Systematic review: the burden of post-operative complications following colectomy for ulcerative colitis

Background: Ulcerative colitis [UC] patients failing medical management require colectomy

Methods: Literature search in MEDLINE , CINAHL and Embase, targeting studies reporting the outcomes of colorectal procedures [from 2002 to 2016 with total and subtotal colectomy postoperative complications in adults with ulcerative colitis as an endpoint. Texts and authoritative Web sites were also reviewed then identification of papers according to the inclusion and exclusion criteria and data extraction were performed by two independent researchers

Results: Following data extraction and synthesis, we identified 24 articles for review. Reporting outcomes from procedures conducted from 2002-2016. Most frequent short-term complications: infectious complications and ileus [mean incidence 21% and 19%], while most frequent long-term complications: pouchitis, fecal incontinence and small bowel obstruction [mean incidence 31%, 22% and 18%]. Post-operative early complications [

Conclusion: Although Colectomy remains an appropriate therapeutic strategy for specific groups of patients- it is not the optimal cure for UC. Clinicians need to fully understand the various postoperative complications and comorbidities that are highly prevalent with over a third of patients expected to experience long-term or late arising post-operative complications. Thus, while surgical procedures are recommended as an appropriate therapeutic strategy for a specific group of patients, the post-operative complications associated with these surgical procedures should not be underestimated

Treatment of iron deficiency anaemia in patients with inflammatory bowel disease

In spite of the fact that anemia is the most widely recognized systemic sign of inflammatory bowel disease [IBD], among the expansive range of extraintestinal malady complexities experienced in IBD, including joint inflammation and osteopathy, it has for the most part gotten little thought. In any case, as far as recurrence, as well as to its potential impact on hospitalization rates and on the personal satisfaction and work, sickliness is, in fact, a huge and expensive intricacy of IBD

Frailty is multifactorial in nature, the most predominant etiological structures being iron deficiency anemia [IDA] and anemia of a chronic disease. In a condition related to irritation, for example, IBD, the assurance of iron status utilizing normal biochemical parameters alone is insufficient. A more exact evaluation might be achieved utilizing new iron lists including reticulocyte hemoglobin content, the rate of hypochromic red cells or zinc protoporphyrin. While oral iron supplementation has generally been a backbone of IDA treatment, it has likewise been connected to a broad gastrointestinal reactions and conceivable infection compounding. Be that as it may, numerous doctors are as yet hesitant to administer iron intravenously, in spite of the wide accessibility of an assortment of new IV arrangements with enhanced safety profiles, and in spite of the proposals of worldwide master rules. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD