The American Gastroenterological Association (AGA) has introduced a groundbreaking guideline, advocating the use of blood and stool-based biomarkers for the effective management of Crohn’s disease.
Published in Gastroenterology, this evidence-based guideline marks a significant advancement in the care of approximately 2.74 million Americans affected by this inflammatory bowel disease (IBD).
Role of Biomarkers in Crohn’s Disease
Biomarkers, including C-reactive protein (CRP) in blood and fecal calprotectin (FCP) in stool, are crucial in evaluating inflammation levels.
Their accurate measurement allows healthcare professionals to determine the activity status of Crohn’s disease, whether it’s active or in remission.
These biomarkers provide a more comprehensive understanding of the disease, supplementing the insights gained from colonoscopies and imaging studies.
Guidelines for Biomarker Use
Dr. Siddarth Singh from the University of California, San Diego, emphasizes the significance of biomarkers, especially when patients’ symptoms don’t align with endoscopic findings. The guidelines recommend the following approach:
For Patients in Remission: Conduct CRP and FCP tests every six to twelve months, particularly effective when previous biomarker levels have correlated with endoscopic assessments.
For Active Symptoms: Check CRP and FCP every two to four months if patients report increased symptoms like diarrhea and abdominal pain, to adjust treatments accordingly.
Post-Surgery Monitoring: FCP tests are suggested for low-risk patients post-surgery. However, in cases of suspected disease recurrence, radiologic or endoscopic assessments are preferred over solely relying on biomarkers.
Impact on Crohn’s Disease Management
This guideline, as explained by Dr. Ashwin Ananthakrishnan from Massachusetts General Hospital, elevates biomarkers from experimental to essential tools in IBD care.
Their ease of acquisition, cost-effectiveness, and non-invasive nature make them ideal for more frequent monitoring. This approach aims to ensure tighter disease control and improved long-term outcomes for patients with Crohn’s disease.
In summary, the AGA’s new guideline is a significant step forward in the management of Crohn’s disease, offering a more efficient, patient-friendly approach to monitoring and treatment.
By incorporating biomarkers into routine care, healthcare providers can achieve a more accurate and less invasive way of managing this challenging condition.
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The research findings can be found in Gastroenterology.
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