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Article: A Multi-Disciplinary Approach to Perianal Fistulizing Crohn's Disease.

Wiseman, Jacob / Chawla, Tanya / Morin, Frederic / de Buck van Overstraeten, Anthony / Weizman, Adam V

2022 Volume 35, Issue 1, Page(s) 51–57

Abstract: Perianal fistulizing Crohn's disease represents a severe phenotype associated with significant morbidity. Patients with perianal fistulizing disease are more likely to have a severe disease course and have significant reductions in quality of life. ... ...

Abstract	Perianal fistulizing Crohn's disease represents a severe phenotype associated with significant morbidity. Patients with perianal fistulizing disease are more likely to have a severe disease course and have significant reductions in quality of life. Moreover, these patients are at risk for the development of distal rectal and anal cancers. Given the complexity and severity of this patient group, the management of perianal Crohn's disease must be undertaken by a multidisciplinary team. The gastroenterologist and colorectal surgeon play a critical role in the diagnosis and management of perianal fistulizing disease. An examination under anesthesia provides critical information and is an essential part of the work-up of complex perianal fistulas. The radiologist also plays a central role in characterizing anatomy and assessing response to treatment. Several imaging modalities are available for these patients with magnetic resonance imaging as the imaging modality of choice. Perianal disease developing after ileal pouch-anal anastomosis represents a particularly challenging form of fistulizing disease and requires a multidisciplinary clinical and radiologic approach to differentiate surgical complications from recurrent Crohn's disease.
Language	English
Publishing date	2022-01-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2048635-2
ISSN	1531-0043
ISSN	1531-0043
DOI	10.1055/s-0041-1740038
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Article ; Online: AGA Technical Review on the Role of Probiotics in the Management of Gastrointestinal Disorders.

Preidis, Geoffrey A / Weizman, Adam V / Kashyap, Purna C / Morgan, Rebecca L

Gastroenterology

2020 Volume 159, Issue 2, Page(s) 708–738.e4

MeSH term(s)	Bacteria/growth & development ; Consensus ; Dysbiosis ; Evidence-Based Medicine/standards ; Gastroenterology/standards ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/microbiology ; Gastrointestinal Diseases/therapy ; Gastrointestinal Microbiome ; Humans ; Intestines/microbiology ; Probiotics/therapeutic use ; Treatment Outcome
Language	English
Publishing date	2020-06-09
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Research Support, N.I.H., Extramural ; Systematic Review
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2020.05.060
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Article ; Online: Risk Factors for Developing Hidradenitis Suppurativa in Patients With Inflammatory Bowel Disease: A Retrospective Case-Control Study.

Tandon, Parul / Govardhanam, Vivek / Gallinger, Zane / Weizman, Adam V

Journal of the Canadian Association of Gastroenterology

2020 Volume 4, Issue 4, Page(s) 165–172

Abstract: Background: Hidradenitis suppurativa (HS) is associated with inflammatory bowel disease (IBD), though risk factors remain to be determined.: Aim: To characterize HS among a cohort of IBD patients and identify risk factors for its development.: ... ...

Abstract	Background: Hidradenitis suppurativa (HS) is associated with inflammatory bowel disease (IBD), though risk factors remain to be determined. Aim: To characterize HS among a cohort of IBD patients and identify risk factors for its development. Methods: This was a retrospective case-control study at the ambulatory IBD centre at Mount Sinai Hospital from inception to May 2019. Patients with IBD who developed HS were included. Cases were matched 5:1 by age, gender (male versus female) and IBD type (ulcerative colitis [UC] or Crohn's disease [CD]) to controls who had IBD without HS. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs). Results: Twenty-nine cases of HS (19 CD and 10 UC) and 145 controls were included. Of the 29 patients with HS, 11 (37.9%) were male and 18 (62.1%) were female. The severity of HS was mild in 10 (34.5%), moderate in 16 (55.2%) and severe in 3 (10.3%) patients. Patients with HS and IBD were more likely to be active (OR 10.3, 95% CI 2.0 to 54.0, Conclusions: Active IBD, perianal disease and smoking may be associated with HS in IBD. Larger studies are needed to better characterize this morbid condition.
Language	English
Publishing date	2020-07-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2940642-0
ISSN	2515-2092 ; 2515-2084
ISSN (online)	2515-2092
ISSN	2515-2084
DOI	10.1093/jcag/gwaa024
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Article: A Multi-Disciplinary Approach to Perianal Fistulizing Crohn's Disease

Wiseman, Jacob / Chawla, Tanya / Morin, Frederic / de Buck van Overstraeten, Anthony / Weizman, Adam V.

