Affiliation: Cleveland Clinic Foundation
- Arora Z, Shen B. Biological therapy for ulcerative colitis. Gastroenterol Rep (Oxf). 2015;3:103-9 pubmed publisher..This paper reviews the currently available knowledge and evidence for the use of various biological agents in the treatment of UC. ..
- Paine E, Shen B. Endoscopic therapy in inflammatory bowel diseases (with videos). Gastrointest Endosc. 2013;78:819-835 pubmed publisher..Risk management of endoscopy-associated adverse events is also evolving. The application of endoscopic techniques in novel ways in the treatment of IBD is just beginning and will likely expand rapidly in the near future. ..
- Seril D, Yao Q, Shen B. Auto-inflammatory diseases in ileal pouch patients with NOD2/CARD15 mutations. Gastroenterol Rep (Oxf). 2016;4:73-6 pubmed publisher..Both of the patients demonstrated clinical improvement of these diverse systemic complaints following treatment with immunosuppressive and anti-inflammatory therapies. ..
- Shen B, Fazio V, Remzi F, Brzezinski A, Bennett A, Lopez R, et al. Risk factors for diseases of ileal pouch-anal anastomosis after restorative proctocolectomy for ulcerative colitis. Clin Gastroenterol Hepatol. 2006;4:81-9; quiz 2-3 pubmed..The identification and modification of these risk factors might help patients and clinicians to make a preoperative decision for IPAA, reduce IPAA-related morbidity, and improve response to treatment. ..
- Shen B, Brzezinski A, Fazio V, Remzi F, Achkar J, Bennett A, et al. Maintenance therapy with a probiotic in antibiotic-dependent pouchitis: experience in clinical practice. Aliment Pharmacol Ther. 2005;22:721-8 pubmed..Our review of patient outcome from the treatment placebo showed that only a minority of patients with antibiotic-dependent pouchitis remained on the probiotic therapy and in symptomatic remission after 8 months. ..
- Shen B, Achkar J, Lashner B, Ormsby A, Remzi F, Bevins C, et al. Endoscopic and histologic evaluation together with symptom assessment are required to diagnose pouchitis. Gastroenterology. 2001;121:261-7 pubmed..26 to 0.20; P > 0.05). The symptom, endoscopy, and histology scores each contribute to the PDAI and appear to be independent of each other. Symptoms alone do not reliably diagnose pouchitis. ..
- Kochhar G, Navaneethan U, Parungao J, Hartman J, Gupta R, Lopez R, et al. Impact of transjugular intrahepatic portosystemic shunt on post-colectomy complications in patients with ulcerative colitis and primary sclerosing cholangitis. Gastroenterol Rep (Oxf). 2015;3:228-33 pubmed publisher..Patients with PSC and UC who underwent TIPS prior to colectomy had higher rates of complications; however, this was probably due to the greater severity of cirrhosis and PSC in this population. ..
- Kochhar G, Shen B. Endoscopic fistulotomy in inflammatory bowel disease (with video). Gastrointest Endosc. 2018;: pubmed publisher..One patient had postoperative bleeding requiring blood transfusion and hospitalization. Endoscopic fistulotomy with a needle-knife appears to be safe and effective in treating IBD-related fistulas. ..
- Wu X, Ashburn J, Remzi F, Li Y, Fass H, Shen B. Male Gender Is Associated with a High Risk for Chronic Antibiotic-Refractory Pouchitis and Ileal Pouch Anastomotic Sinus. J Gastrointest Surg. 2016;20:631-9 pubmed publisher..61). Among the pouch patients referred to our subspecialty Pouch Center, male patients were found to have an increased risk for the CARP and ileal pouch sinus. The pathogenic mechanisms of the association warrant further study. ..
- Shen B, Bennett A, Navaneethan U, Lian L, Shao Z, Kiran R, et al. Primary sclerosing cholangitis is associated with endoscopic and histologic inflammation of the distal afferent limb in patients with ileal pouch-anal anastomosis. Inflamm Bowel Dis. 2011;17:1890-900 pubmed publisher..61 (95% CI: 1.00, 2.58), respectively. Concurrent PSC appears to be associated with a significant prepouch ileitis on endoscopy and histology in patients with IPAA. Pouch patients with long segment of ileitis should be evaluated for PSC. ..
- Li Y, Stocchi L, Rui Y, Liu G, Gorgun E, Remzi F, et al. Perioperative Blood Transfusion and Postoperative Outcome in Patients with Crohn's Disease Undergoing Primary Ileocolonic Resection in the "Biological Era". J Gastrointest Surg. 2015;19:1842-51 pubmed publisher..The presumed immunosuppressive effect of blood transfusion did not confer any protective effect on disease recurrence. ..
