Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch

Bo Shen, Feza H. Remzi, Jeffrey P. Hammel, Bret A. Lashner, Charles L Bevins, Ian C. Lavery, Jan Wehkamp, Victor W. Fazio

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch-anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. Methods: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. Results: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56-6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48-11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19-3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74-11.4). Conclusions: The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure.

Original languageEnglish (US)
Pages (from-to)163-170
Number of pages8
JournalInflammatory Bowel Diseases
Volume15
Issue number2
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Crohn Disease
Odds Ratio
Restorative Proctocolectomy
Confidence Intervals
Pouchitis
Colonic Pouches
Colitis
Ulcerative Colitis
Multivariate Analysis
Logistic Models
Smoking
Regression Analysis
Demography

Keywords

  • Crohn's disease
  • Family history
  • Ileal pouch
  • Inflammatory bowel disease
  • Pouchitis
  • Restorative proctocolectomy
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch. / Shen, Bo; Remzi, Feza H.; Hammel, Jeffrey P.; Lashner, Bret A.; Bevins, Charles L; Lavery, Ian C.; Wehkamp, Jan; Fazio, Victor W.

In: Inflammatory Bowel Diseases, Vol. 15, No. 2, 2009, p. 163-170.

Research output: Contribution to journalArticle

Shen, B, Remzi, FH, Hammel, JP, Lashner, BA, Bevins, CL, Lavery, IC, Wehkamp, J & Fazio, VW 2009, 'Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch', Inflammatory Bowel Diseases, vol. 15, no. 2, pp. 163-170. https://doi.org/10.1002/ibd.20646
Shen, Bo ; Remzi, Feza H. ; Hammel, Jeffrey P. ; Lashner, Bret A. ; Bevins, Charles L ; Lavery, Ian C. ; Wehkamp, Jan ; Fazio, Victor W. / Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch. In: Inflammatory Bowel Diseases. 2009 ; Vol. 15, No. 2. pp. 163-170.
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abstract = "Background: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch-anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. Methods: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. Results: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95{\%} confidence interval [CI] 1.56-6.67), or with a first-degree relative with CD (OR = 4.18, 95{\%} CI, 1.48-11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95{\%} CI, 1.19-3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95{\%} CI, 2.74-11.4). Conclusions: The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure.",
keywords = "Crohn's disease, Family history, Ileal pouch, Inflammatory bowel disease, Pouchitis, Restorative proctocolectomy, Ulcerative colitis",
author = "Bo Shen and Remzi, {Feza H.} and Hammel, {Jeffrey P.} and Lashner, {Bret A.} and Bevins, {Charles L} and Lavery, {Ian C.} and Jan Wehkamp and Fazio, {Victor W.}",
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T1 - Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch

AU - Shen, Bo

AU - Remzi, Feza H.

AU - Hammel, Jeffrey P.

AU - Lashner, Bret A.

AU - Bevins, Charles L

AU - Lavery, Ian C.

AU - Wehkamp, Jan

AU - Fazio, Victor W.

PY - 2009

Y1 - 2009

N2 - Background: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch-anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. Methods: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. Results: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56-6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48-11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19-3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74-11.4). Conclusions: The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure.

AB - Background: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch-anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. Methods: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. Results: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56-6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48-11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19-3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74-11.4). Conclusions: The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure.

KW - Crohn's disease

KW - Family history

KW - Ileal pouch

KW - Inflammatory bowel disease

KW - Pouchitis

KW - Restorative proctocolectomy

KW - Ulcerative colitis

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