Crohn’s disease
aspects of epidemiology, clinical course,
and faecal calprotectin
Yaroslava Zhulina
Medical Science with a specialisation in Medicine
Örebro Studies in Medicine 141 I ÖREBRO 2016
ÖREBRO STUDIES IN MEDICINE 141 2016
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yaroslava zhulina earned her medical degree from the Faculty of General Medicine at Bogomolets National Medical University, Kiev, Ukraine in 1996. After moving to Sweden, she did her internship and obtained her specialist qualification in internal medicine, gastroenterology, and hepatology at Karlskoga Hospital. She is currently working as a consultant at the Internal Medicine and Geriatrics Clinic at the same hospital. The work presented in this thesis began in 2007 with Jonas Halfvarsson, MD as supervisor. Inflammatory bowel diseases, comprising the two major entities Crohn’s di-sease and ulcerative colitis, are didi-seases of unknown aetiology characterized by severe, chronic intestinal inflammation. This thesis studied time trends in the epidemiology and natural history of Crohn’s disease in the Örebro pri-mary uptake area during 1963-2010. The incidence of Crohn’s disease seems to be on the increase, and the prevalence is high. The proportion of patients with uncomplicated disease at diagnosis is increasing, and the proportion of patients progressing to complications within five years from diagnosis is decreasing. During the same period after diagnosis, the proportion of patients that receive immunomodulators has increased, and the requirement for surgery has decreased.
Environmental influences might have contributed to increased faecal cal-protectin and subclinical inflammation in healthy relatives of inflammatory bowel disease patients. Consecutive monitoring of faecal calprotectin in patients in clinical remission is useful for prediction of relapse.
issn 1652-4063 isbn 978-91-7529-135-2
