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2.
Artigo em Inglês | MEDLINE | ID: mdl-38716208

RESUMO

Background: We assert that the ubiquitous environmental factor in inflammatory bowel disease (IBD) is our westernized diet. Therefore, all of our newly diagnosed patients were admitted to experience a plant-based diet (PBD). In the present study, we investigated the efficacy of a PBD in pregnant women with IBD. Case Description: Included in the study were women with IBD provided with a PBD (lacto-ovo-vegetarian diet) between 2004 and 2020 who were either pregnant or became pregnant. There were 10 pregnancies in eight cases: seven cases of ulcerative colitis (UC) and one case of Crohn's disease (CD). Five active cases during pregnancy were treated. The other five cases experienced the diet before pregnancy. Two cases developed UC either during pregnancy or in the postpartum period. The PBD without medication induced remission in two mild cases of UC. Infliximab and the PBD induced remission in a relapsed case of CD. There were six conceptions during remission without medication in four cases of UC. No case relapsed during pregnancy in these cases. Vaginal, cesarean, and vacuum extraction were undertaken in four, four, and two deliveries, respectively. Three in two cases were preterm deliveries. There were 10 live births in the eight cases. Two neonates from a mother had jaundice. In the median follow-up period of 71 months, all eight cases were in the quiescent phase. PBD scores in their follow-up period, which indicate adherence to the PBD, exceeded the baseline scores. Conclusions: Our case series study indicated that a PBD was effective for pregnant women with IBD.

3.
J Lifestyle Med ; 14(2): 98-102, 2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39280937

RESUMO

Diet-related cardiometabolic diseases and inflammatory bowel disease, common previously in Western countries, are global problems. We hypothesized that inflammatory bowel disease is a lifestyle disease primarily mediated by the current Western diet. We report here the simultaneous onset of ulcerative colitis and autoimmune pancreatitis, a rare systemic complication of inflammatory bowel disease, 2 months after acute myocardial infarction in a patient with type 2 diabetes. A 67-year-old man with type 2 diabetes was referred to us because of newly diagnosed ulcerative colitis 2 months after acute myocardial infarction. A plant-based diet was provided during hospitalization. An abrupt deterioration in plasma glucose and hemoglobin A1c due to asymptomatic type 2 autoimmune pancreatitis was observed. Prednisolone administration under intensive insulin therapy led to the remission of both diseases. This case was an illustrative one of association between cardiometabolic diseases and inflammatory bowel diseases caused by current unhealthy diets and their shared pathogenesis.

4.
Dig Endosc ; 25(6): 622-5, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24164601

RESUMO

Diffuse gastroduodenitis resembling ulcerative colitis in respect to macro- and microscopic findings occurs in ulcerative colitis, although it is rare. Reports of gastroduodenitis associated with ulcerative colitis treated with infliximab are rare. A 58-year-old man had tarry stool in March 2011. He had a history of ulcerative colitis that was diagnosed in 1984. He underwent subtotal colectomy in 1991. Endoscopy and radiography revealed diffuse friable mucosa throughout the duodenum and an ulcer in the middle of the descending portion, resulting in a narrow portion.In the stomach, numerous small aphthae were observed in the antrum. Biopsy specimens of the duodenum and antrum showed marked inflammatory cell infiltration in both areas and cryptitis in the duodenum. Standard induction therapy of infliximab was started in April. The ulcer in the descending portion became a scar without diffuse mucosal friability in September 2011.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Colite Ulcerativa/complicações , Duodenite/tratamento farmacológico , Gastrite/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Biópsia , Úlcera Duodenal/complicações , Úlcera Duodenal/diagnóstico , Duodenite/dietoterapia , Duodenite/etiologia , Endoscopia do Sistema Digestório , Gastrite/etiologia , Humanos , Infliximab , Masculino , Pessoa de Meia-Idade , Indução de Remissão
5.
Metabolites ; 13(3)2023 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-36984772