Clinics in Colon and Rectal Surgery

(The Essential Role of a Multidisciplinary Approach in Inflammatory Bowel Diseases)

2022 Volume 35, Issue 01, Page(s) 51–57

Series title	The Essential Role of a Multidisciplinary Approach in Inflammatory Bowel Diseases
Abstract	Perianal fistulizing Crohn's disease represents a severe phenotype associated with significant morbidity. Patients with perianal fistulizing disease are more likely to have a severe disease course and have significant reductions in quality of life. Moreover, these patients are at risk for the development of distal rectal and anal cancers. Given the complexity and severity of this patient group, the management of perianal Crohn's disease must be undertaken by a multidisciplinary team. The gastroenterologist and colorectal surgeon play a critical role in the diagnosis and management of perianal fistulizing disease. An examination under anesthesia provides critical information and is an essential part of the work-up of complex perianal fistulas. The radiologist also plays a central role in characterizing anatomy and assessing response to treatment. Several imaging modalities are available for these patients with magnetic resonance imaging as the imaging modality of choice. Perianal disease developing after ileal pouch-anal anastomosis represents a particularly challenging form of fistulizing disease and requires a multidisciplinary clinical and radiologic approach to differentiate surgical complications from recurrent Crohn's disease.
Keywords	Crohn's disease ; examination under anesthesia ; inflammatory bowel disease ; magnetic resonance imaging ; perianal fistula
Language	English
Publishing date	2022-01-01
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2048635-2
ISSN	1530-9681 ; 1531-0043
ISSN (online)	1530-9681
ISSN	1531-0043
DOI	10.1055/s-0041-1740038
Database	Thieme publisher's database

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Article ; Online: Gastrointestinal aspects of vasculitides.

Soowamber, Medha / Weizman, Adam V / Pagnoux, Christian

Nature reviews. Gastroenterology & hepatology

2017 Volume 14, Issue 3, Page(s) 185–194

Abstract: Systemic vasculitides are caused by inflammation of blood vessels and can affect any organ and any part of the gastrointestinal tract, hepatic and biliary system, as well as the pancreas. These disorders can cause a wide array of gastrointestinal ... ...

Abstract	Systemic vasculitides are caused by inflammation of blood vessels and can affect any organ and any part of the gastrointestinal tract, hepatic and biliary system, as well as the pancreas. These disorders can cause a wide array of gastrointestinal manifestations, from asymptomatic elevated transaminase levels and mild abdominal pain to potentially life-threatening bowel perforations and peritonitis. A diagnosis based solely on gastrointestinal symptoms is challenging as these manifestations are not specific. Conversely, diagnostic and therapeutic delays can be rapidly detrimental. In this article, we review the epidemiology, characteristics and management of the main gastrointestinal manifestations of systemic vasculitides, including polyarteritis nodosa and antineutrophil cytoplasm antibody-associated vasculitides, as well as isolated vasculitides limited to the gastrointestinal tract.
MeSH term(s)	Arteritis/diagnosis ; Arteritis/epidemiology ; Arteritis/physiopathology ; Arteritis/therapy ; Diagnosis, Differential ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/epidemiology ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/therapy ; Global Health ; Humans ; Systemic Vasculitis/diagnosis ; Systemic Vasculitis/epidemiology ; Systemic Vasculitis/physiopathology ; Systemic Vasculitis/therapy
Language	English
Publishing date	2017
Publishing country	England
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2493722-8
ISSN	1759-5053 ; 1759-5045
ISSN (online)	1759-5053
ISSN	1759-5045
DOI	10.1038/nrgastro.2016.179
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Article ; Online: Colorectal cancer in inflammatory bowel disease: a shift in risk?

Gallinger, Zane R / Weizman, Adam V

Expert review of anticancer therapy

2014 Volume 14, Issue 7, Page(s) 847–856

Abstract: Patients with inflammatory bowel disease are at an increased risk for the development of colorectal cancer. However, the magnitude of this risk may not be as high as earlier studies have suggested. This shift in risk may be a result of changes in quality ...

