Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead 'Optimised Monitoring' Recommendations

被引：19

作者：

Sauter, Bernhard ^{[1
]}

Beglinger, Christoph ^{[4
]}

Girardin, Marc ^{[5
]}

Macpherson, Andrew ^{[6
]}

Michetti, Pierre ^{[8
]}

Schoepfer, Alain ^{[9
]}

Seibold, Frank ^{[7
]}

Vavricka, Stephan R. ^{[2
]}

Rogler, Gerhard ^{[3
]}

机构：

[1] GastroZentrurn Hirslanden, Zurich, Switzerland

[2] Triemli Hosp, Div Gastroenterol & Hepatol, Zurich, Switzerland

[3] Univ Zurich Hosp, Div Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland

[4] Univ Basel Hosp, Dept Gastroenterol & Hepatol, CH-4031 Basel, Switzerland

[5] Univ Hosp Geneva, Div Gastroenterol & Hepatol, Geneva, Switzerland

[6] Univ Hosp Bern, Dept Med, Div Gastroenterol, Bern, Switzerland

[7] Tiefenau Hosp, Dept Gastroenterol, Bern, Switzerland

[8] Clin La Source Baulieu, Lausanne, Switzerland

[9] Univ Hosp Ctr, Dept Gastroenterol & Hepatol, Lausanne, Switzerland

来源：

DIGESTION | 2014年 / 89卷 / 04期

关键词：

Chronic inflammatory bowel disease; Crohn's disease; Disease monitoring; Recommendations; Best-practice guidelines; Endoscopy; Multidetector computed tomography; Calprotectin; Small intestine contrast ultrasonography; Contrast-enhanced ultrasound; INFLAMMATORY-BOWEL-DISEASE; C-REACTIVE PROTEIN; WIRELESS CAPSULE ENDOSCOPY; INTESTINE CONTRAST ULTRASONOGRAPHY; IDENTIFY POSTOPERATIVE RECURRENCE; IONIZING-RADIATION EXPOSURE; QUALITY-OF-LIFE; FECAL CALPROTECTIN; COMPUTED-TOMOGRAPHY; PERIANAL FISTULAS;

D O I：

10.1159/000360283

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims:The structured IBD Ahead 'Optimised Monitoring' programme was designed to obtain the opinion, insight and advice of gastroenterologists on optimising the monitoring of Crohn's disease activity in four settings: (1) assessment at diagnosis, (2) monitoring in symptomatic patients, (3) monitoring in asymptomatic patients, and (4) the postoperative follow-up. For each of these settings, four monitoring methods were discussed: (a) symptom assessment, (b) endoscopy, (c) laboratory markers, and (d) imaging. Based on literature search and expert opinion compiled during an international consensus meeting, recommendations were given to answer the question 'which diagnostic method, when, and how often'. The International IBD Ahead Expert Panel advised to tailor this guidance to the healthcare system and the special prerequisites of each country. The IBD Ahead Swiss National Steering Committee proposes best-practice recommendations adapted for Switzerland. Methods: The IBD Ahead Steering Committee identified key questions and provided the Swiss Expert Panel with a structured literature research. The expert panel agreed on a set of statements. During an international expert meeting the consolidated outcome of the national meetings was merged into final statements agreed by the participating International and National Steering Committee members - the IBD Ahead 'Optimized Monitoring' Consensus. Results: A systematic assessment of symptoms, endoscopy findings, and laboratory markers with special emphasis on faecal calprotectin is deemed necessary even in symptom-free patients. The choice of recommended imaging methods is adapted to the specific situation in Switzerland and highlights the importance of ultrasonography and magnetic resonance imaging besides endoscopy. Conclusion: The recommendations stress the importance of monitoring disease activity on a regular basis and by objective parameters, such as faecal calprotectin and endoscopy with detailed documentation of findings. Physicians should not rely on symptoms only and adapt the monitoring schedule and choice of options to individual situations. (C) 2014 S. Karger AG, Basel

引用

页码：299 / 309

页数：11

共 137 条

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