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February 2021

Volume 160Issue 3SupplementS1-20
Abstracts From the 2021 Crohn’s & ColitisCongress® held January 21-24, 2021

Adverse Events Related to Therapy

  • KAPOSI SARCOMA IN AN IMMUNOSUPPRESSED PATIENT WITH PRESUMED CROHN’S DISEASE: IATROGENIC OR EPIDEMIC?

    • Jennifer Claytor,
    • Omar Viramontes,
    • Stephanie Conner,
    • Kwun Wah Wen,
    • Kendall Beck
    Published in issue: February 2021
    S1
    Biologic immunosuppression and HIV infection both carry risks of infection and malignancy. Small series suggest that patients living with well-controlled HIV may safely and efficaciously use biologics, like TNF-alpha inhibitors (TNF-I). However, no current U.S. guidelines exist to screen for HIV infection among high-risk groups prior to starting TNF-I. We describe the case of a patient who received TNF-I for Crohn’s Disease without any HIV testing, who developed potentially avoidable extensive Kaposi Sarcoma.
  • SAFETY OF AMISELIMOD IN HEALTHY SUBJECTS: RESULTS FROM A PHASE 1 RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

    • Stephen Hanauer,
    • Terry O’Reilly,
    • Robert Lester,
    • ...
    • Howard Franklin,
    • Angela Bulawski,
    • Robert Israel
    Published in issue: February 2021
    S1-S2
    To evaluate the safety profile of amiselimod, a selective sphingosine 1-phosphate receptor modulator which has been shown to regulate lymphocyte trafficking and is in development for the treatment of inflammatory bowel disease.
  • THE CUMULATIVE INCIDENCE OF POUCHITIS AND POUCH-RELATED COMPLICATIONS IN PEDIATRIC PATIENTS WITH ULCERATIVE COLITIS

    • Ellen Cowherd,
    • Matthew Egberg,
    • Michael Kappelman,
    • ...
    • Robert Sandler,
    • Hans Herfarth,
    • Edward Barnes
    Published in issue: February 2021
    S2
    Despite highly effective therapies, many children develop medically refractory ulcerative colitis (UC) and undergo proctocolectomy with ileal pouch anal anastomosis (IPAA). There is little real world evidence regarding IPAA outcomes in pediatric UC patients. We sought to determine the risk of pouchitis, recurrent pouchitis, and change in diagnosis to Crohn’s disease (CD) within two years of IPAA surgery among pediatric patients with UC using a large, geographically diverse insurance claims database.

Animal Models: Pre-Clinical Treatment of Intestinal Inflammation

  • ADVANCING HIGH TECH DRUG DELIVERY SYSTEMS FOR THE TREATMENT OF CROHN’S DISEASE

    • Douglas Miller,
    • Robert Niichel
    Published in issue: February 2021
    S2-S3
    High tech drug delivery systems, which allow for precise location targeting and efficient delivery mechanisms, can reduce the risk of side effects and increase dosage effectiveness in the treatment of Crohn’s disease. We describe a revolutionary capsule technology which uses radiofrequency signaling to trigger an optimal release of the pharmaceutical contents to specified regions of the gastrointestinal tract.
  • DIETARY FIBER GUAR GUM EXACERBATES COLONIC INFLAMMATION IN MULTIPLE EXPERIMENTAL MODELS OF INFLAMMATORY BOWEL DISEASE

    • Divek V.T. Nair,
    • Devendra Paudel,
    • Margherita Cantorna,
    • Vishal Singh
    Published in issue: February 2021
    S3
    The role of fermentable dietary fibers in patients with inflammatory bowel disease (IBD) is not understood. Herein, we elucidated the effect of dietary fiber guar gum, commonly added to a wide range of processed foods, on colonic inflammation. The use of three different IBD models allowed us to examine the effect of guar gum on various aspects of human IBD, such as immune hyperactivity [IL-10 receptor (IL-10R) neutralization], epithelial injury [dextran sulfate sodium (DSS)], and infection [Citrobacter rodentium (CR)]-mediated inflammation.
  • DYSREGULATION OF GASTROINTESTINAL RAGE (RECEPTOR FOR ADVANCED GLYCATION END PRODUCTS) EXPRESSION IN A SPONTANEOUS ANIMAL MODEL OF INFLAMMATORY BOWEL DISEASE