Abstract	Patients with inflammatory bowel disease are at an increased risk for the development of colorectal cancer. However, the magnitude of this risk may not be as high as earlier studies have suggested. This shift in risk may be a result of changes in quality of analyses, aging cohorts, or may indeed represent true declines in the risk of cancer as a result of improvements in medical therapy and surveillance programs. The best surveillance practices for colorectal cancer screening in patients with inflammatory bowel disease remains unclear. The finding of dysplasia on colonoscopy in these patients warrants multi-disciplinary consultation between endoscopist, pathologist, and patient. At present, major organizations offer guidelines for surveillance interval, as well as when surgical consultation is advised. Moreover, newer endoscopic technologies have been developed and their incorporation into dysplasia surveillance programs continues to evolve.
MeSH term(s)	Colitis, Ulcerative/complications ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/etiology ; Crohn Disease/complications ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/pathology ; Risk Factors
Language	English
Publishing date	2014-07
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2112544-2
ISSN	1744-8328 ; 1473-7140
ISSN (online)	1744-8328
ISSN	1473-7140
DOI	10.1586/14737140.2014.895936
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Article ; Online: Probiotics Reduce Mortality and Morbidity in Preterm, Low-Birth-Weight Infants: A Systematic Review and Network Meta-analysis of Randomized Trials.

Morgan, Rebecca L / Preidis, Geoffrey A / Kashyap, Purna C / Weizman, Adam V / Sadeghirad, Behnam

Gastroenterology

2020 Volume 159, Issue 2, Page(s) 467–480

Abstract: Background & aims: We aimed to compare the effectiveness of single- vs multiple-strain probiotics in a network meta-analysis of randomized trials.: Methods: We searched MEDLINE, Embase, Science Citation Index Expanded, CINAHL, Scopus, Cochrane ... ...

Abstract	Background & aims: We aimed to compare the effectiveness of single- vs multiple-strain probiotics in a network meta-analysis of randomized trials. Methods: We searched MEDLINE, Embase, Science Citation Index Expanded, CINAHL, Scopus, Cochrane CENTRAL, BIOSIS Previews, and Google Scholar through January 1, 2019, for studies of single-strain and multistrain probiotic formulations on the outcomes of preterm, low-birth-weight neonates. We used a frequentist approach for network meta-analysis and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence. Primary outcomes included all-cause mortality, severe necrotizing enterocolitis (NEC) (Bell stage II or more), and culture-proven sepsis. Results: We analyzed data from 63 trials involving 15,712 preterm infants. Compared with placebo, a combination of 1 or more Lactobacillus species (spp) and 1 or more Bifidobacterium spp was the only intervention with moderate- or high-quality evidence of reduced all-cause mortality (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.39-0.80). Among interventions with moderate- or high-quality evidence for efficacy compared with placebo, combinations of 1 or more Lactobacillus spp and 1 or more Bifidobacterium spp, Bifidobacterium animalis subspecies lactis, Lactobacillus reuteri, or Lactobacillus rhamnosus significantly reduced severe NEC (OR, 0.35 [95% CI, 0.20-0.59]; OR, 0.31 [95% CI, 0.13-0.74]; OR, 0.55 [95% CI, 0.34-0.91]; and OR, 0.44 [95% CI, 0.21-0.90], respectively). There was moderate- or high-quality evidence that combinations of 1 or more Lactobacillus spp and 1 or more Bifidobacterium spp and Saccharomyces boulardii reduced the number of days to reach full feeding (mean reduction of 3.30 days [95% CI, reduction of 5.91-0.69 days]). There was moderate- or high-quality evidence that, compared with placebo, the single-species product B animalis subsp lactis or L reuteri significantly reduced duration of hospitalization (mean reduction of 13.00 days [95% CI, reduction of 22.71-3.29 days] and mean reduction of 7.89 days [95% CI, reduction of 11.60-4.17 days], respectively). Conclusions: In a systematic review and network meta-analysis of studies to determine the effects of single-strain and multistrain probiotic formulations on outcomes of preterm, low-birth-weight neonates, we found moderate to high evidence for the superiority of combinations of 1 or more Lactobacillus spp and 1 or more Bifidobacterium spp vs single- and other multiple-strain probiotic treatments. The combinations of Bacillus spp and Enterococcus spp, and 1 or more Bifidobacterium spp and Streptococcus salivarius subsp thermophilus, might produce the largest reduction in NEC development. Further trials are needed.
MeSH term(s)	Enterocolitis, Necrotizing/epidemiology ; Enterocolitis, Necrotizing/microbiology ; Enterocolitis, Necrotizing/physiopathology ; Enterocolitis, Necrotizing/prevention & control ; Gastrointestinal Microbiome/physiology ; Humans ; Infant ; Infant Mortality ; Infant, Low Birth Weight/physiology ; Infant, Newborn ; Infant, Premature/physiology ; Neonatal Sepsis/epidemiology ; Neonatal Sepsis/microbiology ; Neonatal Sepsis/physiopathology ; Neonatal Sepsis/prevention & control ; Network Meta-Analysis ; Probiotics/administration & dosage ; Randomized Controlled Trials as Topic ; Treatment Outcome
Language	English
Publishing date	2020-06-24
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Systematic Review
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2020.05.096
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Article ; Online: Spotlight: Probiotics Guidelines.

