Intestinal Research

Original Articles

IBD

Are Truelove and Witts criteria for diagnosing acute severe colitis relevant for the Indian population? A prospective study: Saransh Jain, Saurabh Kedia, Sawan Bopanna, Dawesh P Yadav, Sandeep Goyal, Peush Sahni, Sujoy Pal, Nihar Ranjan Dash, Govind Makharia, Simon P. L. Travis, Vineet Ahuja; Intest Res 2018;16(1):69-74. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.69

Background/Aims

Truelove and Witts criteria have been used to define acute severe colitis since the 1950s. However, hemoglobin (an additional criterion of the definition) levels in the general population in developing countries are lower than in the population of developed countries. We aimed to determine the relevance of Truelove and Witts criteria in the Indian population.

Methods

Consecutive patients with acute severe colitis satisfying the Truelove and Witts criteria, hospitalized at a single center between April 2015 and December 2016 were included. All patients received intravenous corticosteroids and 16 required colectomy. The hemoglobin levels at admission were subsequently excluded from the classification criteria, and the effect this had on the criteria for diagnosis was determined.

Results

Out of 61 patients of acute severe colitis diagnosed according to the original Truelove and Witts criteria, 12 patients (20%) had 1 additional criterion, 33 (54%) had 2 additional criteria and 16 (26%) had 3 or more additional criteria in addition to 6 or more blood stained stools on admission. On excluding hemoglobin as an additional criterion from the Truelove and Witts definition, all patients still met the criteria for acute severe colitis.

Conclusions

Truelove and Witts criteria can be used to define acute severe colitis in India, despite lower mean hemoglobin in the native population.

Citations

Citations to this article as recorded by

Early management of acute severe UC in the biologics era: development and international validation of a prognostic clinical index to predict steroid response
Alex Adams, Vipin Gupta, Waled Mohsen, Thomas P Chapman, Deloshaan Subhaharan, Pradeep Kakkadasam Ramaswamy, Sudheer Kumar, Saurabh Kedia, Colleen GC McGregor, Tim Ambrose, Bruce D George, Rebecca Palmer, Oliver Brain, Alissa Walsh, Vineet Ahuja, Simon P
Gut.2023; 72(3): 433. CrossRef
Inflammatory bowel disease
Mayank Jain, Jayanthi Venkataraman
Indian Journal of Medical Research.2021; 153(4): 421. CrossRef
High Serum Osmolality May Predict the Disease Severity in Patients with Acute Ulcerative Colitis
Abdussamed VURAL, Aslı VURAL, Selahattin VURAL, Selim TURFAN, Ahmet Cumhur DÜLGER
Online Türk Sağlık Bilimleri Dergisi.2020; 5(2): 324. CrossRef
Relationship Between Vitamin D Deficiency and Disease Activity in Patients with Inflammatory Bowel Disease in Ahvaz, Iran

Esmat Rasouli, Narges Sadeghi, Abazar Parsi, Seyed Jalal Hashemi, Morteza Nayebi, Aliakbar Shayesteh
Clinical and Experimental Gastroenterology.2020; Volume 13: 419. CrossRef
A current overview of corticosteroid use in active ulcerative colitis
Marco Salice, Fernando Rizzello, Carlo Calabrese, Lucia Calandrini, Paolo Gionchetti
Expert Review of Gastroenterology & Hepatology.2019; 13(6): 557. CrossRef
Optimal management of acute severe ulcerative colitis
Saransh Jain, Vineet Ahuja, Jimmy K Limdi
Postgraduate Medical Journal.2019; 95(1119): 32. CrossRef
A challenge in diagnosis and management of ulcerative colitis in elderly patient with atypical presentation: A reported case
Panutchaya Kongon, Vorapatu Tangsirapat, Vittawat Ohmpornuwat, Kannakrit Sumtong, Vichack Chakrapan Na Ayudhya, Kobkool Chakrapan Na Ayudhya, Paiboon Sookpotarom, Paisarn Vejchapipat
International Journal of Surgery Case Reports.2019; 61: 234. CrossRef

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The prevalence and clinical characteristics of anemia in Korean patients with inflammatory bowel disease: Dae Sung Lee, Ki Bae Bang, Ji Yeon Kim, Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Young Choi, Dong Il Park; Intest Res 2016;14(1):43-49. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.43

Abstract PDF PubReader ePub

Background/Aims

Quality of life is closely related to anemia in patients with inflammatory bowel disease (IBD). Several studies have reported on anemia in patients with IBD in Western countries. This study investigated the prevalence and clinical characteristics of anemia in Korean patients with IBD.