RESUMO

There has been no study of the therapeutic effect of a plant-based diet (PBD) in inflammatory bowel disease (IBD) except for our studies in Japan. In this review, we describe the rationale for the requirement of PBD in IBD and the outcomes of our modality incorporating PBD together with a literature review. The biggest problem in current therapy for IBD is the lack of a widely appreciated ubiquitous environmental factor in IBD. Therefore, a radical strategy against IBD has not been established. Japanese data showed an increased incidence of IBD in association with dietary westernization. Current global consumption consists of an excess of unhealthy foods and a shortage of healthy foods recognized as pro-inflammatory. Patients with IBD are no exception. One of the recommended healthy reference diets is PBD recognized as anti-inflammatory. We assert that IBD occurs in susceptible individuals mainly as a result of our omnivorous (westernized) diet. Therefore, we developed and began to provide a PBD, a lacto-ovo-vegetarian diet, for IBD patients in 2003. Infliximab and PBD as first-line (IPF) therapy was administered for all patients with newly developed Crohn's disease (CD) and for severe ulcerative colitis (UC). Our modality broke the barrier of primary nonresponders to biologics, with a remission rate of 96% in CD, and created a new relapse-free course in slightly over half of the patients (52%) with CD. Based on the rationale derived from available evidence and the clinical outcomes, PBD is highly recommended for IBD.

6.
Artigo em Inglês | MEDLINE | ID: mdl-38021365

RESUMO

Identification and recognition of the ubiquitous environmental factor are prerequisite for treatment and prevention of the disease. The biggest problem with current practice in inflammatory bowel disease (IBD) is the lack of a widely appreciated ubiquitous environmental factor for the disease. The incidence of IBD is associated with dietary transition from a traditional diet to the current (westernized) diet. Prospective cohort studies and case-control studies indicate that the current diet is a risk factor for IBD. The current diet tends to cause gut microbial dysbiosis resulting in a pro-inflammatory state. Therefore, we regard our current diet as this factor. Even nutritionally balanced meals are unable to suppress relapse, particularly in Crohn's disease (CD). Therefore, we developed a plant-based diet (PBD) (lacto-ovo-semi-vegetarian diet) to counter the current diet. By incorporating the PBD into practice, we achieved far better outcomes in both ulcerative colitis (UC) and CD in both the induction and quiescent phases compared to the current standard therapy. All patients were treated on an inpatient basis and provided with a PBD. CD is far more untenable than UC and is destined to follow a disabling course. Therefore, infliximab was indicated in all patients with CD, but only in severe cases with UC. This infliximab and PBD as first-line (IPF) therapy broke the barrier of primary nonresponders to biologics (around 30%): the remission rate was 96% (44/46) in CD and 76% (13/17) in severe UC. A PBD can induce remission without medication in approximately one-third of mild cases of UC. All patients were advised to adhere PBD after discharge. In CD, a relapse-free outcome was achieved in nearly a half of patients (52%) at 10-year follow-up without biologics or immunosuppressants. Cumulative relapse rates for 51 initial episode cases of UC (18 mild, 30 moderate, 3 severe) at 1 and 5 years were 14% and 27%, respectively. We believe our assertion that the current diet is the ubiquitous environmental factor underlying IBD is correct and a PBD is right diet for the disease.

7.
J Gastroenterol Hepatol ; 27(8): 1388-94, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22497500

RESUMO

BACKGROUND AND AIM: Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) of unknown etiology. We aimed to identify the etiological agent of CD using a molecular cloning strategy that was particularly focused on identifying agents causing immune abnormalities and infectious agents. METHODS: We constructed a cDNA library derived from the inflamed intestinal tissue of a CD patient, and screened 1.5 million clones in this library with the serum from another typical CD patient. The expressed cDNA clones that positively reacted with the serum were then expressed as fusion proteins with glutathione S-transferase, and western blotting was performed using the sera of 22 CD, 13 ulcerative colitis (UC), and 16 non-IBD patients. RESULTS: We identified nine positive clones that did not contain any viral or bacterial genomic DNA. Of these, we selected one clone (clone 50) with which the typical CD patient's serum most strongly reacted. Clone 50 is highly homologous to the antioxidant protein peroxiredoxin 6. In western blotting, the sera of 47.6% CD patients (small intestine type 80%, large and small intestine type 43%, large intestine type 0%) showed strong reactivity to clone 50, none of the UC patients were reactive to clone 50, and 18.8% of non-IBD patients were very weakly reactive to it. We also found that the expression of peroxiredoxin 6 was significantly increased in inflamed intestinal epithelia of CD. CONCLUSION: The present study first showed that some CD patients have an antibody against peroxiredoxin 6-like protein, which may be involved in the pathogenesis of CD.