- Nyabanga C, Veniero J, Shen B. Computed tomography-guided endoscopic needle knife therapy for ileal pouch sinus. Gastroenterol Rep (Oxf). 2016;4:334-336 pubmed..Here we report a case of complicated presacral sinus with a closed orifice that was not amenable to NKSi, necessitating a CT-guided guide wire placement and subsequent NKSi. ..
- Arora Z, Mukewar S, Wu X, Shen B. Risk factors and clinical implication of superimposed Campylobacter jejuni infection in patients with underlying ulcerative colitis. Gastroenterol Rep (Oxf). 2016;4:287-292 pubmed..There was a trend for worse clinical outcomes of UC with in patients with superimposed CJI, which was frequently associated with UC flare requiring hospital admission. ..
- Fialho A, Fialho A, Kochhar G, Shen B. The presence of primary sclerosing cholangitis in patients with ileal pouch anal- anastomosis is associated with an additional risk for vitamin D deficiency. Gastroenterol Rep (Oxf). 2016;4:320-324 pubmed..The presence of PSC was found to be an independent risk factor for vitamin D deficiency in UC patients with IPAA. These patients should be routinely screened and closely monitored for vitamin D deficiency. ..
- Shen B, Goldblum J, Hull T, Remzi F, Bennett A, Fazio V. Clostridium difficile-associated pouchitis. Dig Dis Sci. 2006;51:2361-4 pubmed..Clostridium difficile-associated pouchitis is rare. However, Clostridium difficile infection should be excluded in patients with chronic refractory pouchitis. ..
- Gu J, Remzi F, Lian L, Shen B. Practice pattern of ileal pouch surveillance in academic medical centers in the United States. Gastroenterol Rep (Oxf). 2016;4:119-24 pubmed publisher..The detection of pouch neoplasia appears to be related to patient volume and physician experience. ..
- Taleban S, van Oijen M, Vasiliauskas E, Fleshner P, Shen B, Ippoliti A, et al. Colectomy with Permanent End Ileostomy Is More Cost-Effective than Ileal Pouch-Anal Anastomosis for Crohn's Colitis. Dig Dis Sci. 2016;61:550-9 pubmed publisher..37. ..
- Arora Z, Wu X, Navaneethan U, Shen B. Non-surgical porto-mesenteric vein thrombosis is associated with worse long-term outcomes in inflammatory bowel diseases. Gastroenterol Rep (Oxf). 2016;4:210-5 pubmed publisher..01-0.51) was found to be a protective factor. IBD patients who were inpatients or receiving corticosteroid therapy had an increased risk of the development of PMVT. The presence of PMVT was associated with poor clinical outcomes in IBD. ..
- Rai T, Wu X, Shen B. Frequency and risk factors of low immunoglobulin levels in patients with inflammatory bowel disease. Gastroenterol Rep (Oxf). 2015;3:115-21 pubmed publisher..Increasing age, disease duration and hypoalbuminemia appeared to be risk factors. The findings may provide rationale for targeted therapy to boost humoral immunity in selected patients with IBD. ..
- Shen B, Achkar J, Lashner B, Ormsby A, Remzi F, Brzezinski A, et al. A randomized clinical trial of ciprofloxacin and metronidazole to treat acute pouchitis. Inflamm Bowel Dis. 2001;7:301-5 pubmed..Ciprofloxacin should be considered as one of the first-line therapies for acute pouchitis. ..
- Bharadwaj S, Barber M, Graff L, Shen B. Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterol Rep (Oxf). 2015;3:185-93 pubmed publisher..Understanding changes in GI symptomatology during the menstrual cycle may help to determine the true extent of disease exacerbation and proper management strategy. ..
- Lian L, Stocchi L, Remzi F, Shen B. Comparison of Endoscopic Dilation vs Surgery for Anastomotic Stricture in Patients With Crohn's Disease Following Ileocolonic Resection. Clin Gastroenterol Hepatol. 2017;15:1226-1231 pubmed publisher..However, EBD could delay time until need for a second surgery and be attempted first for patients with a lower risk for disease progression. Patients at risk for recurrent disease may benefit from upfront surgical therapy. ..
- Shen B, Fazio V, Remzi F, Bennett A, Lopez R, Brzezinski A, et al. Combined ciprofloxacin and tinidazole therapy in the treatment of chronic refractory pouchitis. Dis Colon Rectum. 2007;50:498-508 pubmed..Combination therapy with ciprofloxacin and tinidazole was generally well tolerated and was effective in treating patients with chronic refractory pouchitis. ..
- Schaus B, Fazio V, Remzi F, Bennett A, Lashner B, Shen B. Clinical features of ileal pouch polyps in patients with underlying ulcerative colitis. Dis Colon Rectum. 2007;50:832-8 pubmed..Although the majority of polyps were inflammatory type, polyps in two patients were dysplastic or malignant. Endoscopic polypectomy with concomitant medical therapy seemed to improve patients' symptom scores. ..