    • Angela Isabel Cabrera-García,
    • Martina Protschka,
    • Stefanie Kather,
    • ...
    • Uwe Müller,
    • Joerg Steiner,
    • Romy Heilmann
    Published in issue: February 2021
    S3-S4
    The receptor for advanced glycation end products (RAGE), a pattern recognition receptor, plays a role in chronic inflammation. Abrogation of proinflammatory RAGE signaling by ligand binding (e.g., S100/calgranulins) to soluble RAGE decoy (sRAGE) is a promising novel therapeutic avenue for chronic inflammatory diseases, such as inflammatory bowel disease (IBD). However, the opportunities for studying S100/calgranulin-RAGE pathways in conventional animal models are limited due to species differences in the expression and function of S100/calgranulins (e.g., lack of the S100A12 protein in rodents).
  • MUC1-C IS A DRUGGABLE TARGET FOR TREATMENT OF COLITIS AND PROGRESSION OF COLITIS-ASSOCIATED COLORECTAL CANCER

    • Yoshihiro Morimoto,
    • Wei Li,
    • Ning Zhang,
    • Hidekazu Takahashi,
    • Caining Jin,
    • Donald Kufe
    Published in issue: February 2021
    S4-S5
    The MUC1-C oncoprotein evolved in mammals to protect epithelial cells, such as those lining the gastrointestinal tract, from loss of homeostasis. In this way, MUC1-C activates pathways that contribute to inflammation, proliferation and remodeling associated with the wound healing response.
  • NANOPARTICLE-ENCAPSULATED BROMODOMAIN-CONTAINING PROTEIN 4 INHIBITORS FOR THERAPEUTICS OF INFLAMMATORY BOWEL DISEASE

    • Mansi Shah,
    • Yi Li,
    • Wang Pingyuan,
    • ...
    • Erik Rytting,
    • Jia Zhou,
    • Bing Tian
    Published in issue: February 2021
    S5
    Ulcerative Colitis (UC) and Crohn’s disease (CD), the two major types of inflammatory bowel disease (IBD), are chronic diseases with recurrent symptoms and significant morbidity. Long-term persistence of chronic inflammation in IBD is among the major factors contributing to neoplastic transformation and the development of colitis-associated colorectal cancer. There exists a lack of efficient medications for IBD, primarily due to either limited efficacy or side effects. Targeting bromodomain-containing protein 4 (BRD4) represents a novel therapeutic strategy for IBD.
  • STOCHASTIC INTERINDIVIDUAL MICROBIOME VARIATION MAY GUIDE PROTECTIVE PERINATAL PROBIOTIC DEVELOPMENT AGAINST IBD

    • Mahesh Krishna,
    • Melinda Engevik,
    • Karen Queliza,
    • ...
    • Hangtao Wang,
    • James Versalovic,
    • Richard Kellermayer
    Published in issue: February 2021
    S5
    The purpose of our experiment was to explore how stochastic inter-individual variation in the mammalian gut microbiome may link to inflammatory bowel disease (IBD) susceptibility, and guide the development of a perinatal preventative probiotic.
  • THE ROLE OF MYELOPEROXIDASE AND NEUTROPHIL EXTRACELLULAR TRAPS IN THE PATHOGENESIS OF INFLAMMATORY BOWEL DISEASE

