Serrated polyposis syndrome associated with long-standing inflammatory bowel disease

Ulcerative Colitis With Concomitant Serrated Polyposis Syndrome: A Case Report and Literature Review

Serrated polyposis syndrome (SPS) is a pre-cancerous condition associated with increased risk of developing colorectal cancer (CRC). Its role in inflammatory bowel disease (IBD)-associated CRC remains unknown. Despite the growing understanding and recognition of SPS, there is limited literature about its impact on the colon in individuals with IBD. Herein, we report a case of a 45-year-old female who was diagnosed with ulcerative colitis (UC) and SPS. We also reviewed the literature surrounding this association and highlighted the intricacies in managing this unique patient population. At present, there are no screening guidelines for CRC in SPS patients with IBD. However, given the potential synergistic risk for CRC, a close surveillance approach may be utilized. Tracking lifetime cumulative features of SPS and endoscopic clearance of adenomas and serrated polyps are the mainstays of management.

Medication Belief is Associated with Improved Adherence to Exclusive Enteral Nutrition in Patients with Crohn's Disease

BACKGROUND

The prevalence of Crohn's disease (CD) has been increasing rapidly in China, and the role of exclusive enteral nutrition (EEN) in the management of adult patients with active CD is evolving. Adherence is a key factor in the effective treatment of many chronic diseases.

AIM

The aim of this study was to assess adherence to EEN of CD patients and to evaluate the relationship between medication belief and EEN adherence.

METHODS

A cross-sectional study was conducted, and demographic information, adherence to EEN, and beliefs about EEN were investigated. Medication belief was measured using the Beliefs about Medicines Questionnaire (BMQ)-Specific.

RESULTS

In all, 131 CD patients completed the questionnaire and were enrolled in this study. The high adherence rate was 73.3% (96 of 131 patients), and we found that medication belief, residency, medical insurance, and history of enteral nutrition therapy were factors affecting EEN adherence. More patients with a high BMQ score had high adherence to EEN (n = 54, 56.2%) compared to those with a low BMQ (n = 42, 43.8%). Moreover, price, taste, storage method, portability, and purchase convenience of EEN were not associated with adherence.

CONCLUSION

The adherence to EEN among patients with CD is relatively high and is related to medication belief, residency and history of enteral nutrition. The type of enteral nutrition, taste, storage, and convenience of purchase were not associated with EEN adherence. Future study is warranted to explore the possible role of improving patients' beliefs in increasing adherence.

Serrated Lesions in patients with Inflammatory Bowel Disease

BACKGROUND

a new serrated histologic finding has recently been discovered in patients with inflammatory bowel disease (IBD), known as serrated epithelial change (SEC). Recent studies suggest that SEC is strongly associated with dysplasia.

CASE REPORT

the case was a 62-year-old male in a dysplasia-colorectal cancer screening program with periodic chromoendoscopies, with CES findings in the previous chromoendoscopy studies.

DISCUSSION

a prophylactic colectomy seems a reasonable option for patients with several serrated lesions identified via chromoendoscopy screening. Particularly, if they are extensive and poorly defined, due to the possibility of developing high-grade dysplasia or colorectal cancer (CRC) during surveillance.