Update on idiopathic colitides

Sebastian Strobel, Maria T Abreu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: This article summarizes the latest developments for three types of idiopathic colitis: ulcerative colitis, Crohn's disease, and microscopic colitis. RECENT FINDINGS: Crohn's disease and ulcerative colitis are highly related genetically. Colonoscopy remains the gold standard for making a diagnosis. The addition of chromoendoscopy can aid in identification and removal of colonic dysplasia in both disorders. The therapy for ulcerative colitis and Crohn's disease has been transformed with the introduction of anti-TNF treatment. For ulcerative colitis, recent data show that prolonged use of infliximab is effective, well tolerated and that early mucosal healing is associated with decreased risk of colectomy. There is no evidence of a significant increased risk for anti-TNF-induced malignancies. Combination therapy with azathioprine and infliximab for ulcerative colitis has now been shown to be superior to monotherapy. Natalizumab is effective in anti-TNF failures and patients can be risk stratified for progressive multifocal leukoencephalopathy by testing for John Cunningham virus antibodies. Microscopic colitis can often be related to medications, and symptoms may be worsened by coexisting celiac disease. SUMMARY: Combination therapy with an anti-TNF and a thiopurine is currently the most effective treatment for moderate-to-severe Crohn's disease or ulcerative colitis. Stem cell therapy for perianal fistulas in patients with Crohn's disease is a promising new therapy approach.

Original languageEnglish
Pages (from-to)60-65
Number of pages6
JournalCurrent Opinion in Gastroenterology
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Colitis
Ulcerative Colitis
Crohn Disease
Microscopic Colitis
Therapeutics
JC Virus
Progressive Multifocal Leukoencephalopathy
Colectomy
Azathioprine
Celiac Disease
Colonoscopy
Cell- and Tissue-Based Therapy
Fistula
Stem Cells
Antibodies
Neoplasms

Keywords

  • Crohn's disease
  • idiopathic colitis
  • indeterminate colitis
  • microscopic colitis
  • ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Update on idiopathic colitides. / Strobel, Sebastian; Abreu, Maria T.

In: Current Opinion in Gastroenterology, Vol. 29, No. 1, 01.01.2013, p. 60-65.

Research output: Contribution to journalArticle

Strobel, Sebastian ; Abreu, Maria T. / Update on idiopathic colitides. In: Current Opinion in Gastroenterology. 2013 ; Vol. 29, No. 1. pp. 60-65.
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