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Evaluating clinical, dietary, and psychological risk factors for relapse of ulcerative colitis in clinical, endoscopic, and histological remission.

Authors :
Dhingra R
Kedia S
Mouli VP
Garg SK
Singh N
Bopanna S
Singla V
Choudhury BN
Verma P
Tiwari V
Gupta SD
Makharia G
Ahuja V
Source :
Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2017 Oct; Vol. 32 (10), pp. 1698-1705.
Publication Year :
2017

Abstract

Background and Aim: The literature on possible factors that could trigger a relapse in patients with ulcerative colitis (UC) in clinical, endoscopic, and histological remission on long-term follow up is scarce. To determine the relapse rate in patients with UC in clinical, endoscopic, and histological remission and identify factors that may influence the risk of relapse.<br />Methods: Patients with UC in clinical, endoscopic, and histological remission were enrolled between January and July 2010 and followed up for 1 year to determine the effect of clinical, dietary, and psychological factors on relapse. Information regarding factors that may affect relapse such as infection, antibiotic, or non-steroidal anti-inflammatory drugs (NSAIDs) use and any other factor that the patient felt important and compliance with medications was obtained.<br />Results: Ninety-seven patients (59 males, mean age 39 ± 11.9 years) were followed up for a mean duration of 9 ± 2.3 months. Eighteen (18.6%) relapsed with the median time to relapse being 3.5 months. On univariate analysis, more relapsers had significantly higher NSAIDs use within 15 days of relapse, respiratory tract infection within 4 weeks, use of steroids more than once in past, higher consumption of calcium, riboflavin, and vitamin A, and lower consumption of sugars. On multivariate analysis, NSAIDs use (HR [95% CI]: 6.41 [1.88-21.9]) and intake of vitamin A (HR [95% CI]: 1.008 [1.000-1.016]) were statistically significant predictors of relapse.<br />Conclusion: With a relapse rate of 18.6% over a follow up of 9 months in patients with UC in clinical, endoscopic, and histological remission, independent predictors of relapse were history of NSAIDs use within 15 days of relapse and higher intake of vitamin A.<br /> (© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Details

Language :
English
ISSN :
1440-1746
Volume :
32
Issue :
10
Database :
MEDLINE
Journal :
Journal of gastroenterology and hepatology
Publication Type :
Academic Journal
Accession number :
28220959
Full Text :
https://doi.org/10.1111/jgh.13770