Document Detail


Editorial: Imaging and the treatment of Crohn's perianal fistulas: to see is to believe.
MedLine Citation:
PMID:  19956118     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fistulizing Crohn's disease is associated with significant morbidity. Although treatment has improved over the last decade, there is still considerable room for improvement. One possible method to improve outcomes is to use advanced imaging techniques, such as endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI), to help guide treatment. In this issue, Ng et al. show again the disconnect between cessation of drainage and the actual deep healing that can be appreciated using these imaging techniques. The authors used MRI to help guide the decision on when to alter medical therapy and were able to identify a subset of patients who could discontinue infliximab. Other authors over the last 5-10 years have also shown the benefit of EUS and MRI in these patients. The time has come for us to not only embrace these imaging modalities as valid end points for clinical trials but more importantly as a means to improve outcomes for our patients with fistulizing Crohn's disease.
Authors:
David A Schwartz
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Publication Detail:
Type:  Comment; Editorial    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  104     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-03     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2987-9     Citation Subset:  IM    
Export Citation:
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents / therapeutic use*
Antibodies, Monoclonal / therapeutic use*
Crohn Disease / drug therapy*,  pathology
Female
Humans
Immunosuppressive Agents / therapeutic use*
Intestinal Fistula / drug therapy*,  pathology
Magnetic Resonance Imaging*
Male
Middle Aged
Perineum*
Thalidomide / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Immunosuppressive Agents; 0/adalimumab; 0/infliximab; 50-35-1/Thalidomide
Comments/Corrections
Comment On:
Am J Gastroenterol. 2009 Dec;104(12):2973-86   [PMID:  19755971 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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