Methods

We reviewed the medical records of 92 patients with ulcerative colitis (UC) and 76 patients with Crohn's disease (CD) who were followed regularly at a single tertiary medical center in Korea between January 2003 and December 2012. Hemoglobin (Hb) thresholds used to define anemia were <13.0 g/dL in men and <12.0 g/dL in women according to the World Health Organization criteria. We chose the lowest Hb level in each year as a representative value because Hb levels changed at each examination and anemia was associated with disease deterioration. The relationship between clinical variables and lowest Hb level was assessed.

Results

The prevalence of anemia was 36.3% in patients with UC and 41.6% in patients with CD. Anemia in patients with CD was associated with hospital admission, 5-aminosalicylate (5-ASA) and infliximab treatment in men. Anemia in patients with UC was associated with hospital admission, oral steroid use, thiopurine and infliximab treatment in men.

Conclusions

The prevalence of anemia in Korean patients with IBD was comparable to that of patients in Western countries. Anemia was associated with male patients with CD who were admitted to the hospital and received medications including 5-ASA and infliximab, and men with UC who were admitted to the hospital and received medications including oral steroids, thiopurine and infliximab.

Citations

Citations to this article as recorded by

Clinical characteristics and north-south differences of inflammatory bowel disease in China: A cross-sectional study and meta-analysis
Qi Liang, Bo Qu, Chunye Li, Yue Hu, Chunyi Yang, Tingting Yang, Yuzhu Di, Hui Li
Frigid Zone Medicine.2024; 4(1): 23. CrossRef
Clinical and Laboratory Characteristics of Anaemia in Hospitalized Patients with Inflammatory Bowel Disease
Małgorzata Woźniak, Anna Borkowska, Marta Jastrzębska, Marcin Sochal, Ewa Małecka-Wojciesko, Renata Talar-Wojnarowska
Journal of Clinical Medicine.2023; 12(7): 2447. CrossRef
Ferric carboxymaltose for anemia in Crohn’s disease patients at a tertiary center: A retrospective observational cohort study
Natália Souza Nunes Siqueira, Livia Bitencourt Pascoal, Bruno Lima Rodrigues, Marina Moreira de Castro, Alan Sidnei Corrêa Martins, Dante Orsetti Silva Araújo, Luis Eduardo Miani Gomes, Michel Gardere Camargo, Maria de Lourdes Setsuko Ayrizono, Raquel Fra
World Journal of Clinical Cases.2023; 11(12): 2740. CrossRef
ANEMIA AND IRON DEFICIENCY IN INFLAMMATORY BOWEL DISEASE PATIENTS IN A REFERRAL CENTER IN BRAZIL: PREVALENCE AND RISK FACTORS
Rogério Serafim PARRA, Marley Ribeiro FEITOSA, Sandro da Costa FERREIRA, José Joaquim Ribeiro da ROCHA, Luiz Ernesto de Almeida TRONCON, Omar FÉRES
Arquivos de Gastroenterologia.2020; 57(3): 272. CrossRef
Frequency, types, and treatment of anemia in Turkish patients with inflammatory bowel disease
Göksel Bengi, Hatice Keyvan, Seda Bayrak Durmaz, Hale Akpınar
World Journal of Gastroenterology.2018; 24(36): 4186. CrossRef
Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease
Seong Jae Yeo, Hyun Seok Lee, Byung Ik Jang, Eun Soo Kim, Seong Woo Jeon, Sung Kook Kim, Kyeong Ok Kim, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Yun Jin Jung, Eun Young Kim, Chang Heon Yang
Intestinal Research.2018; 16(3): 400. CrossRef
Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
The Korean Journal of Internal Medicine.2018; 33(6): 1084. CrossRef
Anemia at the time of diagnosis of inflammatory bowel disease: Prevalence and associated factors in adolescent and adult patients
Alfredo J. Lucendo, Ángel Arias, Óscar Roncero, Daniel Hervías, Cristina Verdejo, Carmen Naveas-Polo, Abdelmouneim Bouhmidi, Rufo Lorente, Luis Miguel Alcázar, Irina Salueña, Julio A. García-Quiñones, María Jesús Carrillo-Ramos
Digestive and Liver Disease.2017; 49(4): 405. CrossRef

5,863 View
66 Download
8 Web of Science
8 Crossref

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