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ABSTRACT: The most frequently prescribed medications for patients suffering from inflammatory bowel disease (IBD) in the Rhein-Main region of Germany are aminosalicylates and corticosteroids irrespective of the disease activity. In contrast, immunomodulators only play a marginal role. As anti-TNF therapy is very costly, it is prescribed in outpatient services of hospitals rather than in gastroenterological practices.
The aim of this study was to evaluate possible gender-related differences in the therapeutic management of IBD patients treated in the Rhein-Main region of Germany.
Data records about past medical history, disease status, laboratory values and medical treatment of outpatients of 10 gastroenterological practices and 3 hospitals were collected from November 1st 2005 to July 31st 2007 and analysed with regard to gender-related differences in therapy and disease management.
Overall, no statistically significant difference in gender-specific medical treatment could be observed in the study cohort. However, detailed analyses revealed, that 1. women suffering from IBD, who are treated in outpatient services of hospitals, are more often under immunosuppressants, irrespective of disease activity, 2. in gastroenterological practices less than 3 % of patients are prescribed any immunosuppressive therapy (vs. 17 % [men] und 42 % [women] in hospital outpatient services), and 3. anti-TNF therapy is applied more frequently in men as compared to women in hospital outpatient services in both remission and active disease.
This study discloses the gender-specific differences in the therapeutic management of IBD patients in a congested urban area in Germany. Further studies are required to confirm the tendencies detected.
Zeitschrift für Gastroenterologie 10/2009; 47(10):1045-51. · 0.90 Impact Factor
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ABSTRACT: Anaemia is the most frequent extraenteric complication of inflammatory bowel disease (IBD, Crohn's disease and ulcerative colitis). A disabling complication of IBD, anaemia worsens the patient's general condition and quality of life, and increases hospitalization rates. The main types of anemia in IBD are iron deficiency anemia and anemia of chronic disease. The combination of the serum transferrin receptor with ferritin concentrations and inflammatory markers allows a reliable assessment of the iron status. Iron deficiency is usually treated with oral iron supplements. However, it is less effective in IBD and may lead to an increased inflammatory activity through the generation of reactive oxygen species. A systematic review of anemia in IBD, its pathogenetic features, epidemiology, diagnosis and therapy based on the evidence from recent studies will be the focus of this article.
Zeitschrift für Gastroenterologie 03/2009; 47(2):228-36. · 0.90 Impact Factor
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ABSTRACT: The prevalence of irritable bowel syndrome (IBS) has increased over the last 50 years in countries where a Western-style diet has been prominent or introduced and 20 - 65 % of patients with irritable bowel syndrome (IBS) attribute their symptoms to something in food that activates an abnormal response. However, data from dietary elimination and re-challenge studies are inconclusive. Although investigations have shown that bran may be helpful in some patients, a complete review of the literature does not reveal conclusive evidence that a high fibre diet therapy is effective in IBS. From the limited reports on probiotics, there appears to be a trend to decreasing symptoms. Despite numerous reviews on this subject, it is very difficult to give general dietary advice to IBS patients, but dietary experts may have a positive role in managing such patients. It is clear that much more prospective research is needed to study both dietary factors and probiotics in these areas.
Zeitschrift für Gastroenterologie 04/2008; 46(3):279-91. · 0.90 Impact Factor
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ABSTRACT: Small bowel bacterial overgrowth is a syndrome caused by an abnormal number of bacteria in the upper part of the small bowel and associated with a complex array of clinical symptoms, i. e., chronic diarrhoea, steatorrhoea, macrocytic anaemia, weight loss, and less commonly, protein-losing enteropathy. The most common underlying factors are small intestinal stagnation or dysmotility, intestinal obstruction, blind or afferent loops, and decreased gastric secretion. The treatment usually consists in the eradication of bacterial overgrowth with repeated courses of antimicrobials, correction of associated nutritional deficiencies and, when possible, correction of the underlying predisposing conditions.
Zeitschrift für Gastroenterologie 08/2007; 45(7):620-8. · 0.90 Impact Factor
