Colon screening programs have reduced colon cancer mortality. Population screening should be minimally invasive, safe, acceptably sensitive, cost-effective, and scalable. The range of screening modalities include guaiac or immunochemical fecal occult blood testing and CT colonography and colonoscopy. A number of carefully controlled studies concur that second-generation capsule endoscopy has excellent sensitivity for polyp detection and a high negative predictive value. Colon capsules fulfill the screening expectation of safety, high sensitivity for polyp detection, and patient acceptance, and appear to straddle the divide between occult blood testing and colonoscopy. While meeting these criteria, there remains the challenges of scaling, capsule practitioner training, resource allocation, and implementing change of practice. Like CT colonography, capsule screening presents the clinician with a decision on the threshold for colonoscopy referral. Overall, colon capsules are an invaluable tool in polyp detection and colon screening and offer a filter that determines “who needs a colonoscopy?”.
Background and Objectives: Health professionals’ working schedules often do not allow them to follow a balanced way of life, and the nature of their work can affect their weight and eating habits. The aim of the present study is to shed some light on the impact of night shift working on the dietary practices of healthcare practitioners in Greece. Materials and Methods: This was a cross-sectional study. With the use of an administered questionnaire several parameters were assessed, including anthropometric characteristics, weight history, as well as nutritional habits of the same group of participants during night shifts and when at regular working hours. Moreover, nutritional beliefs of the subjects were recorded, as well as the level of adherence to the Mediterranean diet. Results: It was observed that in all food groups, including water, used to compare the nutritional patterns of the participants during night shifts and when working regular hours, statistical differences were noted (p = 0.001). Furthermore, the participants who reported a higher adherence to the Mediterranean diet and self-reported healthier nutritional habits, had a statistically lower weight compared to the participants that rarely followed the specific model or reported unhealthier eating routine (p = 0.010 and p = 0.015, respectively). Conclusions: We conclude that shift-working healthcare professionals are associated with disturbed eating behaviours leading to the high consumption of unhealthy food. The implementation of interventions that will concentrate on educating health workers on balanced nutrition and improving physical environment (i.e., food availability, healthier food choices) seems to be of great importance.
Background and Objectives: Emerging evidence is placing the Mediterranean diet (MD) in the spotlight as a potential dietary model that could benefit inflammatory bowel disease (IBD) patients in terms of prevention and progress of the disease. The main aim of the present study is to shed some light on the relationship between the adherence to the MD and the degree of disease activity, as well as the quality of life in patients with Crohn’s disease (CD). Materials and Methods: An administered questionnaire was used to assess and record a number of parameters, including recent medical and weight history, anthropometric characteristics, disease activity (in remission or active disease), and quality of life of both male and female CD patients. Moreover, the level of compliance of the participants to the Mediterranean diet model was evaluated and its relationship with disease activity and quality of life was investigated. Results: Adherence to the MD was significantly higher in patients with inactive disease than in those with active disease (p = 0.019). According to the correlation analysis conducted, adherence to the MD was negatively correlated with disease activity (p = 0.039) and positively correlated with quality of life (QoL) (p = 0.046) of the participants. Intake of fruits, vegetables, and dairy products was significantly higher in remission patients (p = 0.046, p = 0.001, p = 0.041, respectively). Conclusions: We conclude, according to the findings of the study, that adherence to the MD is associated with disease activity and QoL in patients with CD. Future research should focus on MD intervention studies on IBD patients in order to assess its effect on modulating disease activity/course and related inflammatory biomarkers.
Background: Biologic agents used in patients with inflammatory bowel diseases (IBD) may influence the pathophysiology of coexistent metabolic-dysfunction associated steatotic liver disease (MASLD). This study primarily aimed to evaluate the six-month effect of infliximab or vedolizumab vs. no biologics on presumed hepatic steatosis in patients with IBD. Secondary endpoints were their effect on hepatic fibrosis and parameters related to hepatic metabolism. Methods: This prospective, non-randomized, controlled trial assigned adult bio-naïve patients with IBD into three groups: infliximab, vedolizumab, or controls (receiving no biologic). The baseline was the time of the initiation of biologic agents and the endpoint six months later. Hepatic steatosis was evaluated with transabdominal ultrasonography (Hamaguchi score), whereas controlled attenuation parameter (CAP), fatty liver index (FLI), and hepatic steatosis index (HSI) were used as surrogates. Hepatic fibrosis was evaluated with liver stiffness (LS), fibrosis-4 index (FIB-4), and nonalcoholic fatty liver disease (NAFLD) fibrosis score. Results: Sixty-six patients were assigned to infliximab (n = 26), vedolizumab (n = 14), or control (n = 26); At the endpoint, the Hamaguchi score, CAP, FLI, and HSI were not different between groups. LS was not different between groups; however, FIB-4 was increased within all groups, and NAFLD fibrosis score was increased within infliximab and control groups, without significant biologic × time interactions. Conclusions: No positive or adverse effect of infliximab or vedolizumab vs. no biologic agents was shown on presumed hepatic steatosis in patients with IBD, who have not been previously exposed to biologic agents. Although no effect of both biologic agent on LS, a slight but significant increase in FIB-4 and NAFLD fibrosis score warrants further studying.
Background/Objectives: Diet and mental health constitute two significant modifiable factors affecting Inflammatory Bowel Disease (IBD). The present exploratory study explores potential interrelationships between mental health and eating patterns in IBD patients in Greece. Methods: A mixed-methods approach was followed. Two hundred and eighty-three individuals living with IBD in Greece (n = 110 UC, n = 173 CD) participated in an online questionnaire survey examining demographic characteristics, anxiety, depression, and dietary attitudes. Fourteen semi-structured interviews explored the lived experiences of diet, mental health, and disease among IBD patients. Results: Quantitative study revealed that 45.77% of patients scored above the clinical cutoff for anxiety (GAD-7 ≥ 10) and 48.37% for depression (PHQ-9 ≥ 10). Patients with UC exhibited a significantly higher prevalence of moderate to severe anxiety (54.5% vs. 37.0%, p = 0.004) and depression (54.5% vs. 42.2%, p = 0.042) compared to CD. Disordered eating attitudes were present in 27.22% of the total sample, with no significant differences between diagnostic groups (p = 0.985). Thematic analysis revealed three overarching themes, namely (a) ‘life in two phases: IBD impact on health’, (b) ‘mental health and diet interplay—their perceived impact on IBD’ and (c) ‘coping strategies for managing IBD’. Conclusions: Our findings highlight the dynamic interplay among diet, mental health, and IBD experience. The study underscores the importance of developing holistic biopsychosocial interventions integrating medical, dietary, and psychological components for IBD management.
Enteral feeds can be classified as two major types: commercial enteral formulas and blenderized enteral feeds. When deciding the most appropriate type of feed for a patient, several parameters need to be taken into consideration. Benefits associated with the use of blenderized tube feeds include giving a sense of normalcy to patients, having a positive impact on anthropometric indices, allowing for careful control over known food allergens, being associated with improved gastrointestinal tolerance and improved gut microbial composition (mainly in pediatric populations) and being generally less costly compared with commercial formulas. On the other hand, commercial enteral formulas have the advantages of being generally sterile, less likely to cause tube clogging and having a known and consistent nutrition composition. Further studies, specifically well-designed randomized controlled trials including adult populations, that will emphasize the impact of blenderized enteral feeds on various clinical outcomes are warranted. Clinicians need to be conscientious and educated regarding safe food practices for blended food preparation, as well as the characteristics of commercial formula options available to help assist patients in selecting the proper feed for their nutritional needs and clinical condition.