ABSTRACT
BACKGROUND/OBJECTIVES: The epidemiology, natural history, complications, and therapeutic management of chronic pancreatitis (CP) are not well described at the national level. This multi-centre prospective observational study involving eight Belgian hospitals aimed to improve the understanding of these aspects of CP in Belgium. METHODS: All patients with a diagnosis of CP based on imaging were eligible for this study. Data were gathered regarding epidemiology, etiology, CP complications, and treatment modalities. RESULTS: A total of 809 patients were included between 1/9/2014 and 31/8/2015. Most patients (794) were adults ≥16-years old, 74% were male, the median age at symptom onset was 47 (38-57) years, the median disease duration was 7 (3-13) years, and the median Izbicki pain score (IPS) was 96 (0-195). The main etiological risk factors according to the TIGAR-O classification were alcohol and tobacco (67%). Current drinkers had lower body mass index (BMI) (21.4 kg/m2 vs 24.1 kg/m2), higher IPS (110 vs 56), and longer inability to work than non-drinkers. Current smokers had lower BMI (21.5 kg/m2 vs 25 kg/m2) and higher IPS (120 vs 30) than non-smokers. Endocrine insufficiency and/or clinical steatorrhea was recorded in 41% and 36% of patients, respectively. The highest IPS was reported in patients with ongoing endotherapy (166 vs 50 for patients who completed endoscopy). CONCLUSION: This multicentric study on CP patients showed that current alcohol drinking and smoking are associated with pain and malnutrition. Pain scores were higher in patients with ongoing endotherapy, independently of surgery.
ABSTRACT
Coeliac disease is an auto-immune disease due to gluten intolerance. One per cent of the European population is concerned. This small bowel adenocarcinoma is rare and concerns less than 5% of the digestive neoplasias. However the frequency of this rare cancer is higher in presence of coeliac disease. We are reporting the case of a 67-years-old woman whose coeliac disease has been complicated 5 years thereafter by a jejunal adenocarcinoma. The latter was found during an etiology search for iron deficiency anemia.
Subject(s)
Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Celiac Disease/complications , Incidental Findings , Jejunal Neoplasms/complications , Jejunal Neoplasms/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Anemia, Iron-Deficiency/etiology , Celiac Disease/diagnosis , Celiac Disease/surgery , Female , Humans , Jejunal Neoplasms/pathology , Jejunal Neoplasms/surgery , Treatment OutcomeABSTRACT
Irritable Bowel Syndrome (IBS) is a complex and heterogeneous entity that concerns about 1/4 of adults and would be responsible for 50% of gastro-enterology medical consultations. IBS etiopathogenesis and physiopathology are not yet fully known. Implications of food intolerance and allergy in this syndrome remain controversial. In this review we recall numerous mechanisms of allergy or food intolerance generating IBS, as well as clinical entities mimicking an IBS. We present a series of diagnostic tests and potential treatments. We finally propose a management strategy for these patients.
