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Ileocaecal Crohn's disease | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/treatment-ileocaecal-disease

Skip to main content. Ileocaecal Crohn's disease. Treat intercurrent stricturing and penetrating disease. Severity a composite of disease extent and activity. Objective scores exist to assess these criteria (e.g. MaRIA score; simple endoscopic score). Extent usually defined by combination of SBMR. Activity determined by symptoms, biomarkers. Relapse within 3/12 uplifts severity to next category. Measure serum vitamin B12 annually. Also treat foregut,. Small bowel, colonic. Perianal disease if present.

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New presentation | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/new-presentation-0

Skip to main content. Symptoms suggestive of IBD. ECCO Statement 3A (UC 2016). Symptoms of ulcerative colitis are dependent upon extent and severity of disease and include bloody diarrhoea, rectal bleeding, tenesmus, urgency and faecal incontinence. Nocturnal defaecation and fatigue are often reported. Increasing bowel frequency, abdominal pain, anorexia, and fever suggest severe colitis [EL5]. Increase in stool frequency, sometimes with nocturnal actions. Symptoms suggestive of IBD. Confirm presence of ...

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Pouchitis | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/pouchitis

Skip to main content. ECCO Statement 8A (UC 2016). The diagnosis of pouchitis requires the presence of symptoms, together with characteristic endoscopic and histological abnormalities [EL3]. Extensive UC, extra-intestinal manifestations (PSC), being a non-smoker, p-ANCA positive serology and NSAID use are possible risk factors for pouchitis [EL3]. Suspicious symptoms are increased stool frequency and consistency, cramping, tenesmus, incontinence and urgency. Pouchitis more likely with:. The majority of p...

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Acute severe colitis | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/acute-severe-colitis

Skip to main content. Review appropriate mild or. Refer to algorithm for extensive. Review appropriate mild or moderate algorithm. Severe"} , "2":{ "target":".row2-item1" , "linetype":"straight" , "label":" DAY 1. Confirm severe colitis based on the Truelove and Witts scale. ECCO Statement 3C (UC 2016). ECCO Statement 3D (UC 2016). Colitis-like symptoms can be caused by CMV colitis; rectal mucosal prolapse; Crohn’s disease; malignancy; IBS with haemorrhoidal bleeding. Admit patient to hospital. Patients ...

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Colonic Crohn's disease | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/treatment-colonic-disease

Skip to main content. Colonic Crohn's disease. Colonic Crohn's Disease. ECCO Statement 5E (CD 2016). Active colonic CD should be treated with systemic corticosteroids [EL1]. For those who have relapsed, an anti-TNF based strategy is an appropriate option [EL1]. For some patients who have infrequently relapsing disease, restarting steroids with an immunomodulator may be appropriate. When reviewing this algorithm, bear in mind the following:. Effectiveness and tolerance of previous treatments. Active colon...

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Maintenance therapy in ulcerative colitis | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/maintenance-therapy-uc

Skip to main content. Maintenance therapy in ulcerative colitis. If not already performed, plan index colonoscopy. Once disease in remission to classify disease. Define schedule for surveillance. Consider 5-ASA as chemoprevention against cancer. Provide contact details in case of disease flare. ECCO Statement 6B (UC 2016). Maintenance treatment is recommended for all patients [EL1]. Intermittent therapy is acceptable in a few patients with proctitis [EL5]. ECCO Statement 6C1 (UC 2016). Oral 5-ASA compoun...

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Extensive small bowel disease | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/extensive-small-bowel-crohns-disease-0

Skip to main content. Extensive small bowel disease. Extensive small bowel Crohn's disease. Classify and quantify severity. ECCO Statement 5F (CD 2016). Extensive small bowel Crohn’s disease should initially be treated with systemic corticosteroids, but early therapy with an anti-TNF based strategy should also be evaluated [EL5]. For patients with severe disease who have relapsed, an anti-TNF based strategy is appropriate [EL5 ]. Extensive small bowel disease defined as 100cm of inflammatory disease.

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Left-sided colitis | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/left-sided-colitis

Skip to main content. If not already performed, plan index colonoscopy. To classify disease unless intercurrent moderate / severe disease. Define schedule for surveillance. Consider 5-ASA as chemoprevention against cancer. Provide contact details in case of disease flare. ECCO Statement 2B (UC 2016). Assess activity using Truelove and Witts. Or the Mayo scale. Upgrade to more active category if symptoms refractory to appropriate treatment. And response and side-effects of medication. Oral beclametasone d...

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Surgery in ulcerative colitis | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/algorithm/surgery-ulcerative-colitis

Skip to main content. Surgery in ulcerative colitis. Surgery in ulcerative colitis. Patient referred for surgery. Include acute severe colitis, and at least moderate disease refractory to all medical therapy (mesalamine, steroids, immuno-modulators, and biological therapy if available). Definitive indications include persisting toxic megacolon, perforation, massive bleeding and malignancy; and ASC refractory to "rescue" therapy. Patient referred for surgery. ECCO Statement 7T (UC 2012). There is no age l...

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Interventions | ECCO e-Guide

http://www.e-guide.ecco-ibd.eu/interventions

Skip to main content. When to perform colorectal carcinoma surveillance via screening colonoscopy in IBD patients. CRP, ESR, faecal biomarkers and genetic markers. Gastroscopy, flexible sigmoidoscopy, colonoscopy, endoscopic balloon dilation, double and single balloon enteroscopy and capsule endoscopy. Approach for histological assessment. Imaging procedures, non-endoscopic. MRI, ultrasound, CT and BFT. Overview of psychosocial issues related to Crohn's disease and ulcerative colitis. Includes enteral po...