Intestinal Research

Sudheer Kumar Vuyyuru

2 Articles

Miscellaneous

Addition of computed tomography chest increases the diagnosis rate in patients with suspected intestinal tuberculosis: Saurabh Kedia, Raju Sharma, Sudheer Kumar Vuyyuru, Deepak Madhu, Pabitra Sahu, Bhaskar Kante, Prasenjit Das, Ankur Goyal, Karan Madan, Govind Makharia, Vineet Ahuja; Intest Res 2022;20(2):184-191. Published online May 4, 2021; DOI: https://doi.org/10.5217/ir.2020.00104

Background/Aims
Intestinal tuberculosis (ITB) is difficult to diagnose due to poor sensitivity of definitive diagnostic tests. ITB may be associated with concomitant pulmonary tuberculosis (PTB) which may remain undetected on chest X-ray. We assessed the role of contrast enhanced computed tomography (CECT) chest in detecting the prevalence of active PTB, and increasing the diagnostic yield in patients with suspected ITB.
Methods
Consecutive treatment naïve patients with suspected ITB (n=200) who underwent CECT chest (n=88) and had follow-up duration>1 year were recruited in this retrospective study (February 2016 to October 2018). ITB was diagnosed in the presence of caseating granuloma, positive acid fast stain or culture for Mycobacterium tuberculosis on biopsy, presence of necrotic lymph nodes (LNs) on CT enterography or positive response to anti-tubercular therapy. Evidence of active tuberculosis on CECT-chest was defined as presence of centrilobular nodules with or without consolidation/miliary nodules/thick-walled cavity/enlarged necrotic mediastinal LNs.
Results
Sixty-five of eighty-eight patients (mean age, 33.8±12.8 years; 47.7% of females) were finally diagnosed as ITB (4-caseating granuloma on biopsy, 12-necrotic LNs on CT enterography, 1-both, and 48-response to anti-tubercular therapy) and 23 were diagnosed as Crohn’s disease. Findings of active TB on CECT chest with or without necrotic abdominal LNs were demonstrated in 5 and 20 patients, respectively. No patient with Crohn’s disease had necrotic abdominal LNs or active PTB. Addition of CECT chest in the diagnostic algorithm improved the sensitivity of ITB diagnosis from 26.2% to 56.9%.
Conclusions
Addition of CECT chest significantly improves the sensitivity for definite diagnosis in a patient with suspected ITB.

Citations

Citations to this article as recorded by

Imaging in Abdominal Tuberculosis
Anuradha Sharma, Ankur Goyal, Devasenathipathy Kandasamy, Saurabh Kedia, Vineet Ahuja, Raju Sharma
Indographics.2024; 03(02): 045. CrossRef
Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef
Risk factors identification of COVID‐19 patients with chronic obstructive pulmonary disease: A retrospective study in Punjab‐Pakistan
Muhammad Muneeb Hassan, M. H. Tahir, Muhammad Ameeq, Farrukh Jamal, John T. Mendy, Christophe Chesneau
Immunity, Inflammation and Disease.2023;[Epub] CrossRef
Strengthening Tuberculosis Services for Children and Adolescents in Low Endemic Settings
Jeffrey R. Starke, Connie Erkens, Nicole Ritz, Ian Kitai
Pathogens.2022; 11(2): 158. CrossRef
Stringent screening strategy significantly reduces reactivation rates of tuberculosis in patients with inflammatory bowel disease on anti‐TNF therapy in tuberculosis endemic region
Peeyush Kumar, Sudheer K. Vuyyuru, Bhaskar Kante, Pabitra Sahu, Sandeep Goyal, Deepak Madhu, Saransh Jain, Mukesh Kumar Ranjan, Sandeep Mundhra, Rithvik Golla, Mukesh Singh, Shubi Virmani, Anvita Gupta, Nidhi Yadav, Mani Kalaivani, Raju Sharma, Prasenjit
Alimentary Pharmacology & Therapeutics.2022; 55(11): 1431. CrossRef

5,934 View
425 Download
4 Web of Science
5 Crossref

Inflammatory Bowel Diseases

Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease: Sanchit Sharma, Arti Gupta, Saurabh Kedia, Samagra Agarwal, Namrata Singh, Sandeep Goyal, Saransh Jain, Vipin Gupta, Pabitra Sahu, Sudheer Kumar Vuyyuru, Bhaskar Kante, Raju Sharma, Rajesh Panwar, Peush Sahni, Govind Makharia, Vineet Ahuja; Intest Res 2021;19(3):291-300. Published online May 26, 2020; DOI: https://doi.org/10.5217/ir.2019.09172

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India.
Methods
This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response.
Results
Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P= 0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P= 0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P= 0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P= 0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P= 0.046) predicted response to EEN.
Conclusions
EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN.