- Shen B. The Evaluation of Postoperative Patients with Ulcerative Colitis. Gastrointest Endosc Clin N Am. 2016;26:669-77 pubmed publisher..Endoscopy of the altered bowel includes the evaluation of end ileostomy, Hartmann pouch or diverted rectum, loop ileostomy, diverted pouch, and pouchoscopy. Each segment of the bowel has unique landmarks. ..
- Li Y, Stocchi L, Rui Y, Remzi F, Shen B. Comparable outcomes of the consistent use versus switched use of anti- tumor necrosis factor agents in postoperative recurrent Crohn's disease following ileocolonic resection. Int J Colorectal Dis. 2016;31:1751-1758 pubmed..54) between the consistent and switched groups. The adherence to the same anti-TNF agent appeared to be as effective as the switching approach to different anti-TNF agent in treating postoperative recurrent CD after the inception ICR. ..
- Fialho A, Fialho A, Thota P, McCullough A, Shen B. Small Intestinal Bacterial Overgrowth Is Associated with Non-Alcoholic Fatty Liver Disease. J Gastrointestin Liver Dis. 2016;25:159-65 pubmed publisher..58; 95%CI: 1.70-7.54; p=0.001) remained associated with NAFLD. Patients with SIBO have an increased risk for hepatic steatosis and may benefit from aggressive control of the risk factors for NAFLD including metabolic syndrome. ..
- Liu G, Wu X, Li Y, Rui Y, Stocchi L, Remzi F, et al. Postoperative excessive gain in visceral adipose tissue as well as body mass index are associated with adverse outcomes of an ileal pouch. Gastroenterol Rep (Oxf). 2016;: pubmed..035) was an independent risk factor for the adverse pouch comes. In this cohort of ileal pouch patients, excessive VAT gain as well as gain in BMI after pouch construction was found to be associated with poor long-term outcomes. ..
- Yao Q, Zhou L, Cusumano P, Bose N, Piliang M, Jayakar B, et al. A new category of autoinflammatory disease associated with NOD2 gene mutations. Arthritis Res Ther. 2011;13:R148 pubmed publisher..Our cohort may represent a new disease category of autoinflammatory disease with characteristic clinical phenotypes and genotypes. It may somewhat resemble pediatric Blau's syndrome. ..
- Fialho A, Fialho A, Kochhar G, Schenone A, Thota P, McCullough A, et al. Association Between Small Intestinal Bacterial Overgrowth by Glucose Breath Test and Coronary Artery Disease. Dig Dis Sci. 2018;63:412-421 pubmed publisher..Further studies are necessary to confirm the association of SIBO with CAD. In the presence of risk factors, patients with SIBO may benefit from assessment for CAD. ..
- Horton N, Wu X, Philpott J, Garber A, Achkar J, Brzezinski A, et al. Impact of Low Immunoglobulin G Levels on Disease Outcomes in Patients with Inflammatory Bowel Diseases. Dig Dis Sci. 2016;61:3270-3277 pubmed..Future implications include using immunoglobulin levels in IBD patients as a prognostic indicator or boosting humoral immunity as a treatment in this subset. ..
- Nyabanga C, Kulkarni G, Shen B. Hyperbaric oxygen therapy for chronic antibiotic-refractory ischemic pouchitis. Gastroenterol Rep (Oxf). 2017;5:320-321 pubmed publisher..This case demonstrated the therapeutic role of HBOT as well as the possible disease mechanism in chronic antibiotic-refractory pouchitis. ..
- Chongthammakun V, Fialho A, Fialho A, Lopez R, Shen B. Correlation of the Rutgeerts score and recurrence of Crohn's disease in patients with end ileostomy. Gastroenterol Rep (Oxf). 2017;5:271-276 pubmed publisher..A high RS score based on ileoscopy appeared to be associated with poor outcomes. This may be considered a useful decision-making tool for monitoring disease after ileostomy surgery. ..
- Gao X, Lan N, Chouhan H, Stocchi L, Remer E, Shen B. Pelvic MRI and CT images are interchangeable for measuring peripouch fat. Sci Rep. 2017;7:12443 pubmed publisher..Pelvic MRI and CT images are interchangeable in retrospective measurements of peripouch fat, which will foster future investigation of the role of mesentery fat in colorectal diseases. ..
- Shen B, Remzi F, Brzezinski A, Lopez R, Bennett A, Lavery I, et al. Risk factors for pouch failure in patients with different phenotypes of Crohn's disease of the pouch. Inflamm Bowel Dis. 2008;14:942-8 pubmed publisher..The identification of these risk factors may help delineate the natural history of CD of the pouch and shed light on proper clinical management and prognosis. ..
- Shen B, Remzi F, Hammel J, Lashner B, Bevins C, Lavery I, et al. Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch. Inflamm Bowel Dis. 2009;15:163-70 pubmed publisher..58, 95% CI, 2.74-11.4). 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. ..