Alex Barnes

Flinders Medical Centre · Gastroenterology

Background and Aim: Depression and anxiety are common in patients living with Inflammatory Bowel Disease (IBD). Symptoms impact on quality of life and psychological considerations and management in this population can be complex. Consideration has been given to screening for mental health conditions as a routine part of IBD Clinical care. The study...

Background and Aim: Inflammatory Bowel Disease (IBD) is a chronic condition requiring long-term medication adherence for effective management. Consumer non-adherence remains a significant challenge, influenced by several factors that have been identified as predictors of medication non-adherence in IBD. The relationship with consumer disease-relate...

Background and Aim: Poor adherence to medications in the inflammatory bowel disease (IBD) cohort has a direct negative impact on clinical outcome. However, the self-reported medication non-adherence in the Australian IBD population ranged from 24-45%, with predictive factors including patients' psychological distress and their believe about medicat...

Background and Aim: Depression and anxiety are common in patients with inflammatory bowel disease (IBD). There has been investigation into the influence of anti-tumour necrosis factor (TNF) biologics on depression and anxiety in patients with and without IBD, with longitudinal studies and small randomized controlled trials showing conflicting resul...

Background: Depression and anxiety are common comorbidities in patients with inflammatory bowel disease (IBD). Anti-tumor necrosis factor (TNF) biologics and small molecule therapies have been used to manage IBD, but their impact on depression and anxiety remains unclear. Aims: This systematic review and meta-analysis aim to evaluate the impact of...

Background and Aim: Australia has one of the highest prevalences of inflammatory bowel disease (IBD) in the world which represents a significant burden on the healthcare system. The presence of inflammation not only impacts patient quality of life, but also affects the quality of surveillance colonoscopy which is conducted for colorectal cancer pre...

Objectives Fatigue is common in people with inflammatory bowel disease (IBD) and is associated with IBD activity, sleep disturbance, anxiety and depression. The relative contribution of these factors to fatigue is unclear. This study aimed to investigate the relationship between fatigue and these factors through a novel approach using structural eq...

Background and Aim Quality of life is reduced in people with inflammatory bowel disease (IBD) and poor sleep is prevalent in people with IBD. This study aimed to investigate the influence of sleep on quality of life (QoL) in people with inflammatory bowel disease. Methods An online questionnaire was administered through three tertiary IBD centers,...

Introduction Poor sleep quality has been associated with inflammatory bowel disease (IBD) activity, although studies incorporating actigraphy suggest that the perception of sleep differs rather than objective difference in sleep quality. Short sleep duration has been associated with increased pro-inflammatory cytokines that have been implicated in...

Introduction Fatigue is prevalent in people with inflammatory bowel disease (IBD) and has been associated with IBD activity, sleep quality, depression, and anxiety. This study aimed to identify fatigue profiles or clusters through latent profile analysis. Methods An online questionnaire was administered through three tertiary IBD centres, social m...

Background Body image dissatisfaction is common in inflammatory bowel disease (IBD) and is associated with worse quality of life in this population. In other populations body image dissatisfaction has been associated with psychological distress. We aimed to investigate the relationship between body image and depression, anxiety, and self-harm in an...

Background Quality of life is reduced in people with inflammatory bowel disease. Poor sleep is prevalent in people with inflammatory bowel disease. This study aimed to investigate the influence of sleep on quality of life in people with inflammatory bowel disease. Methods An online questionnaire was administered through three tertiary IBD centres,...

Quality of life is reduced in people with inflammatory bowel disease and poor sleep is prevalent in people with inflammatory bowel disease. This study aimed to investigate the influence of sleep on quality of life in people with inflammatory bowel disease. Methods An online questionnaire was administered through three tertiary IBD centres, social m...

Background/Aims Insomnia is common in people with chronic medical conditions, such as inflammatory bowel disease (IBD), and is readily treatable through cognitive behavioral therapy for insomnia. This study aimed to describe the associations with insomnia in people with IBD and its relationship to IBD-related disability. Methods An online questionn...

Background and Aim: Fatigue is prevalent in people with inflammatory bowel disease (IBD) and has been associated with IBD activity, sleep quality, depression, and anxiety. This study aimed to identify fatigue profiles through latent class analysis. Methods: An online questionnaire was administered through three tertiary IBD centers, social media,...

Background and Aim: Colonoscopy is vital in the management of inflammatory bowel disease (IBD) and has a critical role in diagnosis, monitoring response to therapy, and colorectal cancer surveillance. The aim of this study was to conduct an audit of colonoscopy practices and reporting for patients with IBD against established key performance measur...

