Intestinal Research

Original Articles

IBD

Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India: Arshdeep Singh, Vandana Midha, Vikram Narang, Saurabh Kedia, Ramit Mahajan, Pavan Dhoble, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Ashish Tripathi, Shivam Kalra, Narender Pal Jain, Namita Bansal, Rupa Banerjee, Devendra Desai, Usha Dutta, Vineet Ahuja, Ajit Sood; Intest Res 2023;21(4):452-459. Published online December 2, 2022; DOI: https://doi.org/10.5217/ir.2022.00087

Background/Aims
Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD.
Methods
Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated.
Results
Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD.
Conclusions
Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.

Citations

Citations to this article as recorded by

Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis
Dongyuan Zheng, Qinke Xu, Jin Wu, Zhouyue Gu, Jieya Chen, Yingchao Liu
Gastroenterología y Hepatología.2025; : 502346. CrossRef
Frequency, spectrum and outcome of patients with primary sclerosing cholangitis among patients presenting with cholestatic jaundice
Srikanth Kothalkar, Sayan Malakar, Piyush Mishra, Akash Mathur, Uday C. Ghoshal
Indian Journal of Gastroenterology.2024;[Epub] CrossRef
Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: Predictors of Early and Late Complications
Yajnadatta Sarangi, Ashok Kumar, Somanath Malage, Nalinikanta Ghosh, Rahul Rahul, Ashish Singh, Supriya Sharma, Rajneesh K Singh, Anu Behari, Ashok Kumar
Cureus.2024;[Epub] CrossRef
Incidence of Hepatobiliary Malignancies in Primary Sclerosing Cholangitis: Systematic Review and Meta-analysis
Matheus Souza, Luan C.V. Lima, Lubna Al-Sharif, Daniel Q. Huang
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD): a condition exemplifying the crosstalk of the gut–liver axis
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Experimental & Molecular Medicine.2023; 55(7): 1380. CrossRef
Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Intestinal Research.2023; 21(4): 420. CrossRef
Regional variations in the prevalence of primary sclerosing cholangitis associated with inflammatory bowel disease
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2023; 21(4): 413. CrossRef

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Inflammatory Bowel Diseases

Trends of inflammatory bowel disease at a tertiary care center in northern India: Ajit Sood, Kirandeep Kaur, Arshdeep Singh, Vandana Midha, Ramit Mahajan, Namita Bansal, Varun Mehta, Dharmatma Singh; Intest Res 2021;19(3):282-290. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00010

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is increasingly being reported from India and other Asian countries. This study looks into the changing trends of IBD at a tertiary care center in north India over last two decades.
Methods
Retrospective analysis of a prospectively maintained database of patients diagnosed with IBD between January 1991 and December 2015 was conducted. The study period was divided into five times cohorts (1991–1995, 1996–2000, 2001–2005, 2006–2010, 2011–2015).
Results
During the study period, 2,467 patients (UC [n = 2,137, 86.6%], CD [n = 330, 13.3%], mean age 38.5 ± 13.3 years; 55.9% males) were registered. The proportion of patients with CD increased (ratio of UC to CD declined from 15.7:1 to 4:1). The mean age at diagnosis decreased for UC (45.7 ± 12.1 years in 1991–1995 vs. 37.6 ± 13.0 years in 2011–2015; P= 0.001) and remained consistent for CD (41.3 ± 13.6 years in 1996–2000 vs. 41.3 ± 16.9 years in 2011–2015, P= 0.86). Patients with proctitis in UC and isolated ileal disease in CD increased over the study period (P= 0.001 and P= 0.007, respectively). Inflammatory CD increased (P= 0.009) whereas stricturing CD decreased (P= 0.01) across all cohorts. There was a trend towards less severe presentation of both UC and CD. The use of thiopurines (P= 0.02) and biologics increased (P= 0.001) with no significant change in trends for requirements of surgery (P= 0.9).
Conclusions
Increasing prevalence of CD, younger age at diagnosis, diagnosis at an earlier and milder stage, greater use of thiopurines and biologics were observed.

