Ulcerative Colitis and Crohn's Disease Have the Same Burden and Goals for Treatment.
Fiche publication
Date publication
juillet 2019
Journal
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PEYRIN-BIROULET Laurent
Tous les auteurs :
Le Berre C, Ananthakrishnan AN, Danese S, Singh S, Peyrin-Biroulet L
Lien Pubmed
Résumé
It is unclear whether ulcerative colitis (UC) is a progressive disease like Crohn's disease (CD). Patients with UC are often undertreated, because of the possibility of curative colectomy and the perception that the disease burden is lower than that of CD. We discuss findings from studies that aimed to determine whether UC and CD have the same disease burden and should be treated in the same intensive way. We discuss the similarities between CD and UC, including effects on quality of life, long-term complications, strictures, increased risk of cancer, pseudopolyps, functional abnormalities, and anorectal dysfunction. Contrary to the generally accepted idea, surgery cannot cure UC. Post-operative complications, especially pouchitis and fecal incontinence, affect more than one-third of patients. CD and UC each pose substantial economic burdens. Monitoring, treatments, and goals of therapy are similar for all inflammatory bowel diseases. Earlier initiation of disease-modifying drugs might reduce progression of UC and reduce its burden after surgery, although UC might not cause the irreversible damage observed in patients with CD.
Mots clés
IBD, disability, severity, treat to target
Référence
Clin. Gastroenterol. Hepatol.. 2019 Jul 10;: