Intestinal Research

Wen-Sy Tsai

2 Articles

IBD

Improvement of ulcerative colitis control by searching and restricting of inflammatory trigger factors in daily clinical practice: Kun-Yu Tsai, Jeng-Fu You, Tzong-Yun Tsai, Yih Jong Chern, Yu-Jen Hsu, Shu-Huan Huang, Wen-Sy Tsai; Intest Res 2023;21(1):100-109. Published online November 14, 2022; DOI: https://doi.org/10.5217/ir.2021.00110

Background/Aims
Exacerbating factors of ulcerative colitis (UC) are multiple and complex with individual influence. We aimed to evaluate the efficacy of disease control by searching and restricting inflammation trigger factors of UC relapse individually in daily clinical practice.
Methods
Both patients with UC history or new diagnosis were asked to avoid dairy products at first doctor visit. Individual-reported potential trigger factors were restricted when UC flared up (Mayo endoscopy score ≥1) from remission status. The remission rate, duration to remission and medication were analyzed between the groups of factor restriction complete, incomplete and unknown.
Results
The total remission rate was 91.7% of 108 patients with complete restriction of dairy product. The duration to remission of UC history group was significantly longer than that of new diagnosis group (88.5 days vs. 43.4 days, P=0.006) in patients with initial endoscopic score 2–3, but no difference in patients with score 1. After first remission, the inflammation trigger factors in 161 relapse episodes of 72 patients were multiple and personal. Milk/dairy products, herb medicine/Chinese tonic food and dietary supplement were the common factors, followed by psychological issues, non-dietary factors (smoking cessation, cosmetic products) and discontinuation of medication by patients themselves. Factor unknown accounted for 14.1% of patients. The benefits of factor complete restriction included shorter duration to remission (P<0.001), less steroid and biological agent use (P=0.022) when compared to incomplete restriction or factor unknown group.
Conclusions
Restriction of dairy diet first then searching and restricting trigger factors personally if UC relapse can improve the disease control and downgrade the medication usage of UC patients in daily clinical practice.

Citations

Citations to this article as recorded by

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A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease: Chun-Chi Lin, Shu-Chen Wei, Been-Ren Lin, Wen-Sy Tsai, Jinn-Shiun Chen, Tzu-Chi Hsu, Wei-Chen Lin, Tien-Yu Huang, Te-Hsin Chao, Hung-Hsin Lin, Jau-Min Wong, Jen-Kou Lin; Intest Res 2016;14(3):248-257. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.248

Abstract PDF PubReader ePub

<b>Background/Aims</b><br/>

With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD.

Methods

A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients' demographic data, indications for surgery, and outcome details were recorded and analyzed.

Results

The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P=0.013 and 0.034, respectively).

Conclusions

In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount.

Citations

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BMJ Open.2021; 11(8): e045090. CrossRef
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Journal of Translational Medicine.2019;[Epub] CrossRef
Variant Two-Stage Ileal Pouch-Anal Anastomosis: An Innovative and Effective Alternative to Standard Resection in Ulcerative Colitis
Jennifer Samples, Krista Evans, Nicole Chaumont, Paula Strassle, Timothy Sadiq, Mark Koruda
Journal of the American College of Surgeons.2017; 224(4): 557. CrossRef

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