    • Belal Chami,
    • Gulfam Ahmad,
    • Angie Schroder,
    • Patrick San Gabriel,
    • Paul Witting
    Published in issue: February 2021
    S5-S6
    Neutrophils are short-lived immune cells that represent the major cell type recruited to the inflamed bowel releasing their azurophilic granules containing enzymes myeloperoxidase (MPO). Fecal and serum MPO levels has previously been shown to correlate to disease severity in IBD patients. MPO, in the presence of H2O2 and free Cl- undergoes a halogenation cycle, yielding the two-electron oxidant, hypochlorous acid (HOCl) - a potent bactericidal agent. However, chronic intestinal exposure to MPO/HOCl due to perpetual inflammation may cause secondary host-tissue injury and cell death.
  • TOXICOLOGICAL FINDINGS OF A RECOMBINANT CHOLERA TOXIN B SUBUNIT VARIANT WITH THERAPEUTIC POTENTIAL IN ULCERATIVE COLITIS

    • Micaela Reeves,
    • Daniel Tuse,
    • Krystal Hamorsky,
    • Joshua Royal,
    • Nobuyuki Matoba
    Published in issue: February 2021
    S6
    The cholera toxin B subunit (CTB) is the nontoxic and homopentameric component of the holotoxin. Upon binding to GM1 ganglioside on the surface of epithelial cells, CTB mediates entry and retrograde transport through the endomembrane system and disengages the catalytic A subunit in the endoplasmic reticulum (ER). EPICERTIN (EPT) is a recombinant variant of CTB with a non-native C-terminal extension harboring an ER-retention motif, KDEL. We have found that increased ER-retention time resulting from this modification allowed EPT to induce an unfolded protein response and TGF-β signaling in colon epithelial cells, triggering wound healing activity in preclinical colitis models.

Comparative Effectiveness Studies

Controlled Clinical Trials in Humans

  • A POPULATION-BASED APPROACH TO DIGITAL OUTREACH, TRIAGE, AND MONITORING OF IBD PATIENTS DURING THE COVID-19 PANDEMIC

    • Ashish Atreja,
    • Farah Fasihuddin,
    • Shashank Garge,
    • ...
    • Charu Madhwani Jain,
    • Sravya Kurra,
    • Bruce Sands
    Published in issue: February 2021
    S7-S8
    In March 2020, the Mount Sinai Health System Inflammatory Bowel Disease (IBD) center reported an increase in telephone call volume, with many IBD patients expressing anxiety about being on immunosuppressive agents during the COVID-19 pandemic. Consistent with GI society and CDC recommendations, we leveraged the Rx.Universe platform (Rx.Health, New York, NY) to rapidly design and deliver a population-based digital navigation program (DNP) to provide outreach, remote COVID-19 symptom monitoring, triage, and Telehealth to IBD patients.
  • A TRANSLATIONAL PHASE I STUDY OF TAUROURSODEOXYCHOLIC ACID (TUDCA) TO REDUCE SYMPTOMS AND ER STRESS IN ACTIVE ULCERATIVE COLITIS

    • Katherine Huang,
    • Ruishu Deng,
    • Ta-Chiang Liu,
    • ...
    • Nicholas Davidson,
    • Randal Kaufman,
    • Matthew Ciorba
    Published in issue: February 2021
    S8
    Emerging evidence has demonstrated that protein misfolding in the endoplasmic reticulum (ER), i.e., ER stress, plays fundamental roles in IBD development in humans. Patients with active Crohn’s disease and ulcerative colitis exhibit signs of ER stress in their ileal and/or colonic epithelium. Human genetic studies of IBD have identified primary genetic abnormalities in several genes that encode proteins associated with ER stress. We recently reported that oral delivery of tauroursodeoxycholic acid (TUDCA), a naturally occurring bile salt proven to reduce ER stress both in vitro and in vivo, dramatically decreases the clinical, histological and biochemical signs of inflammation in four different IBD mouse models through reducing ER stress in colonic epithelial cells.
  • EFFECT OF OZANIMOD ON FECAL CALPROTECTIN AND FECAL LACTOFERRIN, BIOMARKERS OF INTESTINAL INFLAMMATION, IN THE PHASE 2 TOUCHSTONE STUDY OF PATIENTS WITH MODERATE-TO-SEVERE ULCERATIVE COLITIS