Citations

Citations to this article as recorded by

Burden of inflammatory bowel disease in India: analysis of the Global Burden of Disease study from 1990 to 2019
Suprabhat Giri, Anuraag Jena, Praveen Kumar-M, Jaikumar Rajavoor Muniswamy, Preetam Nath, Vishal Sharma
Intestinal Research.2025;[Epub] CrossRef
Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
Inflammatory bowel disease: a narrative review of disease evolution in South Asia and India over the last decade
Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
Evaluation of Nutritional Characteristics Reveals Similar Prevalence of Malnutrition in Patients with Ulcerative Colitis and Crohn’s Disease
Arshdeep Singh, Vandana Midha, Ramit Mahajan, Shruti Verma, Chandan Kakkar, Jasmine Grover, Dharmatma Singh, Ramandeep Kaur, Abhishek Masih, Namita Bansal, Catherine Wall, Ajit Sood
Digestive Diseases and Sciences.2023; 68(2): 580. CrossRef
Impact of Sarcopenia on Clinical Course of Inflammatory Bowel Disease in Korea
Kwangwoo Nam, Jae Yong Lee, Yousun Ko, Kyung Won Kim, Ho-Su Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byoun, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Digestive Diseases and Sciences.2023; 68(6): 2165. CrossRef
Real-world effectiveness and safety of ustekinumab induction therapy for Korean patients with Crohn’s disease: a KASID prospective multicenter study
Kyunghwan Oh, Hee Seung Hong, Nam Seok Ham, Jungbok Lee, Sang Hyoung Park, Suk-Kyun Yang, Hyuk Yoon, You Sun Kim, Chang Hwan Choi, Byong Duk Ye
Intestinal Research.2023; 21(1): 137. CrossRef
Clinical and magnetic resonance imaging spectrum of complex perianal fistulizing Crohn’s disease: A cohort study from northern India
Arshdeep Singh, Chandan Kakkar, Shreya Garg, Kirti Arora, Vandana Midha, Ramit Mahajan, Satpal Singh Virk, Narender Pal Jain, Dharmatma Singh, Kriti Sood, Ashish Tripathi, Dhruv Gupta, Ishita Gupta Kaushal, Ritu Dhawan Galhotra, Kavita Saggar, Ajit Sood
Indian Journal of Gastroenterology.2023; 42(5): 668. CrossRef
Update on the epidemiology of inflammatory bowel disease in Asia: where are we now?
Sang Hyoung Park
Intestinal Research.2022; 20(2): 159. CrossRef
Medication Adherence in Korean Patients with Inflammatory Bowel Disease and Its Associated Factors
Kyunghwan Oh, Eun Ja Kwon, Jeong Hye Kim, Kyuwon Kim, Jae Yong Lee, Hee Seung Hong, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jeong Yun Park, Sang Hyoung Park
The Ewha Medical Journal.2022; 45(2): 35. CrossRef
Oral beclomethasone dipropionate as an add-on therapy and response prediction in Korean patients with ulcerative colitis
Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
The Korean Journal of Internal Medicine.2022; 37(6): 1140. CrossRef
Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef
Clinical Features and Long-term Prognosis of Crohn’s Disease in Korea: Results from the Prospective CONNECT Study
Seung Wook Hong, Byong Duk Ye, Jae Hee Cheon, Ji Hyun Lee, Ja Seol Koo, Byung Ik Jang, Kang-Moon Lee, You Sun Kim, Tae Oh Kim, Jong Pil Im, Geun Am Song, Sung-Ae Jung, Hyun Soo Kim, Dong Il Park, Hyun-Soo Kim, Kyu Chan Huh, Young-Ho Kim, Jae Myung Cha, Ge
Gut and Liver.2022; 16(6): 907. CrossRef
Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?
Soo-Young Na, Yun-Jeong Lim
Diagnostics.2021; 11(12): 2240. CrossRef

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15 Web of Science
13 Crossref

Inflammatory Bowel Diseases

Colitis and Crohn’s Foundation (India): a first nationwide inflammatory bowel disease registry: Ajit Sood, Kirandeep Kaur, Ramit Mahajan, Vandana Midha, Arshdeep Singh, Sarit Sharma, Amarender Singh Puri, Bhabhadev Goswami, Devendra Desai, C. Ganesh Pai, Kiran Peddi, Mathew Philip, Rakesh Kochhar, Sandeep Nijhawan, Shobna Bhatia, N. Sridhara Rao; Intest Res 2021;19(2):206-216. Published online July 13, 2020; DOI: https://doi.org/10.5217/ir.2019.09169

Abstract PDF PubReader ePub

Background/Aims
The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India.
Methods
A multicenter, cross-sectional, prospective registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed.
Results
A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC [83.7%] and 631 CD [16.3%]) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south.
Conclusions
The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care.

