S. Vavricka
Triemli Hospital
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Publication
Featured researches published by S. Vavricka.
Journal of Crohns & Colitis | 2016
Marcus Harbord; Vito Annese; S. Vavricka; Matthieu Allez; Manuel Barreiro-de Acosta; Kirsten Muri Boberg; Johan Burisch; Martine De Vos; Anne-Marie De Vries; Andrew D. Dick; Pascal Juillerat; Tom H. Karlsen; Ioannis E. Koutroubakis; Peter L. Lakatos; Timothy R. Orchard; Pavol Papay; Tim Raine; Max Reinshagen; Diamant Thaci; Herbert Tilg; Franck Carbonnel
This is the first European Crohn’s and Colitis Organisation [ECCO] consensus guideline that addresses extra-intestinal manifestations [EIMs] in inflammatory bowel disease [IBD]. It has been drafted by 21 ECCO members from 13 European countries. Although this is the first ECCO consensus guideline that primarily addresses EIMs, it is partly derived from, updates, and replaces previous ECCO consensus advice on EIMs, contained within the consensus guidelines for Crohn’s disease1 [CD] and ulcerative colitis2 [UC]. The strategy to define consensus was similar to that previously described in other ECCO consensus guidelines [available at www.ecco-ibd.eu]. Briefly, topics were selected by the ECCO guidelines committee [GuiCom]. ECCO members were selected to form working groups. Provisional ECCO Statements and supporting text were written following a comprehensive literature review, then refined following two voting rounds which included national representative participation by ECCO’s 35 member countries. The level of evidence was graded according to the Oxford Centre for Evidence-based Medicine [www.cebm.net]. The ECCO Statements were finalised by the authors at a meeting in Vienna in October 2014 and represent consensus with agreement of at least 80% of participants. Complete consensus [100% agreement] was reached for most statements. The supporting text was then finalised under the direction of each working group leader [VA, SV, FC, MH] before being integrated by the two consensus leaders [MH, FC]. This consensus guideline is pictorially represented within the freely available ECCO e-Guide [http://www.e-guide.ecco-ibd.eu/]. Up to 50% of patients with inflammatory bowel disease [IBD] experience at least one extra-intestinal manifestation [EIM], which can present before IBD is diagnosed.34,5,6 EIMs adversely impact upon patients’ quality of life and some, such as primary sclerosing cholangitis [PSC] or venous thromboembolism [VTE], can be life-threatening. The probability of developing EIMs increases with disease duration and in patients who already have one EIM.7 …
United European gastroenterology journal | 2013
Benjamin Misselwitz; Daniel Pohl; Heiko Frühauf; Michael Fried; S. Vavricka; Mark Fox
Lactose malabsorption is a common condition caused by reduced expression or activity of lactase in the small intestine. In such patients, lactose intolerance is characterized by abdominal symptoms (e.g. nausea, bloating, and pain) after ingestion of dairy products. The genetic basis of lactose malabsorption is established and several tests for this condition are available, including genetic, endoscopic, and H2-breath tests. In contrast, lactose intolerance is less well understood. Recent studies show that the risk of symptoms after lactose ingestion depends on the dose of lactose, lactase expression, intestinal flora, and sensitivity of the gastrointestinal tract. Lactose intolerance has recently been defined as symptoms developing after ingestion of lactose which do not develop after placebo challenge in a person with lactose maldigestion. Such blinded testing might be especially important in those with functional gastrointestinal diseases in whom self-reported lactose intolerance is common. However, placebo-controlled testing is not part of current clinical practice. Updated protocols and high-quality outcome studies are needed. Treatment options of lactose intolerance include lactose-reduced diet and enzyme replacement. Documenting the response to multiple doses can guide rational dietary management; however, the clinical utility of this strategy has not been tested. This review summarizes the genetic basis, diagnosis, and treatment of lactose malabsorption and intolerance.