    • William Sandborn,
    • Brian Feagan,
    • Douglas Wolf,
    • ...
    • Subrata Ghosh,
    • Harry Southworth,
    • Sarah Harris
    Published in issue: February 2021
    S8-S9
    Efficacy and safety of ozanimod, an oral sphingosine-1-phosphate (S1P) receptor modulator selectively targeting S1P1 and S1P5, was previously demonstrated in the double-blind phase 2 TOUCHSTONE study (NCT01647516) in patients with moderate-to-severe ulcerative colitis. Here we report the effect of ozanimod on levels of fecal calprotectin (FCP) and fecal lactoferrin (FLF), two markers of intestinal inflammation.
  • EFFECTIVENESS OF ANTIBIOTICS AS A TREATMENT OPTION FOR PATIENTS WITH CROHN’S DISEASE: A META ANALYSIS

    • Joshua Patterson
    Published in issue: February 2021
    S9
    Crohn’s Disease (CD) is an Inflammatory Bowel Disease (IBD) whose etiology has been suspected to include bacterial antigens. A treatment option, therefore, would be the usage of antibiotics. To that end, the purpose of this study was to perform a meta-analysis on the ability of antibiotics inducing remission or a favorable clinical response in Crohn’s disease (CD) patients. Thirty-two randomized, double-blind, placebo-controlled trials of antibiotics for treatment of CD in adults, totaling 3269 patients, were reviewed.
  • LOW DOSE IL-2 FOR THE TREATMENT OF MODERATE TO SEVERE ULCERATIVE COLITIS

    • Jessica Allegretti,
    • James Canavan,
    • Vanessa Mitsialis,
    • ...
    • Athos Bousvaros,
    • Josh Korzenik,
    • Scott Snapper
    Published in issue: February 2021
    S9-S10
    A significant proportion of patients with ulcerative colitis (UC) have suboptimal responses to medical therapy. Expansion of regulatory T cells (Tregs), but not conventional T cells (Tcons), through the use of low doses (LD) of the T cell growth factor Interleukin-2 (IL-2, Proleukin®), has been a promising approach in other immune-mediated diseases and pre-clinical humanized UC mouse models. We performed a phase 1b/2a clinical trial in patients with moderate-to-severe UC to determine if subcutaneously (SC) administered LD IL-2 is safe and results in a biological response.
  • REINVENTING INFLAMMATORY BOWEL DISEASE (IBD) CLINICAL TRIAL RECRUITMENT USING NOVEL DIGITAL MEDICINE TOOLS

    • Farah Fasihuddin,
    • Nicole Wedel,
    • Ashish Atreja,
    • ...
    • Ashish Atreja,
    • Sarthak Kakkar,
    • Shashank Garge
    Published in issue: February 2021
    S10
    Issues with patient recruitment and enrolment are the primary barriers for missed clinical trial timelines; 8 out of 10 clinical trials are delayed or unable to be completed because of the lack of timely patient recruitment. Current patient recruitment efforts are inefficient as they are typically dependent on the manual screening of patients during face-to-face visits. With the rapid development of digital communication platforms within healthcare and the broad consumer adoption of smartphones, there are increasing opportunities to overcome some of these barriers.

Cytokines, Signaling, And Receptors

  • MESENCHYMAL TNFR1 EXPRESSION PRESERVES THE COLONIC EPITHELIAL STEM CELL NICHE

    • Safina Gadeock,
    • Cambrian Liu,
    • Brent Polk
    Published in issue: February 2021
    S10-S11
    Tumor necrosis factor (TNF) is a highly expressed cytokine in inflammatory bowel disease (IBD). Although TNF can induce colonic epithelial dysfunction and apoptosis, recent studies suggest that TNF signalling promotes epithelial wound repair and stem cell function. Here we investigated the role of TNF receptor 1 (TNFR1) in mediating TNF’s effects on colonic epithelial stem cells, integral to mucosal healing in colitis. We demonstrate that Tnfr1-/- mice exhibit loss in Lgr5 expression (-52%, p<0.02; N=6) compared to wildtype (WT) controls.