Su, Grace L / Ko, Cynthia W / Bercik, Premysl / Morgan, Rebecca L / Weizman, Adam V / Kashyap, Purna / Preidis, Geoffrey A

Gastroenterology

2020 Volume 159, Issue 2, Page(s) 707

MeSH term(s)	Bacteria/growth & development ; Consensus ; Dysbiosis ; Evidence-Based Medicine/standards ; Gastroenterology/standards ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/microbiology ; Gastrointestinal Diseases/therapy ; Gastrointestinal Microbiome ; Humans ; Intestines/microbiology ; Probiotics/therapeutic use ; Treatment Outcome
Language	English
Publishing date	2020-07-22
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Research Support, N.I.H., Extramural
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2020.07.025
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Article ; Online: AGA Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders.

Su, Grace L / Ko, Cynthia W / Bercik, Premysl / Falck-Ytter, Yngve / Sultan, Shahnaz / Weizman, Adam V / Morgan, Rebecca L

Gastroenterology

2020 Volume 159, Issue 2, Page(s) 697–705

MeSH term(s)	Bacteria/growth & development ; Consensus ; Dysbiosis ; Evidence-Based Medicine/standards ; Gastroenterology/standards ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/microbiology ; Gastrointestinal Diseases/therapy ; Gastrointestinal Microbiome ; Humans ; Intestines/microbiology ; Probiotics/therapeutic use ; Treatment Outcome
Language	English
Publishing date	2020-06-09
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Systematic Review
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2020.05.059
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Article ; Online: Quality of care delivered to hospitalized inflammatory bowel disease patients.

Weizman, Adam V / Nguyen, Geoffrey C

World journal of gastroenterology

2013 Volume 19, Issue 38, Page(s) 6360–6366

Abstract: Hospitalized patients with inflammatory bowel disease (IBD) are at high risk for morbidity, mortality, and health care utilization costs. While the literature on trends in hospitalization rates for this disease is conflicting, there does appear to be ... ...

Abstract	Hospitalized patients with inflammatory bowel disease (IBD) are at high risk for morbidity, mortality, and health care utilization costs. While the literature on trends in hospitalization rates for this disease is conflicting, there does appear to be significant variation in the delivery of care to this complex group, which may be a marker of suboptimal quality of care. There is a need for improvement in identifying patients at risk for hospitalization in an effort to reduce admissions. Moreover, appropriate screening for a number of hospital acquired complications such as venous thromboembolism and Clostridium difficile infection is suboptimal. This review discusses areas of inpatient care for IBD patients that are in need of improvement and outlines a number of potential quality improvement initiatives such as pay-for-performance models, quality improvement frameworks, and healthcare information technology.
MeSH term(s)	Clostridioides difficile/isolation & purification ; Delivery of Health Care/standards ; Enterocolitis, Pseudomembranous/diagnosis ; Enterocolitis, Pseudomembranous/drug therapy ; Enterocolitis, Pseudomembranous/microbiology ; Hospitalization ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/diagnosis ; Inflammatory Bowel Diseases/therapy ; Outcome and Process Assessment, Health Care/standards ; Patient Readmission/standards ; Practice Guidelines as Topic ; Quality Improvement/standards ; Quality Indicators, Health Care/standards ; Treatment Outcome ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control
Language	English
Publishing date	2013-10-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v19.i38.6360
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