Ahuja, Vineet and Hilmi, Ida and Ye, Byong Duk and Ling, Khoon Lin and Ng, Siew C. and Leong, Rupert W. and Kumar, Peeyush and Khoo, Xin Hui and Makharia, Govind K. and Sollano, Jose and Pisespongsa, Pises and Mustaffa, Nazri and Banerjee, Rupa and Leow, Alex Hwong-Ruey and Raja Ali, Raja Affendi and Chuah, Sai Wei and Palaniappan, Shanthi and Ooi, Choon Jin and Leung, Wai K. (2024) Ten missteps in the management of inflammatory bowel disease in Asia: An expert report by the Asian Pacific Association of Gastroenterology Working Group on Inflammatory Bowel Disease. Journal of Gastroenterology and Hepatology, 39 (8). pp. 1500-1508. ISSN 0815-9319, DOI https://doi.org/10.1111/jgh.16599.
Full text not available from this repository.Abstract
Inflammatory bowel disease (IBD) is rapidly emerging in the Asia Pacific region. However, there are many challenges in the diagnosis and management of this condition. The Asian Pacific Association of Gastroenterology (APAGE) Working Group on IBD conducted a round table meeting to identify 10 common mistakes in the management of IBD in Asia. To summarize, many physicians still over rely on a definitive histological diagnosis before starting treatment and do not fully establish disease extent such as perianal and proximal gastrointestinal involvement in Crohn's disease (CD) or extent of involvement in ulcerative colitis (UC). It is also essential to actively look for evidence of extra-intestinal manifestations, which may influence choice of therapy. In terms of conventional therapy, underuse of topical 5 aminosalicylates (5-ASAs) in UC and inappropriate dosing of corticosteroids are also important considerations. Acute severe UC remains a life-threatening condition and delay in starting rescue therapy after inadequate response to intravenous steroids is still common. Anti-tumor necrosis factors should be considered first line in all cases of complex perianal fistulizing CD. Most patients with IBD are on potent immunosuppressive therapy and should be screened for latent infections and offered vaccinations according to guidelines. Under-recognition and management of significant complications such as anemia, osteoporosis, malnutrition, and thromboembolism should also be addressed. Colonoscopy is still not properly performed for dysplasia/cancer surveillance and for evaluating post-op recurrence of CD. Another common misstep is inappropriate withdrawal of medications during pregnancy leading to increased complications for the mother and the newborn. image
| Item Type: | Article |
|---|---|
| Funders: | Takeda Pharmaceutical Company Ltd, APAGE Working Group in Inflammatory Bowel Disease |
| Uncontrolled Keywords: | Clinical trials; Pre-clinical treatment; Novel therapies; Immunology; Microbiology; Inflammatory bowel diseases |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 13 Jan 2025 02:15 |
| Last Modified: | 13 Jan 2025 02:15 |
| URI: | http://eprints.um.edu.my/id/eprint/46945 |
Actions (login required)
 |
View Item |