Diagnostics in IBD

  • A BASELINE GENE EXPRESSION-BASED PROGNOSTIC FOR ANTI-TNFα THERAPY RESPONSE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

    • Suraj Sakaram,
    • Yudong He,
    • Timothy Sweeney
    Published in issue: February 2021
    S11
    Although anti-TNFα therapies have revolutionized the management and care of IBD, their administration and usage remain suboptimal because 1) over 50% of patients do not have a lasting therapeutic response, 2) they increase risk of infections, liver problems, arthritis, and lymphoma, and 3) they are expensive. With approximately 1.6 million people suffering from IBD in the US and global prevalence of IBD on the rise, a predictive test for anti-TNFα response would greatly improve the efficacy and cost-to-benefit ratio of these biologics.
  • CLINICAL SIGNIFICANCE OF PSOAS MUSCLE COMPOSITION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

    • Bixuan Lin,
    • Poonam Beniwal-Patel
    Published in issue: February 2021
    S11-S12
    Total psoas muscle cross sectional area, as identified with computed tomography (CT), has been associated with clinical outcomes in various disease states. Unfortunately, total psoas CSA does not differentiate muscle density nor fat, both of which may be abnormal in obesity. Using a novel CT method to partition psoas muscle into low and high density muscle, recent studies have demonstrated low and high attenuating psoas muscle may be superior to total psoas CSA in identifying sarcopenic obesity.
  • CRYPTOGENIC MULTIFOCAL ULCEROUS STENOSING ENTERITIS (CMUSE): A 20-YEAR SINGLE CENTER CLINICAL AND RADIOLOGIC EXPERIENCE

    • Guilherme Piovezani Ramos,
    • David Bartlett,
    • Adam Bledsoe,
    • ...
    • Jeff Fidler,
    • Shannon Sheedy,
    • Joseph Murray
    Published in issue: February 2021
    S12-S13
    Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare illness characterized by multiple strictures and shallow ulcers of the small bowel. Even though diagnostic criteria have been described, further ellucidation is needed on therapeutic interventions and potential discriminating factors between CMUSE and other more common causes of intestinal ulcerations, including Crohn’s disease.
  • IDENTIFYING RELEVANT PATHWAYS AND BIOMARKERS IN CROHN’S DISEASE USING CONTEXTUALIZED METABOLIC NETWORK MODEL

    • Brooklyn McGrew,
    • Aman Shrivastava,
    • Philip Fernandes,
    • ...
    • Subra Kugathasan,
    • Lee Denson,
    • Sana Syed
    Published in issue: February 2021
    S13
    Candidate markers for Crohn’s Disease (CD) may be identified via gene expression-based construction of metabolic networks (MN). These can computationally describe gene-protein-reaction associations for entire tissues and also predict the flux of reactions (rate of turnover of specific molecules via a metabolic pathway). Recon3D is the most comprehensive human MN to date. We used publicly available CD transcriptomic data along with Recon3D to identify metabolites as potential diagnostic and prognostic biomarkers.
  • MACHINE LEARNING FOR CROHN’S DISEASE PHENOTYPE MODELING USING BIOPSY IMAGES

    • Sana Syed,
    • Saurav Sengupta,
    • Lubaina Ehsan,
    • ...
    • Susan Baker,
    • Tom Walters,
    • Lee Denson
    Published in issue: February 2021
    S14
    Predicting Crohn’s disease (CD) phenotype development has proven challenging due to difficulties in biopsy image interpretation of histologically similar yet biologically distinct phenotypes. At initial diagnosis, mostly CD patients are classified as B1 (inflammatory behavior), they typically either retain B1 phenotype or develop more complicated B2 (stricturing), B3 (internal penetrating), or B2/B3 phenotypes (defined by Montreal Classification). Prediction of phenotype development based on baseline biopsies can radically improve our clinical care by altering disease management.
  • ROLE OF MAGNETIC RESONANCE ENTEROGRAPHY IN THE DIAGNOSTICS OF ACTIVE CROHN’S DISEASE IN CHILDREN