Assuntos
Autoanticorpos/sangue , Clonagem Molecular , Doença de Crohn/imunologia , Intestinos/imunologia , Peroxirredoxinas/imunologia , Adulto , Sequência de Aminoácidos , Autoanticorpos/genética , Biomarcadores/sangue , Western Blotting , Colite Ulcerativa/enzimologia , Colite Ulcerativa/imunologia , Colite Ulcerativa/patologia , Doença de Crohn/enzimologia , Doença de Crohn/genética , Doença de Crohn/patologia , Feminino , Biblioteca Gênica , Humanos , Imuno-Histoquímica , Intestinos/enzimologia , Intestinos/patologia , Masculino , Dados de Sequência Molecular , Peroxirredoxina VI/análise , Peroxirredoxinas/análise , Regulação para Cima , Adulto Jovem
8.
Perm J ; 26(2): 40-53, 2022 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-35933676

RESUMO

Introduction Incorporation of a plant-based diet was effective in both induction and short-term relapse prevention in Crohn's disease. Ten-year long-term relapse-free rates in Crohn's disease are around 10% to 23%. Objective We investigated whether infliximab and plant-based diet as first-line therapy enhance the long-term relapse-free rate in patients with Crohn's disease. Methods This single-group, prospective study was performed in tertiary hospitals in Japan. Remission was induced in 24 consecutive newly diagnosed adult patients with Crohn's disease during hospitalization via 3 standard infliximab infusions together with a plant-based diet. Patients were instructed to continue the diet after discharge. Scheduled maintenance infliximab infusion was not used. The primary endpoint was relapse, which was defined as the appearance of symptoms resulting in the alteration of therapeutic modality. The secondary endpoints were C-reactive protein level, plant-based diet score, and surgery. Results The median follow-up period was 8.6 years. Thirteen cases were relapse-free. The relapse-free rate evaluated by Kaplan-Meier survival analysis at 1, 2, 3, and 4 years was 79%, 66%, 57%, and 52%, respectively. There was no further reduction afterward up to 10 years. The relapse-free rate with normal C-reactive protein levels at 1 to 2 and 3 to 10 years was 57% and 52%, respectively. The plant-based diet score at 20 months and 5 years was significantly higher relative to baseline (p < 0.0001). Surgical rates at 5 and 10 years were 12% and 19%, respectively. Conclusions Infliximab and plant-based diet as first-line therapy created an unprecedented relapse-free course in nearly half of patients with Crohn's disease.


Assuntos
Doença de Crohn , Adulto , Anticorpos Monoclonais/uso terapêutico , Proteína C-Reativa , Doença de Crohn/tratamento farmacológico , Dieta , Dieta Vegetariana , Humanos , Infliximab/uso terapêutico , Estudos Prospectivos , Recidiva , Indução de Remissão , Resultado do Tratamento
9.
Perm J ; 252021 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-35348099

RESUMO

INTRODUCTION: We regard inflammatory bowel disease as a lifestyle disease mainly mediated by a westernized diet. We developed a plant-based diet (PBD) to counter the westernized diet. PBD can induce remission without medication in a subset of mild cases of ulcerative colitis. Medication is provided when induction of remission is not achieved solely with PBD. We describe such a case in this report. CASE PRESENTATION: A 34-year-old woman visited us in October 2016 with a complaint of loose stool for nearly 5 years. Laboratory examination revealed mild abnormalities including elevation of C-reactive protein (CRP). Ulcerative colitis was diagnosed due to diffuse colonic inflammation and pathological findings consistent with ulcerative colitis. She was admitted for educational hospitalization for 19 days in the middle of November, during which PBD was provided. A few days after admission, her stool became normal. CRP concentration decreased to within the normal range. However, colonoscopy on discharge showed minimum improvement. Thereafter, CRP was abnormal on three successive occasions, and her stool alternated between normal and loose. Sulfasalazine was initiated at the end of March 2017. Thereafter, her stool was normally formed, and CRP decreased to normal. Endoscopic remission was confirmed in August. Her PBD score, which evaluates adherence to PBD, was 8 before admission, and 37 and 16 at 7 and 21 months after discharge, respectively. CONCLUSION: Medication was administered when restoration of a healthy dietary lifestyle was insufficient to induce remission. Our stepwise treatment makes the shift from one-size-fits-all medication toward medication to the right patient. REGISTRATION: http://www.umin.ac.jp UMIN000019061.


