Link between 'pouchitis' after ulcerative colitis surgery and changes in gene express

For a long time it has been suspected that IBD is way more subsets than the traditional 2 disease classification of UC and Crohn's. This study lends further support to that suspicion.

The tension has always been between proper diagnosis of what is being treated, which is demanded by insurance companies, and the scientific reality of the difficulty of pigeonholing any one set of symptoms into one neatly defined category or the other. The 2 disease system has survived mainly because the need for treatment based on a definitive diagnosis has outweighed everything else. This is why I have always thought the posts sometimes made by people freaking out about a Crohn's Diagnosis are a somewhat irrational overreaction to nothing. The very 1st step in the diagnostic analysis involves a pigeonholing of one person's symptoms that may be based on a completely outdated and flawed model of diagnosing IBD. Just as science proved wrong the long held theory that the Earth is flat, now the 2 disease classification of IBD is also being proved wrong as well. Rather, IBD is a disease that exists in a spectrum.

There may be enough scientific evidence right now to abandon the traditional 2 disease classification of IBD as either Crohn's or UC, but it is not going to happen, because it is too complicated and the insurance companies who authorize treatment (or not) do not want "complicated", they want "simple diagnosis". To a large extent, patients do not want "complicated" either. They want black and white in diagnosis and in their treatment. Until we shake this mentality, more progress in treatment is not going to be made. I think this study is a step in the right direction.

Thanks for posting this cassiecass.

Evening CTBarrister

I was recently diagnosis with Crohns.I am 2 years post .I had severe diverticulitis and stricture which was cause of my surgery.This was a shock to me.
I will be seeing gastro in few weeks and will discuss this article with him

You are so right about insurance companies
cassiecass

Thanks for the article cassiecass! I too had diverticulitis pan colon along with UC pan colon so had the surgery.

How expensive is it for them to do the genetic testing on us all to find out where we stand in the continuum? They do biopsies but that's not the same thing. Has anyone had the sort of testing discussed in this article? I sure would like to volunteer to be in a trial of some kind or even pay to have the testing done myself.

They are doing this genetic testing at Mount Sinai Hospital in New York City from what I have been told.

Thank you

I will look into this.I am just a subway ride to Sinai

Cassiecass