    • Karolina Siejka,
    • Maryla Kuczynska,
    • Magdalena Grzegorczyk,
    • ...
    • Weronika Cyranka,
    • Agnieszka Brodzisz,
    • Magdalena Maria Wozniak
    Published in issue: February 2021
    S15
    Crohn’s disease (CD) is an idiopathic inflammatory bowel disease of the gastrointestinal tract. It is more common in the developed and industrialized countries, particularly in the Western Europe and North America. Up to 20–30% of patients present first symptoms during childhood or adolescence. Traditionally it is diagnosed by clinical indicates, endoscopy and histological findings. Assessment of the disease activity and location along the gastrointestinal tract are of crucial importance for diagnosis and implementation of the proper treatment.
  • SMALL-BOWEL CAPSULE ENDOSCOPY IN INFLAMMATORY BOWEL DISEASE TYPE UNCLASSIFIED

    • Ana-Maria Singeap,
    • Irina Girleanu,
    • Stefan Chiriac,
    • Tudor Cuciureanu,
    • Carol Stanciu,
    • Anca Trifan
    Published in issue: February 2021
    S15
    Ulcerative colitis (UC) and Crohn’s disease (CD) are idiopathic inflammatory bowel diseases (IBD) with no unique, gold standard diagnostic test. UC and Crohn’s colitis are in approximately 10% of cases impossible to be distinguished. The term IBD type unclassified (IBD-U) is officially proposed for the cases of chronic colitis showing overlapping endoscopic, radiological, and biopsy histological features between UC and CD, while indetermined colitis is reserved for colectomy specimen. Our aim was to evaluate the role of small-bowel capsule endoscopy (SBCE) in the diagnostic work-up of IBD-U.
  • THE MUCOSAL MICRORNA PROFILE RELATES TO AGE AND SEVERITY OF DISEASE IN PATIENTS WITH ULCERATIVE COLITIS

    • Mikkel Malham,
    • Jaslin James,
    • Christian Jakobsen,
    • ...
    • Vibeke Wewer,
    • Boye S. Nielsen,
    • Lene Riis
    Published in issue: February 2021
    S15
    Despite significant evidence that the expression of several microRNA’s (miRNA) impacts on disease activity in patients with ulcerative colitis (UC), it remains unknown if the more severe disease phenotype seen in pediatric-onset UC can be explained by altered miRNA expression. In this study, we aimed to assess the relationship between miRNA expression, age, and disease severity in pediatric and adult patients with UC. Using RT-qPCR, we analyzed the expression of miR-21, miR-31, miR-126, miR-142, and miR-155 in paraffin-embedded rectum biopsies from 30 pediatric and 30 adult-onset UC patients, and found that lesions from adult patients had significantly higher expression levels of miR-21 compared to pediatric patients and that the expression levels of miR-31 (all patients) and miR-155 (pediatric patients only) correlated inversely with histological assessed disease severity.
  • ULTRASOUND - FIRST-LINE IMAGING MODALITY IN EVALUATION OF THE INFLAMMATORY BOWEL LESIONS IN CHILDREN

    • Magdalena Grzegorczyk,
    • Maryla Kuczynska,
    • Karolina Siejka,
    • ...
    • Malgorzata Nowakowska,
    • Magdalena Maria Wozniak,
    • Agnieszka Brodzisz
    Published in issue: February 2021
    S15-S16
    Crohn’s disease is classified as chronic inflammatory bowel disease. The incidence in Europe ranges from 1 to almost 11.4 per 100,000 population per year. Ultrasound examination plays an important role in imaging diagnostics of inflammatory bowel lesions. It allows for assessing response to therapy as well as recognizing possible penetrating complications of the disease, i.e. fistula or abscess.
  • WEARABLE SWEAT SENSING DEVICE FOR DETECTION OF IBD BIOMARKERS