Citations

Citations to this article as recorded by

Progress and Clinical Applications of Crohn’s Disease Exclusion Diet in Crohn’s Disease
Duo Xu, Ziheng Peng, Yong Li, Qian Hou, Yu Peng, Xiaowei Liu
Gut and Liver.2024; 18(3): 404. CrossRef
Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) (Version 4.1) – living guideline
Andreas Sturm, Raja Atreya, Dominik Bettenworth, Bernd Bokemeyer, Axel Dignass, Robert Ehehalt, Christoph-Thomas Germer, P. C. Grunert, Ulf Helwig, Karoline Horisberger, Klaus Herrlinger, Peter Kienle, Torsten Kucharzik, Jost Langhorst, Christian Maaser,
Zeitschrift für Gastroenterologie.2024; 62(08): 1229. CrossRef
Use of oral diet and nutrition support in management of stricturing and fistulizing Crohn's disease
Kush Fansiwala, Neha D. Shah, Kelly A. McNulty, Mary R. Kwaan, Berkeley N. Limketkai
Nutrition in Clinical Practice.2023; 38(6): 1282. CrossRef
Exclusive Enteral Nutrition Orchestrates Immunological Balances as Early as Week 4 in Adult Patients of Crohn’s Disease: A Pilot, Open-Lable Study
Na Diao, Xinyu Liu, Minzhi Lin, Qingfan Yang, Bingyang Li, Jian Tang, Ni Ding, Xiang Gao, Kang Chao
Nutrients.2023; 15(24): 5091. CrossRef
Exclusive enteral nutrition with oral polymeric diet helps in inducing clinical and biochemical remission in adults with active Crohn's disease
Pradeep Kakkadasam Ramaswamy
Journal of Parenteral and Enteral Nutrition.2022; 46(2): 423. CrossRef
Is the frequency of dietitian support associated with greater clinical improvements in adults with Crohn's disease undertaking exclusive enteral nutrition?
Liz Purcell, Rumbidzai Mutsekwa, Rebecca Angus, Dheeraj Shukla, Michelle Palmer
Journal of Human Nutrition and Dietetics.2022; 35(3): 435. CrossRef
Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – August 2021 – AWMF-Registernummer: 021-004
Andreas Sturm, Raja Atreya, Dominik Bettenworth, Bernd Bokemeyer, Axel Dignaß, Robert Ehehalt, Christoph Germer, Philip C. Grunert, Ulf Helwig, Klaus Herrlinger, Peter Kienle, Martin E. Kreis, Torsten Kucharzik, Jost Langhorst, Christian Maaser, Johann Oc
Zeitschrift für Gastroenterologie.2022; 60(03): 332. CrossRef
Diet and nutrition in the management of inflammatory bowel disease
Pabitra Sahu, Saurabh Kedia, Vineet Ahuja, Rakesh K. Tandon
Indian Journal of Gastroenterology.2021; 40(3): 253. CrossRef
Review of exclusive enteral therapy in adult Crohn’s disease
Nikola Mitrev, Hin Huang, Barbara Hannah, Viraj Chandana Kariyawasam
BMJ Open Gastroenterology.2021; 8(1): e000745. CrossRef
Current Use of EEN in Pre-Operative Optimisation in Crohn’s Disease
Sharafaath Shariff, Gordon Moran, Caris Grimes, Rachel Margaret Cooney
Nutrients.2021; 13(12): 4389. CrossRef
Exclusive Enteral Nutrition in Adult Crohn’s Disease: an Overview of Clinical Practice and Perceived Barriers
Roberto de Sire, Olga Maria Nardone, Anna Testa, Giulio Calabrese, Anna Caiazzo, Fabiana Castiglione
Clinical and Experimental Gastroenterology.2021; Volume 14: 493. CrossRef
Making Decisions about Dietary Therapy in Inflammatory Bowel Disease
Sydney Solomon, Eunie Park, Joseph A. Picoraro
Gastrointestinal Disorders.2020; 2(4): 353. CrossRef
EEN Yesterday and Today … CDED Today and Tomorrow
Marta Herrador-López, Rafael Martín-Masot, Víctor Manuel Navas-López
Nutrients.2020; 12(12): 3793. CrossRef

6,467 View
295 Download
13 Web of Science
13 Crossref

Author index