Inflammatory Bowel Diseases | 2014
Natalie Filmann; Julia Rey; Sven Schneeweiss; Palle Bager; Gaetano Bergamaschi; Ioannis E. Koutroubakis; Stefan Lindgren; Felipe de la Morena; Bjørn Moum; S. Vavricka; Oliver Schröder; Eva Herrmann; Irina Blumenstein
Background:The main objective is to determine the overall prevalence of anemia in inflammatory bowel diseases (IBD) in Europe. Methods:A systematic literature search in PubMed and Embase was performed for studies published between January 2007 and May 2012. Eligible studies were included if they were original full-paper publications originated from Europe and if the authors agreed to provide their data. An overall prevalence of anemia in IBD, disease specific, and age–gender stratified basis prevalences were estimated. The influence of disease entity (Crohns disease/ulcerative colitis), gender, age, disease activity (remission/active disease), and IBD-specific treatment strategies on the prevalence of anemia was analyzed by a mixed logistic regression model. Thereby, the factor country of origin was included as a random effect. Results:Data were available for 2192 patients, mainly treated in tertiary referral centers. The overall prevalence of anemia in IBD patients was 24% (95% confidence interval, 18–31). Age–gender stratified prevalences were estimated for the age strata 18 to 29, 30 to 39, 40 to 49, 50 to 64, 65 to 74, >74 years and ranged from 18% to 35%. Patients receiving IBD-specific medication (P = 0.0002, odds ratio 1.54), and patients with active disease status (P < 0.0001, odds ratio 2.72) were significantly more likely to have anemia compared with patients not receiving IBD-specific medication or being in remission. Patients with ulcerative colitis tended to have anemia less likely than patients with Crohns disease (P = 0.01, odds ratio 0.77). Conclusions:The overall prevalence of anemia in patients with Crohns disease was 27% (95% confidence interval, 19–35) and 21% (95% confidence interval, 15–27) in patients with ulcerative colitis. Thereby, 57% of the anemic patients were iron deficient.
Allergy | 2014
Tanja Kuchen; Alex Straumann; Ekaterina Safroneeva; Yvonne Romero; Christian Bussmann; S. Vavricka; Peter Netzer; A. Reinhard; Susanne Portmann; Alain Schoepfer
Long‐lasting food impactions requiring endoscopic bolus removal occur frequently in patients with eosinophilic esophagitis (EoE) and harbor a risk for severe esophageal injuries. We evaluated whether treatment with swallowed topical corticosteroids is able to reduce the risk of occurrence of this complication.
Allergy | 2015
B. Giriens; Pu Yan; Ekaterina Safroneeva; Marcel Zwahlen; A. Reinhard; Andreas Nydegger; S. Vavricka; Christine Sempoux; Alex Straumann; Alain Schoepfer
Eosinophilic esophagitis (EoE) is a chronic, inflammatory disease of the esophagus with a rapidly increasing incidence. However, population‐based epidemiologic data on EoE are rare and limited to regions with less than 200 000 inhabitants. We evaluated the incidence and prevalence of EoE over time in Canton of Vaud, Switzerland.
Journal of Crohns & Colitis | 2013
Gerhard Rogler; Xavier Aldeguer; Wolfgang Kruis; Anders Lasson; Ulrich Mittmann; Kenneth Nally; Laurent Peyrin-Biroulet; Alain Schoepfer; Morten H. Vatn; S. Vavricka; Robert Logan
No abstract available Keywords: Crohns disease; Diagnostic tests; Inflammatory bowel disease; Irritable bowel syndrome; Ulcerative colitis.
Alimentary Pharmacology & Therapeutics | 2015
Ekaterina Safroneeva; S. Vavricka; Nicolas Fournier; Valérie Pittet; Laurent Peyrin-Biroulet; Alex Straumann; Gerhard Rogler; Alain Schoepfer
The impact of early treatment with immunomodulators (IM) and/or TNF antagonists on bowel damage in Crohns disease (CD) patients is unknown.