    • Badrinath Jagannath,
    • Sriram Muthukumar,
    • Shalini Prasad
    Published in issue: February 2021
    S16
    Inflammatory Bowel Disease affects 1.2 million in the United States. Flare-up of the disease occurs in a random way and current testing methods lack ability for real-time prediction of a flare up. The levels of cytokines elevate during a flareup. Therefore, we hypothesize that real-time monitoring of cytokine biomarkers can be useful for early detection of flare-ups and provide better patient management. In this context, sweat-based diagnostics can be promising for real-time tracking of IBD biomarkers.

Disease Activity Assessment

Disease Complications

  • A RARE AND UNFORTUNATE CASE OF PARESTHESIAS SECONDARY TO INFLIXIMAB

    • Neethi Dasu,
    • Brian Blair,
    • Yaser Khalid
    Published in issue: February 2021
    S18-S19
    The tumor necrosis factor-α (TNF-α) antagonists infliximab, adalimumab, and etanercept have been approved for treatment of inflammatory bowel disease (IBD). We describe a rare manifestation of a demyelinating neuropathy affecting the peripheral nervous system in a patient on Infliximab for the treatment of Crohn’s disease following progression of his disease.
  • CIGARETTE SMOKE INCREASES RISK FOR COLORECTAL NEOPLASIA IN INFLAMMATORY BOWEL DISEASE

    • Kimberley Van Der Sloot,
    • Johan Tiems,
    • Marijn Visschedijk,
    • ...
    • Rinse Weersma,
    • Gursah Kats-Ugurlu,
    • Gerard Dijkstra
    Published in issue: February 2021
    S19
    Patients with inflammatory bowel disease are at increased risk of colorectal neoplasia (CRN) due to mucosal inflammation. As current surveillance guidelines form a burden on patients and healthcare costs, stratification of high-risk patients is crucial. Cigarette smoke reduces inflammation in ulcerative colitis (UC) but not Crohn’s disease (CD) and forms a known risk factor for CRN in the general population. Due to this divergent association, the effect of smoking on CRN in IBD is unclear and subject of this study.
  • COLORECTAL ADENOCARCINOMA DEVELOPING IN A YOUNG FEMALE WITH OVERLAP SYNDROME AND VERY EARLY ONSET-INFLAMMATORY BOWEL DISEASE: A CASE REPORT

    • Prashanthi Kandavel,
    • Victoria Shakhin,
    • Mallory Chavannes,
    • ...
    • Hillel Naon,
    • Wang Larry,
    • George Yanni
    Published in issue: February 2021
    S20
    We present a 4-year-old female diagnosed with very-early onset inflammatory bowel disease (VEO-IBD), ulcerative colitis type, and overlap syndrome based on clinical presentation, blood and stool studies, diagnostic endoscopies and liver biopsy. Her clinical course was complicated by pervasive psychological stressors, non-compliance with medical therapy, and frequent provider changes. Initial treatment included Prednisone, 6-mercaptopurine and Ursodiol. Treatment was escalated to include multiple biological agents which were stopped prematurely due to non-adherence.
  • IMMATURE LOW-DENSITY NEUTROPHILS AS MEDIATORS OF PYODERMA GANGRENOSUM AND INFLAMMATORY BOWEL DISEASE PATHOGENESIS

