|Title:||The Asia-Pacific consensus on ulcerative colitis||Authors:||Ooi C.J.
De Silva H.J.
|Keywords:||Asia Pacific; Biologic agents; Consensus statements; Delphi; Diagnosis; Epidemiology; Inflammatory bowel disease; Leukocytapheresis; Management; Ulcerative colitis||Issue Date:||2010||Publisher:||Blackwell Publishing||Journal Volume:||25||Journal Issue:||3||Start page/Pages:||453-468||Source:||Journal of Gastroenterology and Hepatology (Australia)||Abstract:||
Inflammatory bowel disease (IBD) is increasing in many parts of the Asia-Pacific region. There is a need to improve the awareness of IBD and develop diagnostic and management recommendations relevant to the region. This evidence-based consensus focuses on the definition, epidemiology and management of ulcerative colitis (UC) in Asia. A multi-disciplinary group developed the consensus statements, reviewed the relevant literature, and voted on them anonymously using the Delphi method. The finalized statements were reviewed to determine the level of consensus, evidence quality and strength of recommendation. Infectious colitis must be excluded prior to diagnosing UC. Typical histology and macroscopic extent of the disease seen in the West is found in the Asia-Pacific region. Ulcerative colitis is increasing in many parts of Asia with gender distribution and age of diagnosis similar to the West. Extra-intestinal manifestations including primary sclerosing cholangitis are rarer than in the West. Clinical stratification of disease severity guides management. In Japan, leukocytapheresis is a treatment option. Access to biologic agents remains limited due to high cost and concern over opportunistic infections. The high endemic rates of hepatitis B virus infection require stringent screening before initiating immune-suppressive agents. Vaccination and prophylactic therapies should be initiated on a case-by-case basis and in accordance with local practice. Colorectal cancer complicates chronic colitis. A recent increase in UC is reported in the Asia-Pacific region. These consensus statements aim to improve the recognition of UC and assist clinicians in its management with particular relevance to the region. ? 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
|ISSN:||0815-9319||DOI:||10.1111/j.1440-1746.2010.06241.x||SDG/Keyword:||6 mercaptopurine derivative; adalimumab; antibiotic agent; antivirus agent; azathioprine; BCG vaccine; corticosteroid; cyclosporin A; ganciclovir; hydrocortisone; infliximab; isoniazid; mercaptopurine; mesalazine; methotrexate; methylmercaptopurine; methylprednisolone; nucleoside; nucleoside analog; placebo; prednisolone; salazosulfapyridine; steroid; tacrolimus; thalidomide; thiopurine methyltransferase; tioguanine; tumor necrosis factor inhibitor; unclassified drug; ursodeoxycholic acid; biological product; immunosuppressive agent; aplastic anemia; Asia; chemoprophylaxis; clinical feature; clinical trial; colitis; colon biopsy; colon resection; colonoscopy; colorectal cancer; continuous infusion; cytapheresis; cytomegalovirus infection; differential diagnosis; disease course; drug efficacy; drug mechanism; drug megadose; drug safety; environmental factor; gastrointestinal dysplasia; gastrointestinal endoscopy; gingiva hyperplasia; hepatitis B; heredity; histopathology; human; hyperglycemia; hypertension; immunopathology; infection; injection site reaction; leukopenia; liver toxicity; low drug dose; morbidity; nephrotoxicity; neurologic disease; nonhuman; prevalence; primary sclerosing cholangitis; priority journal; proctitis; proctocolectomy; quality of life; review; seizure; serum sickness; sex ratio; single drug dose; treatment response; tremor; tuberculosis; ulcerative colitis; unspecified side effect; Article; colorectal cancer; consensus; Delphi study; disease classification; disease severity; endemic disease; epidemic; gender; hepatitis B; Japan; opportunistic infection; Pacific islands; primary sclerosing cholangitis; ulcerative colitis
|Appears in Collections:||醫學系|
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