Assuntos
Colite Ulcerativa , Dieta Vegetariana , Adulto , Proteína C-Reativa/metabolismo , Colite Ulcerativa/terapia , Feminino , Humanos
10.
JMA J ; 4(4): 347-357, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34796289

RESUMO

INTRODUCTION: Inflammatory bowel disease has become a global disease, but its key environmental factors still remain unrecognized. This study aimed to clarify the role of dietary transition (westernization) in the increased incidence of inflammatory bowel disease in Japan. METHODS: Annual numbers of new cases of inflammatory bowel disease in Japan over the period from 1965 to 2000 found in a nationwide database compiled by the government and the daily amount of food and nutrient intake per capita for the same period revealed by the National Nutrition Survey have been used to analyze their interrelation. RESULTS: Rapid increases in the estimated incidence per 100,000 population have been observed, that is, from 0.08 in 1965 to 4.8 in 2000 for ulcerative colitis and from 0.003 to 1.3 in 2000 for Crohn's disease, with an extremely high correlation between the annual numbers of new cases of the respective diseases (r = 0.970). Intake of both animal fat and animal protein increased, while intake of rice decreased during the period. Of all food groups, the intake of rice as a staple food showed the highest negative correlation coefficient with the numbers of new cases of both ulcerative colitis (r = -0.825, 95% CI: -0.908 to -0.681, p < 0.0001) and Crohn's disease (r = -0.836, 95% CI: -0.914 to -0.700, p < 0.0001). CONCLUSIONS: An increased incidence of inflammatory bowel disease was observed to coincide with dietary westernization in Japan. Our results support the assertion that dietary westernization is a key environmental factor in inflammatory bowel disease.

11.
Autops Case Rep ; 10(4): e2020187, 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-33344315

RESUMO

We describe a scarcely reported case in which ulcerative colitis (UC) occurred in the postpartum period. The aims of this case report are to reinforce the recent assertion that a diet is a ubiquitous environmental factor in inflammatory bowel disease (IBD) and that a plant-based diet (PBD) is recommended for IBD. A 29-year-old woman normally delivered her first child. She first noticed bloody diarrhea 4.5 months after delivery. She was diagnosed with UC (left-sided colitis, moderate severity). Sulfasalazine induced remission. She then experienced and learned about PBD during an educational hospitalization. She resumed breast-feeding and stopped medication. An interview and questionnaire revealed a change in her diet 3 months after delivery, from a sound diet (plant-based diet score: 25) to an unhealthy diet (score: 9). It happened along with a change in residence, from her parent's home where her mother prepared traditional Japanese meals to her home where she prepared meals by herself. A feeling of release from childbirth prompted her to eat sweets and cheese despite being aware that the quality of the meals deteriorated. We described a scarcely reported case in which UC occurred in the postpartum period. It happened along with a change in her diet, from a sound diet to an unhealthy diet due to a feeling of release from childbirth. She replaced an omnivorous diet by PBD and stopped medication. The critical role of diet is largely ignored by healthcare professionals. We believe that greater appreciation of diet will change and improve management of IBD.