    • Samreen Jatana,
    • Nancy Rebert,
    • Anthony Fernandez,
    • Jean-Paul Achkar,
    • Christine McDonald
    Published in issue: February 2021
    S20
    Pyoderma gangrenosum (PG) is a debilitating skin condition characterized by deep, pus-filled, non-healing ulcers packed with neutrophils and is a common extraintestinal manifestation of inflammatory bowel disease (IBD). Strikingly, ∼40% of people with an initial presentation of PG go on to be also diagnosed with IBD, suggesting that both diseases have common factors driving their pathogenesis. The molecular and cellular mechanisms of PG and IBD co-development are currently unknown, hampering the development of effective treatment strategies for individuals affected by both diseases.
  • IS ILEOANAL POUCH EXCISION A DESTINATION THERAPY FOR INFLAMMATORY BOWEL DISEASE? DATA FROM A QUATERNARY POUCH REFERRAL CENTER

    • Sarah Choi,
    • Amy Lightner,
    • Jeremy Lipman,
    • ...
    • Scott Steele,
    • Stefan Holubar,
    • Florian Rieder
    Published in issue: February 2021
    S20-S21
    Although ileal pouch-anal anastomosis (IPAA) is the surgical procedure of choice of many patients with ulcerative colitis and other conditions, some patients may require pouch excision (PE). We aimed to describe our experience with pouch excisions and associated outcomes with an emphasis on late medical, endoscopic, and surgical interventions for IBD.
  • MINIMAL INVASIVE MANAGEMENT OF PEDIATRIC CROHN’S ANORECTAL STRICTURE, LESS IS MORE

    • Dorothy Rocourt,
    • Travis Hoover
    Published in issue: February 2021
    S21-S22
    Anorectal stricture (ARS) is an uncommon but potentially disabling manifestation of perianal Crohn disease (CD) in pediatric patients. Various treatment options are available but there is little data regarding their efficacy, particularly in the pediatric population. We present three case reports of patients with symptomatic ARS treated with serial dilation and biologic therapy.
  • SHAPE MEMORY POLYMER HYDROGEL FOAMS FOR FISTULA CLOSURE

    • Mary Monroe,
    • Henry Beaman,
    • Anand Vakil,
    • Changling Du
    Published in issue: February 2021
    S22
    Crohn’s disease can lead to fistula formation between portions of the urinary, reproductive, and digestive systems. The abnormal connections caused by these tunneling sores cause severe pain, infections, and abscess formation. Currently, 83% of Crohn’s patients with fistula formation undergo surgical intervention to either drain or bypass the fistula openings, and ∼23% of these patients ultimately require bowel resections.
  • TWISTED POUCH SYNDROME - A DIFFICULT TO DIAGNOSE MECHANICAL COMPLICATION OF ILEAL POUCH-ANAL ANASTOMOSIS: OUTCOMES AFTER REDO POUCH PROCEDURES

    • Stefan Holubar,
    • Amy Lightner,
    • Taha Qazi,
    • ...
    • Mark Baker,
    • Tracy Hull,
    • Scott Steele
    Published in issue: February 2021
    S22-S23
    Ileal pouch-anal anastomosis (IPAA) is a technically demanding procedure. Intraoperatively, great care must be taken to assure a straight superior mesenteric axis. Rarely, twisted pouches are inadvertently constructed, resulting in deviations of expected pouch function, i.e. patients readily able to open their bowels on average 7x/24 hours without pain. Twisted pouches may result in symptoms classified as pouch dysfunction. Herein we describe our quaternary pouch referral center experience with twisted pouch syndrome (TPS).
  • URINARY BLADDER NECROSIS - AN EXTRAINTESTINAL MANIFESTATION OF INFLAMMATORY BOWEL DISEASE IN A PEDIATRIC PATIENT

    • Nicholas Norris,
    • Bruce Schlomer,
    • Bhaskar Gurram
    Published in issue: February 2021
    S23
    Extraintestinal manifestations are common in inflammatory bowel disease (IBD), and genitourinary complications are known, including nephrolithiasis, fistulas, and ureteral obstruction. Bladder involvement is less common, and limited to cystitis including xanthogranulomatous cystitis. Bladder necrosis has not been previously described in association with IBD. Here, we describe an unusual case of IBD associated with total bladder necrosis at the time of initial diagnosis.

Epidemiology

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