 vaccine hesitancy.
    Results: A total of 239 individuals completed the survey. Over a third of respondents (35.6%) expressed hesitancy toward receiving the COVID-19 vaccine due to vaccine safety concerns (49.4%) and efficacy (23.5%), while others reported non-specific concerns (34.1%). On univariate analysis, Crohn's disease (OR 2.33 CI 1.28-4.25 p = 0.0056), use of biologic medications (OR 1.93 CI 1.16-3.23, p = 0.012), previous self-reported vaccine refusal (OR 8.13 CI 2.90-22.82 p = 0.0001), earlier date of survey administration (OR 2.01 CI 1.17-3.44 p = 0.011), and self-reported COVID infection (OR 2.55 CI 1.16-5.61 p = 0.0056) were more likely to be associated with COVID-19 vaccine hesitancy. On multivariate analysis, patient age, previous vaccine refusal and date of survey administration were more likely to be associated with COVID-19 vaccine hesitancy.
    Conclusions: Over one-third of patients with IBD expressed COVID-19 vaccine hesitancy. Vaccine safety and efficacy were the most common reasons. Younger age, previous vaccine refusal and earlier date of survey were more likely to be associated with hesitancy. Our findings suggest that there is room for targeted education to improve COVID-19 vaccine uptake in patients with IBD.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines ; Crohn Disease ; Health Knowledge, Attitudes, Practice ; Humans ; Inflammatory Bowel Diseases ; Vaccination ; Vaccination Hesitancy
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-01-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-021-07377-5
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  6. Article ; Online: Symptoms and Extraintestinal Manifestations in Active Cannabis Users with Inflammatory Bowel Disease.

    Coates, Matthew D / Dalessio, Shannon / Walter, Vonn / Stuart, August / Bernasko, Nana / Tinsley, Andrew / Razeghi, Sanam / Williams, Emmanuelle D / Clarke, Kofi / Vrana, Kent

    Cannabis and cannabinoid research

    2021  Volume 7, Issue 4, Page(s) 445–450

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Abdominal Pain ; Arthralgia ; Cannabis/adverse effects ; Chronic Disease ; Crohn Disease/complications ; Female ; Humans ; Inflammatory Bowel Diseases/epidemiology ; Male ; Retrospective Studies
    Language English
    Publishing date 2021-03-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2867624-5
    ISSN 2378-8763 ; 2578-5125
    ISSN (online) 2378-8763
    ISSN 2578-5125
    DOI 10.1089/can.2020.0155
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  7. Article ; Online: Abdominal pain is associated with an increased risk of future healthcare resource utilization in inflammatory bowel disease.

    Zubrzycka, Izabela / Bogale, Kaleb / Stuart, August / Cesaire, Melissa / Walter, Vonn / Dalessio, Shannon / Tinsley, Andrew / Williams, Emmanuelle / Clarke, Kofi / Coates, Matthew D

    International journal of colorectal disease

    2023  Volume 38, Issue 1, Page(s) 213

    Abstract: Background: Numerous factors influence healthcare resource utilization (HRU) in inflammatory bowel disease (IBD). We previously demonstrated an association between the presence of certain IBD-related symptoms and HRU. We conducted a longitudinal study ... ...