Journal of Crohns & Colitis | 2015
Luc Biedermann; Nicolas Fournier; Benjamin Misselwitz; Pascal Frei; Jonas Zeitz; Christine N. Manser; Valérie Pittet; Pascal Juillerat; Roland von Känel; Michael Fried; S. Vavricka; Gerhard Rogler
BACKGROUND AND AIMS Smoking is a crucial environmental factor in inflammatory bowel disease [IBD]. However, knowledge on patient characteristics associated with smoking, time trends of smoking rates, gender differences and supportive measures to cease smoking provided by physicians is scarce. We aimed to address these questions in Swiss IBD patients. METHODS Prospectively obtained data from patients participating in the Swiss IBD Cohort Study was analysed and compared with the general Swiss population [GSP] matched by age, sex and year. RESULTS Among a total of 1770 IBD patients analysed [49.1% male], 29% are current smokers. More than twice as many patients with Crohns disease [CD] are active smokers compared with ulcerative colitis [UC] [UC, 39.6% vs CD 15.3%, p < 0.001]. In striking contrast to the GSP, significantly more women than men with CD smoke [42.8% vs 35.8%, p = 0.025], with also an overall significantly increased smoking rate compared with the GSP in women but not men. The vast majority of smoking IBD patients [90.5%] claim to never have received any support to achieve smoking cessation, significantly more in UC compared with CD. We identify a significantly negative association of smoking and primary sclerosing cholangitis, indicative of a protective effect. Psychological distress in CD is significantly higher in smokers compared with non-smokers, but does not differ in UC. CONCLUSIONS Despite well-established detrimental effects, smoking rates in CD are alarmingly high with persistent and stagnating elevations compared with the GSP, especially in female patients. Importantly, there appears to be an unacceptable underuse of supportive measures to achieve smoking cessation.
Endoscopy | 2012
Stephan M. Wildi; Alain Schoepfer; S. Vavricka; Heiko Fruehauf; Ekaterina Safroneeva; N Wiegand; Peter Bauerfeind; Michael Fried
BACKGROUND AND STUDY AIMS Removal of colorectal polyps is routinely performed during withdrawal of the endoscope. However, polyps detected during insertion of the colonoscope may be missed at withdrawal. We aimed to evaluate whether polypectomy during both insertion and withdrawal increases polyp detection and removal rates compared with polypectomy at withdrawal only, and to assess the duration of both approaches. PATIENTS AND METHODS Patients were included into the study when the first polyp was detected, and randomized into two groups; in group A, polyps ≤ 10 mm in diameter were removed during insertion and withdrawal of the colonoscope, while in group B, these polyps were removed at withdrawal only. Main outcome measures were duration of colonoscopy, number of polyps detected during insertion but not recovered during withdrawal, technical ease, patient discomfort, and complications. RESULTS 150 patients were randomized to group A and 151 to group B. Mean (± standard deviation [SD]) duration of colonoscopy did not differ between the groups (30.8 ± 15.6 min [A] vs. 28.5 ± 13.8 min [B], P = 0.176). In group A 387 polyps (mean 2.58 per colonoscopy) were detected and removed compared with 389 polyps detected (mean 2.58 per colonoscopy) in group B of which 376 were removed (13 polyps were missed, mean size [SD] 3.2 [1.3] mm; 7.3 % of patients). Patient tolerance was similar in the two groups. CONCLUSIONS Removal of polyps ≤ 10 mm during withdrawal only is associated with a considerable polyp miss rate. We therefore recommend that these polyps are removed during both insertion and withdrawal.
Alimentary Pharmacology & Therapeutics | 2015
Ekaterina Safroneeva; S. Vavricka; Nicolas Fournier; Frank Seibold; Christian Mottet; Andreas Nydegger; J. Ezri; A. Straumann; Gerhard Rogler; Alain Schoepfer
Studies that systematically assess change in ulcerative colitis (UC) extent over time in adult patients are scarce.