Información del artículo
Resumen
En esta reunión de la DDW 2012 (Digestive Disease Week 2012) celebrada en San Diego se han presentado múltiples trabajos en relación con la epidemiología de las enfermedades inflamatorias intestinales, algunos de ellos poblacionales, que nos aportan mayor información sobre factores de riesgo ya descritos en la bibliografía y, por otra parte, nos ayudan a eliminar algunos de ellos propuestos sin ninguna evidencia científica. Especial atención se ha prestado en esta reunión a los hallazgos, tanto en evolución natural como en cirugía, de los pacientes mayores de 65 años que claramente han de tratarse como un subgrupo de población “diferente” al de la población estándar de los ensayos clínicos de los que están excluidos. Otro apartado especialmente importante ha sido el de las complicaciones y manifestaciones extraintestinales con Clostridium difficile y la colangitis esclerosante primaria como principales protagonistas. Finalmente, y referentes al diagnóstico, la calprotectina se confirma como marcador imprescindible en diferentes escenarios, y nuevas técnicas de imagen como la cromoendoscopia virtual (i-scan) buscan su posición en el manejo de estos pacientes.
Palabras clave:
Enfermedad inflamatoria intestinal
Colitis ulcerosa
Enfermedad de Crohn
Epidemiología
Diagnóstico
Historia natural
Complicaciones
Cirugía
Abstract
In Digestive Disease Week 2012, held in San Diego, numerous studies were presented on the epidemiology of inflammatory bowel disease. Some of these studies were population-based, providing greater information on known risk factors and helping to eliminate proposed risk factors for which there is no known evidence. In this meeting, special attention was paid to the natural history of the disease as well as surgery in patients aged more than 65 years old who should clearly be treated as a separate subgroup from the standard population in clinical trials from which older individuals are excluded. Another especially important topic were extraintestinal complications and manifestations, with Clostridium difficile and primary sclerosing cholangitis as the main culprits. Finally, with reference to diagnosis, calprotectin was confirmed as an essential marker in distinct scenarios and new imaging techniques such as virtual chromoendoscopy (i-scan) will be important in the management of these patients, although their precise role remains to be defined.
Keywords:
Inflammatory bowel disease
Ulcerative colitis
Crohn's disease
Epidemiology
Diagnosis
Natural history
Complications
Surgery
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