12.
Perm J ; 24: 1-10, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33482946

RESUMO

INTRODUCTION: About one-third of patients with severe ulcerative colitis (UC) do not respond to corticosteroid therapy and receive rescue therapy with infliximab or cyclosporine. Up to 20% of such patients fail to respond to rescue therapy and undergo colectomy. OBJECTIVE: We investigated the outcomes of infliximab and a plant-based diet (PBD) as first-line therapy for severe UC. METHODS: Patients with severe UC defined by the Truelove and Witts criteria were admitted and given standard induction therapy with infliximab (5.0 mg/kg-7.5 mg/kg) at 0, 2, and 6 weeks. Additionally, they received a PBD. The primary endpoint was remission or colectomy in the induction phase and 1 year after discharge. Secondary endpoints were changes in inflammatory markers in the induction phase and the PBD score at baseline and follow-up. A higher PBD score indicates greater adherence to a PBD. RESULTS: Infliximab and PBD as first-line therapy was administered in 17 cases. The remission rate was 76% (13/17), and the colectomy rate was 6% (1/17) in the induction phase. C-reactive protein values and the erythrocyte sedimentation rate significantly decreased at week 6 from 9.42 mg/dL to 0.33 mg/dL and from 59 to 17 mm/h, respectively (p < 0.0001). At 1-year follow-up, the cumulative relapse rate was 25%, and there were no additional colectomy cases. Mean PBD scores of 27.7 at 1 year and 23.8 at 4 years were significantly higher than baseline scores of 8.3 and 9.9, respectively (p < 0.0001 and p = 0.0391). CONCLUSION: This new first-line therapy for severe UC demonstrated a higher remission rate and lower colectomy rate than with the current modality.


Assuntos
Colite Ulcerativa , Colectomia , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/cirurgia , Ciclosporina , Dieta Vegetariana , Humanos , Infliximab/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
16.
Autops Case Rep ; 9(1): e2018068, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30863735

RESUMO

There is scarce knowledge on early intestinal obstruction in Crohn's disease (CD) after infliximab treatment. Therefore, we describe two cases of early intestinal obstruction in a series of 46 CD patients treated with infliximab. Both our two cases were 21-year-old men with newly diagnosed CD who were diagnosed with perianal disease 2 years previously. They were suffering from diarrhea and abdominal pain, but there were no symptoms indicating bowel obstruction. Radiographic studies revealed stenotic sites in the terminal ileum in both cases. In both cases, infliximab 300 mg was infused, after which their abnormal laboratory data as well as symptoms such as diarrhea and abdominal pain clearly improved. However, on the 11th or 13th day post-treatment, they presented abdominal distension with air-fluid levels on imaging studies. Ileocolonic resection was performed in both cases. Early intestinal obstruction after infliximab therapy is characterized by initial improvement of the symptoms and the laboratory data, which is soon followed by clinical deterioration. This outcome indicates that infliximab is so swiftly effective that the healing process tapers the stenotic site, resulting in bowel obstruction. Thus, although unpleasant and severe, the obstruction cannot be considered as a side effect but rather a consequence of infliximab's efficacy. CD patients with intestinal stricture, particularly the penetrating type with stricture, should be well informed about the risk of developing intestinal obstruction after infliximab therapy and the eventual need for surgical intervention.

17.
Perm J ; 23: 18-107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30624192

RESUMO

Inflammatory bowel disease (IBD), a collective term for Crohn disease and ulcerative colitis, is a polygenic disease thought to be triggered by environmental factors. A Western or westernized lifestyle may be a major driver of the growing incidence of IBD. IBD may represent dysregulated mucosal inflammation to gut microbiota. Despite many review articles on environmental factors in IBD, no consensus exists regarding which factor contributes most to trigger the onset of IBD. Identification and recognition of major environmental factors are prerequisite for effective disease treatment and prevention. Representative environmental factors such as smoking, breastfeeding, nonsteroidal anti-inflammatory drugs, antibiotic use in childhood, oral contraceptives, and appendectomy do not correlate with disease onset in most patients with IBD. In contrast, diet appears to be important in most cases of IBD. Diets rich in animal protein (risk factor) and deficient in dietary fiber (preventive factor) are characteristic of westernized diets in affluent societies. Recent research shows that westernized diets are associated with a reduced gut microbial diversity (dysbiosis), which may result in increased susceptibility to IBD and other common chronic diseases. Plant-based diets rich in dietary fiber are associated with increased microbial diversity. Recent reports on IBD therapy that replaced westernized diets with plant-based diets achieved far better outcomes than those previously reported in the literature. We believe that westernized diet-associated gut dysbiosis is the most ubiquitous environmental factor in IBD. Adoption of this concept may have the potential to provide a better quality of life for patients with IBD.