Citations

Citations to this article as recorded by

Diverse Phenotypes, Consistent Treatment: A Study of 30 997 South Asian and White Inflammatory Bowel Disease Patients Using the UK Inflammatory Bowel Disease BioResource
Sharmili Balarajah, Laura Martinez-Gili, James Leslie Alexander, Benjamin Harvey Mullish, Robert William Perry, Jia V Li, Julian Roberto Marchesi, Miles Parkes, Timothy Robin Orchard, Lucy Charlotte Hicks, Horace Richard Timothy Williams
Journal of Crohn's and Colitis.2025;[Epub] CrossRef
Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
Comparison of 1‐Year Clinical Course in Patients With Newly Diagnosed Inflammatory Bowel Disease Between Vietnam and Korea: A Multinational, Multicenter Retrospective Cohort Study
Luan Minh Dang, Eun Soo Kim, Kyeong Ok Kim, Yoo Jin Lee, Hoang Huu Bui, Chuong Dinh Nguyen, Chi Thi Nguyen, Nam Hoai Nguyen, Hien Thi‐Thu Nguyen, Nga Thi Dinh, Lien Thi‐Phuong Nguyen, Khien Van Vu, Minh Cuong Duong
JGH Open.2025;[Epub] CrossRef
Burden of inflammatory bowel disease in India: analysis of the Global Burden of Disease study from 1990 to 2019
Suprabhat Giri, Anuraag Jena, Praveen Kumar-M, Jaikumar Rajavoor Muniswamy, Preetam Nath, Vishal Sharma
Intestinal Research.2025;[Epub] CrossRef
Dietary essential oil components: A systematic review of preclinical studies on the management of gastrointestinal diseases
Rajiv Gandhi Gopalsamy, Poovathumkal James Antony, Kumaraswamy Athesh, Varghese Edwin Hillary, Monalisa Martins Montalvão, Govindasamy Hariharan, Lucas Alves da Mota Santana, Lysandro Pinto Borges, Ricardo Queiroz Gurgel
Phytomedicine.2025; 140: 156630. CrossRef
FoxP3-positive T regulatory cells and its effector mechanisms in Crohn’s disease: an immunohistochemical and image morphometric analysis on endoscopic mucosal biopsies
Susama Patra, Shalini Chaudhary, Subash Chandra Samal, Pavithra Ayyanar, Somanath Padhi, Hemanta Kumar Nayak, Amit Kumar Satapathy, Saurav Nayak, Ajit Sahu, Tapaskanti Parida, Mohammed Shahin
European Journal of Gastroenterology & Hepatology.2025;[Epub] CrossRef
Global prevalence of biologic drugs use in inflammatory bowel diseases: a systematic review and meta-analysis
Caroline Tianeze de Castro, Douglas da Silva Oliveira, Fabrício Freire de Melo, Mauricio Lima Barreto, Carlos Antonio de Souza Teles Santos, Djanilson Barbosa dos Santos
Scandinavian Journal of Gastroenterology.2025; : 1. CrossRef
Tofacitinib in Acute Severe Ulcerative Colitis (TACOS): A Randomized Controlled Trial
Arshdeep Singh, Manjeet Kumar Goyal, Vandana Midha, Ramit Mahajan, Kirandeep Kaur, Yogesh Kumar Gupta, Dharmatma Singh, Namita Bansal, Ramandeep Kaur, Shivam Kalra, Omesh Goyal, Varun Mehta, Ajit Sood
American Journal of Gastroenterology.2024; 119(7): 1365. CrossRef
Clinical profile of patients with ulcerative colitis- A hospital based study from Madhya Pradesh
Mayank Jain
Indian Journal of Gastroenterology.2024; 43(1): 274. CrossRef
Real-world effectiveness and safety of ustekinumab induction therapy for Korean patients with Crohn’s disease: a KASID prospective multicenter study
Kyunghwan Oh, Hee Seung Hong, Nam Seok Ham, Jungbok Lee, Sang Hyoung Park, Suk-Kyun Yang, Hyuk Yoon, You Sun Kim, Chang Hwan Choi, Byong Duk Ye
Intestinal Research.2023; 21(1): 137. CrossRef
Gender Differences in Psychological Symptoms and Quality of Life in Patients with Inflammatory Bowel Disease in China: A Multicenter Study
Chuan Liu, Jixiang Zhang, Min Chen, Ping An, Jiankang Xiang, Rong Yu, Suqi Zeng, Shuchun Wei, Beiying Deng, Zhongchun Liu, Changqing Jiang, Jie Shi, Kaichun Wu, Weiguo Dong
Journal of Clinical Medicine.2023; 12(5): 1791. CrossRef
Clinical and magnetic resonance imaging spectrum of complex perianal fistulizing Crohn’s disease: A cohort study from northern India