    Abstract Background: Numerous factors influence healthcare resource utilization (HRU) in inflammatory bowel disease (IBD). We previously demonstrated an association between the presence of certain IBD-related symptoms and HRU. We conducted a longitudinal study to identify the clinical variables and IBD-related symptoms predictive of HRU.
    Methods: This investigation utilized clinical encounters at an IBD center within a tertiary care referral center between 10/29/2015-12/31/2019. Participants were assessed over two time points (index and follow-up office visits) separated by a minimum of 6 months. Demographics, endoscopic disease severity, totals and sub-scores of surveys assessing for IBD-related symptoms, HRU, and substance use, and IBD-related medications. HRU was defined as any IBD-related emergency room visit, hospitalization, or surgery during the 6 months prior to follow-up appointment. We identified patients exhibiting HRU (at follow-up) and computed descriptive statistics and contingency table analyses of index appointment clinical data to identify predictors of HRU. Multivariable logistic regression models were fit incorporating significant demographic and clinical factors.
    Results: 162 consecutively enrolled IBD patients (mean age 44.0 years; 99f:63 m; 115 Crohn's disease [CD], 45 ulcerative colitis [UC], 2 indeterminate colitis) were included. 121 patients (74.7%) exhibited HRU (mean age 43.6 years; 73f:48 m; 84 CD, 36 UC, 1 IC) preceding follow-up appointment. Abdominal pain (OR = 2.18, 95% CI 1.04-4.35, p = 0.04) at the index appointment was the only study variable significantly associated with HRU on bivariate analysis (Table 1). However, none of the clinical factors evaluated in this study were independently associated with HRU in our multivariable logistic regression model.
    Conclusions: In this longitudinal study, abdominal pain was the only clinical variable that demonstrated an association with future HRU (even when considering other symptoms and key variables such as disease activity, IBD-medications, and psychiatric comorbidities (i.e., anxious or depressed state). These findings reinforce the importance of regularly screening for and effectively treating abdominal pain in IBD.
    MeSH term(s) Humans ; Adult ; Longitudinal Studies ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/diagnosis ; Crohn Disease/complications ; Crohn Disease/therapy ; Crohn Disease/diagnosis ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/diagnosis ; Abdominal Pain/complications ; Patient Acceptance of Health Care
    Language English
    Publishing date 2023-08-14
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-023-04510-w
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    Zs.A 2121: Show issues Location:
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  8. Article: Impact of a nurse navigator on a dedicated inflammatory bowel disease-focused gastroenterology clinic.

    Maheshwari, Parth / Bobb, Anne / Stuart, August / Dalessio, Shannon / Bernasko, Nana / Tinsley, Andrew / Clarke, Kofi / Coates, Matthew D / Williams, Emmanuelle

    Annals of gastroenterology

    2021  Volume 34, Issue 5, Page(s) 675–679

    Abstract: Background: Management of inflammatory bowel disease (IBD) patients can be very challenging. Nurse navigators (NNs) have demonstrated great promise for coordinating care of complex disorders but little is known about their impact on the setting of IBD. ... ...

    Abstract Background: Management of inflammatory bowel disease (IBD) patients can be very challenging. Nurse navigators (NNs) have demonstrated great promise for coordinating care of complex disorders but little is known about their impact on the setting of IBD. We undertook this study to evaluate how the introduction of a NN in a dedicated IBD clinic would influence several outcomes related to patient care.
    Methods: A retrospective chart review was performed evaluating Penn State IBD clinic patients receiving care a year before and after the introduction of a dedicated NN to the clinic. No-show rates, new appointments in less than 21 days, total clinic visits per month, and patient enrolment in our IBD registry and biorepository were measured prior to and after hiring of the NN between 2 providers. Each provider and their composite data were statistically compared using univariate analysis.
    Results: After hiring the NN, there was a statistically significant decrease in combined no-show rates (P=0.02). There was no significant difference in the combined average number of new appointments in less than 21 days (P=0.62) or total clinic visits per month (P=0.09). Enrolment in the database and biorepository increased (from 83% to 90%). Finally, 97% were satisfied with the NN's services, and 94% were satisfied with the IBD education they provided.
    Conclusions: Hiring a NN in our clinic was associated with high patient satisfaction, reduced no-show rates, and increased research participation. Thus, incorporation of a NN can improve care in an IBD-centered gastroenterology clinic.
    Language English
    Publishing date 2021-05-27
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2032850-3
    ISSN 1108-7471
    ISSN 1108-7471
    DOI 10.20524/aog.2021.0627
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  9. Article ; Online: Symptoms associated with healthcare resource utilization in the setting of inflammatory bowel disease

    Kaleb Bogale / Parth Maheshwari / Mitchell Kang / Venkata Subhash Gorrepati / Shannon Dalessio / Vonn Walter / August Stuart / Walter Koltun / Nana Bernasko / Andrew Tinsley / Emmanuelle D. Williams / Kofi Clarke / Matthew D. Coates

    Scientific Reports, Vol 12, Iss 1, Pp 1-

    2022  Volume 8

    Abstract: Abstract Several symptoms have been connected to increased healthcare resource utilization (HRU) in the context of inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and ulcerative colitis (UC). This study was designed to investigate ... ...