Background and Aim: Depression is common in patients with inflammatory bowel disease. There has been investigation into the influence of anti-tumor necrosis factor (TNF) biologics on depression in patients with and without IBD, with longitudinal studies and small randomized controlled trials showing conflicting results. We performed an analysis of...

Background and Aim: Fatigue is a common symptom in people with inflammatory bowel disease (IBD), with a systematic review and meta-analysis reporting a prevalence of 48%. Frequently reported associations with fatigue in patients with IBD include IBD activity, sleep disturbance, anxiety, and depression. This study aimed to investigate the relationsh...

Background and Aim: Sleep abnormalities in the general population have been associated with increased all-cause mortality and adverse health effects, including cardiovascular disease and metabolic syndrome. Sleep disruption is associated with upregulation of proinflammatory cytokines, such as IL-1β, IL-6, and tumor necrosis factor (TNF)-α, that hav...

Introduction Inflammatory bowel disease (IBD) has been associated with increased risk of obstructive sleep apnoea (OSA). We aimed to examine the associations of obstructive sleep apnoea, sleepiness and IBD related data and comorbidities, with the aim of developing a screening tool for sleep apnoea in this population. Methods An online survey of ad...

Background and Aim Inflammatory bowel disease (IBD) can disrupt sleep, leading to poor sleep quality. This may in part be due to the symptoms of IBD and the influence of pro-inflammatory cytokines on sleep. This study aimed to investigate the potential influence of IBD medications on sleep quality. Methods An online survey of adults with IBD was c...

Background In the past IBD has been thought to cause low body weight however current estimates show that 15-40% of those with IBD are obese. Obesity is a pro-inflammatory state and has been linked to disease processes such as psoriasis and rheumatoid arthritis. There is some limited data to suggest that obesity also affects disease activity in IBD....

Background Insomnia is common in those with chronic medical conditions. Insomnia is associated with decreased quality of life and is readily treatable through cognitive behavioural therapy for insomnia (CBTi). This study aimed to describe the associations with insomnia in an IBD population and its relationship with IBD related disability. Methods...

Objective: Sleep has become of increasing interest in inflammatory bowel disease (IBD) as a patient report outcome and as a possible exacerbating factor or extra-intestinal manifestation. This study aimed to document the associations with poor sleep in a IBD and its relationship to other significant patient report outcomes such as disability and qu...

Objective Poor sleep in people with inflammatory bowel disease (IBD) has been demonstrated to be prevalent and has been associated with disease activity. This meta-analysis aimed to assess the prevalence of poor sleep in inactive inflammatory bowel disease and in controls by considering cohort and cross-sectional studies. Methods Electronic databas...

Poor sleep in people with inflammatory bowel disease (IBD) has been demonstrated to be prevalent and has been associated with disease activity. This meta-analysis aimed to assess the prevalence of poor sleep in inactive IBD and in controls by considering cohort and cross-sectional studies. Electronic databases were searched for publications from in...

Background and aim: Sleep has become of increasing interest in inflammatory bowel disease (IBD) as a patient reported outcome and as a possible exacerbating factor or extra-intestinal manifestation. This study aimed to explore the influence of IBD medications on sleep quality and quality of life. Methods: As part of the IBD-SLEEP study a question...

Background and Aims: In the past, inflammatory bowel disease (IBD) has been thought to cause low bodyweight; however, current estimates show that 15–40% of people with IBD are obese. Obesity is a proinflammatory state and has been linked to disease processes, such as psoriasis and rheumatoid arthritis. There are some limited data to suggest that ob...

Background and Aim: The prevalence of inflammatory bowel disease (IBD) in older adults is rising, with vedolizumab increasingly prescribed for its favorable safety profile. However, it is unclear whether there is a trade-off with effectiveness. We aimed to compare the effectiveness and safety of vedolizumab between older (age ≥60 years) and younger...

Background and aim: Sleep is of increasing interest in inflammatory bowel disease (IBD) as a patient reported outcome and as a possible exacerbating factor or extra-intestinal manifestation of IBD. IBD activity and mental illness have both been seen as contributors to poor sleep in this population. This study aimed to look at the relative contribut...

Background and Aim: Sleep has become of increasing interest as a patient-reported outcome and as a possible exacerbating factor or extraintestinal manifestation in people with inflammatory bowel disease (IBD). Poor sleep in patients with active IBD has been largely attributed to IBD symptom-related sleep disturbance, with the causes of poor sleep i...

Background Poor sleep in people with inflammatory bowel disease (IBD) has been associated with worse quality of life, along with anxiety, depression, and fatigue. This meta-analysis aimed to determine the pooled prevalence of poor sleep in IBD. Methods Electronic databases were searched for publications from inception to November 1 st 2021. Poor s...