Arshdeep Singh, Chandan Kakkar, Shreya Garg, Kirti Arora, Vandana Midha, Ramit Mahajan, Satpal Singh Virk, Narender Pal Jain, Dharmatma Singh, Kriti Sood, Ashish Tripathi, Dhruv Gupta, Ishita Gupta Kaushal, Ritu Dhawan Galhotra, Kavita Saggar, Ajit Sood
Indian Journal of Gastroenterology.2023; 42(5): 668. CrossRef
Is disease activity associated with social support and psychological distress in Crohn’s disease patients? Results of a cross-sectional study in a Chinese hospital population
Mengting Huang, Lei Tu, Linxia Wu, Yan Zou, Xin Li, Xiaofei Yue, Chen Huang, Ping Lei, Qian Li, Ping Han, Lian Yang, Liangru Zhu
BMJ Open.2023; 13(10): e076219. CrossRef
Update on the epidemiology of inflammatory bowel disease in Asia: where are we now?
Sang Hyoung Park
Intestinal Research.2022; 20(2): 159. CrossRef
Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef
Inflammatory bowel disease in Korea: epidemiology and pathophysiology
Jung Won Lee, Chang Soo Eun
The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef
Clostridioides Infection in Patients with Inflammatory Bowel Disease
Mi Rae Lee, Eun Soo Kim
The Korean Journal of Gastroenterology.2022; 80(2): 66. CrossRef
Latent and Active Tuberculosis Infection in Patients with Inflammatory Bowel Disease
Byung Chul Jin, Hee Jin Moon, Sang Wook Kim
The Korean Journal of Gastroenterology.2022; 80(2): 72. CrossRef
Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef
What Are the Different Phenotypes of Inflammatory Bowel Disease in Asia?
Su Bee Park, Jin Young Yoon, Jae Myung Cha
Gut and Liver.2022; 16(5): 676. CrossRef
Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
Gastroenterology.2022; 163(5): 1145. CrossRef
Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
Clinical Gastroenterology and Hepatology.2022; 20(11): 2421. CrossRef
Clinical Features and Long-term Prognosis of Crohn’s Disease in Korea: Results from the Prospective CONNECT Study
Seung Wook Hong, Byong Duk Ye, Jae Hee Cheon, Ji Hyun Lee, Ja Seol Koo, Byung Ik Jang, Kang-Moon Lee, You Sun Kim, Tae Oh Kim, Jong Pil Im, Geun Am Song, Sung-Ae Jung, Hyun Soo Kim, Dong Il Park, Hyun-Soo Kim, Kyu Chan Huh, Young-Ho Kim, Jae Myung Cha, Ge
Gut and Liver.2022; 16(6): 907. CrossRef
Clinical Characteristics of Korean Patients with Elderly-Onset Crohn’s Disease: Results from the Prospective CONNECT Study
You Sun Kim, Min Jeong Na, Byong Duk Ye, Jae Hee Cheon, Jong Pil Im, Joo Sung Kim
Gut and Liver.2022; 16(6): 995. CrossRef
The epidemiology of inflammatory bowel disease in Asia and Asian immigrants to Western countries
Satimai Aniwan, Priscila Santiago, Edward V. Loftus, Sang Hyoung Park
United European Gastroenterology Journal.2022; 10(10): 1063. CrossRef
Sociodemographic Characteristics, Smoking, and Family History of Patients with Inflammatory Bowel Disease, Northern Part of Iraq
Blnd Ibrahim Mohammed, Bushra Karem Amin
Medical Journal of Babylon.2022; 19(4): 615. CrossRef
Inflammatory bowel diseases in Tamil Nadu: A survey of demographics, clinical profile, and practices
Rohan V Yewale, Kartik Natarajan, Jeyaraj Ubal Dhus, Sarojini Ashok Parameswaran, Kallipatti Ramaswamy Palaniswamy, Doraisamy Babu Vinish, Aravindh Somasundaram, Arulraj Ramakrishnan, Sibithooran Karmegam, Ramaswamy Saraswathy Arun, Ujjani Shankaraiah Man
JGH Open.2021; 5(11): 1306. CrossRef
Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?
Soo-Young Na, Yun-Jeong Lim
Diagnostics.2021; 11(12): 2240. CrossRef

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503 Download
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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

Abstract PDF PubReader ePub

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

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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