Assuntos
Dieta Ocidental/efeitos adversos , Meio Ambiente , Doenças Inflamatórias Intestinais/epidemiologia , Fibras na Dieta/administração & dosagem , Disbiose/microbiologia , Humanos , Estilo de Vida , Proteínas de Carne/administração & dosagem , Proteínas de Carne/efeitos adversos
18.
Inflamm Bowel Dis ; 25(11): e146-e147, 2019 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-31560040

RESUMO

Nonalcoholic fatty liver disease (NAFLD) develops in ulcerative colitis (UC) and Crohn's disease. However, there is scarce reporting on the onset of UC in patients with NAFLD. A 44-year-old man was diagnosed with UC and referred to us in 2019. His height was 166.0 cm, and body weight was 86.3 kg. The waist circumference was 93.7 cm (normal range <85) and triglyceride was 751 mg/dL. These findings, in addition to hypertension, resulted in a diagnosis of metabolic syndrome. HbA1c was normal. Ultrasonography disclosed severe fatty liver. Nonalcoholic fatty liver disease was diagnosed. He underwent 12 days of educational hospitalization for UC. A lacto-ovo-semi-vegetarian diet (1400 kcal/day), a kind of plant-based diet (PBD), was provided. He lost 4 kg, which was 4.6% of his base body weight. Triglyceride and total cholesterol decreased to the normal ranges. Transaminases and γ-glutamyl transpeptidase also decreased. His body weight decreased further after discharge. Follow-up ultrasonography indicated an improvement in hepatic enlargement. The shear wave velocity decreased from 1.11 to 0.88 m/s. His soft stool became normal stool by 2 months after discharge. Records of his health checkups revealed the presence of metabolic syndrome and abnormal liver function tests already in 2015. Thus, it was concluded that UC developed in a patient with NAFLD in this case. Plant-based diet has already been shown to be effective in inflammatory bowel disease (IBD). In the present case, NAFLD parameters were dramatically improved by PBD. Whether the improvement was due to weight loss per se or due to weight loss with PBD is to be clarified.


Assuntos
Colite Ulcerativa/complicações , Dieta Vegetariana , Síndrome Metabólica/complicações , Hepatopatia Gordurosa não Alcoólica/complicações , Adulto , Colite Ulcerativa/dietoterapia , Humanos , Masculino , Síndrome Metabólica/dietoterapia , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Resultado do Tratamento , Redução de Peso
19.
Perm J ; 232019.
Artigo em Inglês | MEDLINE | ID: mdl-31050638

RESUMO

CONTEXT: No known previous study has focused on plant-based diet (PBD) to prevent relapse of ulcerative colitis (UC) except our previous educational hospitalization study. OBJECTIVE: To describe the relapse rate in a large case series of UC after incorporation of PBD into induction therapy. DESIGN: All patients with UC between 2003 and 2017 were admitted for induction therapy. Patients receiving educational hospitalization or treated with infliximab were excluded. A lacto-ovo-semivegetarian diet (PBD) together with medication prescribed according to UC guidelines was provided during hospitalization. MAIN OUTCOME MEASURES: The primary endpoint was relapse during follow-up. The secondary endpoint was change over time in the plant-based diet score (PBDS), which evaluated adherence to the PBD. RESULTS: Ninety-two cases were studied, of which 51 were initial episodes and 41 were relapses. Cases varied in severity (31 mild, 48 moderate, 13 severe) and extent (15 proctitis, 22 left-sided colitis, 55 extensive colitis). More severe cases existed among the relapse cases than among the initial episode cases. Cumulative relapse rates at 1- and 5-year follow-up (Kaplan-Meier analysis) were 14% and 27%, respectively, for the initial episode cases, and 36% and 53%, respectively, for relapse cases. At long-term follow-up (6 years 4 months), PBDS was significantly higher than baseline PBDS (p < 0.0001). CONCLUSION: Relapse rates in UC after induction therapy with PBD were far lower than those previously reported with conventional therapy. Adherence to PBD was significantly higher than baseline even at 6-year follow-up. We conclude PBD is effective for preventing UC relapse.(Study identification no.: UMIN000019061: Registration: www.umin.ac.jp).


Assuntos
Colite Ulcerativa/dietoterapia , Dieta Vegetariana , Adulto , Colite Ulcerativa/prevenção & controle , Dieta Vegetariana/métodos , Feminino , Humanos , Masculino , Cooperação do Paciente , Prevenção Secundária/métodos , Resultado do Tratamento
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