Background The thiopurine medications are well established in the treatment of inflammatory bowel disease (IBD). There is significant variation in levels of toxic and therapeutic metabolites. Current data from small or short-term studies support therapeutic drug monitoring (TDM) in assessing azathioprine (AZA) and 6-mercaptopurine (6MP). TDM of thi...

Background Poor sleep quality has been associated with active inflammatory bowel disease (IBD) in several studies. This review examines sleep quality in people with active IBD and in those in remission, with meta-analyses performed, considering subjective and objective sleep quality and IBD activity. Methods Electronic databases were searched from...

Background and Aim Medication nonadherence is common in patients with inflammatory bowel disease (IBD) and has been associated with worse outcomes. The coronavirus disease 2019 (COVID‐19) pandemic led to significant consumer and medical concern regarding the possible risks of immunosuppressive medications during the pandemic. This study aimed to ex...

Ocrelizumab is an intravenous anti-CD20 monoclonal antibody, approved for use in primary progressive multiple sclerosis due to its selective depletion of B-lymphocytes. Herein we describe the case of a 56-year-old female who developed odynophagia and bloody diarrhea following treatment with ocrelizumab. This was characterized endoscopically by ulce...

Introduction Steroid exposure has been associated with poorer outcomes following colectomy in acute severe ulcerative colitis (ASUC). Our centre aimed to examine the effect of prolonged oral corticosteroid therapy immediately prior to admission on the likelihood of requiring rescue therapy along with predictors of intravenous corticosteroid failure...

Colonoscopy findings after a low‐risk adenoma in patients with and without inflammatory bowel disease A Barnes1,2, R Mountifield1,2, P Spizzo1 and E Symonds1,2 1Flinders Medical Centre, Adelaide, South Australia, Australia; 2Flinders University, Adelaide, South Australia, Australia Background and Aim: Australian guidelines suggest that the colon...

Medication non‐adherence among patients with inflammatory bowel disease during the COVID‐19 pandemic is associated with increased disease activity and corticosteroid usage A Barnes1,2, P Spizzo1, J Andrews3,4 and R Mountifield1,2 1Flinders Medical Centre, Adelaide, South Australia, Australia; 2Flinders University, Adelaide, South Australia, Austr...

Corticosteroid exposure before admission and predicting need for rescue therapy in patients with acute severe ulcerative colitis A Barnes1,2, P Spizzo1 and R Mountifield1,2 1Flinders Medical Centre, Adelaide, South Australia, Australia; 2Flinders University, Adelaide, South Australia, Australia Background and Aim: Steroid exposure has been assoc...

Incidence of adenoma in patients with inflammatory bowel disease undergoing surveillance colonoscopy A Barnes1, R Mountifield1,2, P Spizzo1 and E Symonds1,2 1Flinders Medical Centre, Adelaide, South Australia, Australia; 2Flinders University, Adelaide, South Australia, Australia Background and Aim: Inflammatory bowel disease (IBD) colitis‐associ...

Introduction: Faecal calprotectin is a highly sensitive non-invasive marker of intestinal inflammation that has evidence-based roles in outpatient diagnosis and management of inflammatory bowel disease. This study aimed to examine indications for faecal calprotectin (FCP) in a tertiary inpatient population, and its role in inpatient management and...

Background Steroid exposure has been associated with poorer outcomes following colectomy in acute severe ulcerative colitis. Current treatment algorithms suggest three days of high dose intravenous steroid before the decision to commence rescue therapy. We aimed to look at medium-term outcomes in acute severe ulcerative colitis and their predictors...

Background and aims: Palliative care referral for end stage liver disease (ESLD) is uncommon and usually occurs late. We aimed to review the rate of early palliative care referral (EPCR) in ESLD patients, its associations, and its impacts on resource utilisation and survival. Methods: A retrospective review of all patients with ESLD admitted to...

Guidelines suggest that carefully selected patients with neutropenic fever (NF) may be suitable for early discharge on oral antibiotics. Despite these recommendations, many centres manage NF with intravenous antibiotic protocols and inpatient care. We have conducted a retrospective audit of patients with NF, and found that 12 of 40 (30%) patients w...

The syndrome of inappropriate antidiuretic hormone (SIADH) is reported as the most common cause of hyponatraemia. This retrospective cross-sectional study evaluated the diagnosis of SIADH in 110 hospitalised patients in an Australian tertiary hospital with reference to recently published clinical guidelines. Investigation of SIADH was incomplete in...