    Abstract Abstract Several symptoms have been connected to increased healthcare resource utilization (HRU) in the context of inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and ulcerative colitis (UC). This study was designed to investigate the prevalence of IBD-associated symptoms and to determine whether any are independently associated with HRU. We undertook a retrospective analysis of data related to consecutive IBD patient encounters from a tertiary care referral center between 1/1/2015 and 8/31/2019. Demographics, clinical activity, endoscopic severity, IBD-related symptom scores, anxiety and depression scores, and other key clinical data were abstracted. Four hundred sixty-seven IBD patients [247f.: 220 m; 315 CD, 142 UC and 11 indeterminate colitis] were included in this study. The most common symptoms were fatigue (83.6%), fecal urgency (68.2%) and abdominal pain (63.5%). Fatigue, abdominal pain, anxiety or depression, corticosteroids, and opioids were each positively associated with HRU, while NSAID and mesalamine use were inversely associated on bivariate analysis. The only factor that demonstrated a statistically significant association with HRU in the whole cohort on multivariable analysis was abdominal pain. Abdominal pain is independently associated with HRU and should be specifically screened for in IBD patients to identify individuals at risk of undergoing expensive interventions. This study also reinforces the importance of optimizing diagnostic and therapeutic management of abdominal pain in IBD.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
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  10. Article ; Online: Symptoms associated with healthcare resource utilization in the setting of inflammatory bowel disease.

    Bogale, Kaleb / Maheshwari, Parth / Kang, Mitchell / Gorrepati, Venkata Subhash / Dalessio, Shannon / Walter, Vonn / Stuart, August / Koltun, Walter / Bernasko, Nana / Tinsley, Andrew / Williams, Emmanuelle D / Clarke, Kofi / Coates, Matthew D

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 10577

    Abstract: Several symptoms have been connected to increased healthcare resource utilization (HRU) in the context of inflammatory bowel disease (IBD), including both Crohn's disease (CD) and ulcerative colitis (UC). This study was designed to investigate the ... ...

    Abstract Several symptoms have been connected to increased healthcare resource utilization (HRU) in the context of inflammatory bowel disease (IBD), including both Crohn's disease (CD) and ulcerative colitis (UC). This study was designed to investigate the prevalence of IBD-associated symptoms and to determine whether any are independently associated with HRU. We undertook a retrospective analysis of data related to consecutive IBD patient encounters from a tertiary care referral center between 1/1/2015 and 8/31/2019. Demographics, clinical activity, endoscopic severity, IBD-related symptom scores, anxiety and depression scores, and other key clinical data were abstracted. Four hundred sixty-seven IBD patients [247f.: 220 m; 315 CD, 142 UC and 11 indeterminate colitis] were included in this study. The most common symptoms were fatigue (83.6%), fecal urgency (68.2%) and abdominal pain (63.5%). Fatigue, abdominal pain, anxiety or depression, corticosteroids, and opioids were each positively associated with HRU, while NSAID and mesalamine use were inversely associated on bivariate analysis. The only factor that demonstrated a statistically significant association with HRU in the whole cohort on multivariable analysis was abdominal pain. Abdominal pain is independently associated with HRU and should be specifically screened for in IBD patients to identify individuals at risk of undergoing expensive interventions. This study also reinforces the importance of optimizing diagnostic and therapeutic management of abdominal pain in IBD.
    MeSH term(s) Abdominal Pain/complications ; Chronic Disease ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/drug therapy ; Colitis, Ulcerative/epidemiology ; Crohn Disease/complications ; Crohn Disease/epidemiology ; Crohn Disease/therapy ; Fatigue/complications ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/epidemiology ; Inflammatory Bowel Diseases/therapy ; Patient Acceptance of Health Care ; Retrospective Studies
    Language English
    Publishing date 2022-06-22
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-14838-y
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