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The Inflammatory Bowel Disease Newsletter, 2002 Crohn's and Colitis Research Centre, Royal Brisbane Hospital.
Clinical Research
This term refers to research that is directly related to patients. The foundations of this have been built on our database that was created in 1995/96, and on a strong collaboration with Dr Tim Florin, director of gastroenterology and IBD specialist at the Mater hospital, South Brisbane.
The IBD unit at the Royal Brisbane now have over 1200 consented patients registered on this database (570 UC and 583 CD) and it forms an essential part of any project that we undertake. It also represents a unique tool within Australia, possibly the world, and a number of other research centres have consulted us on the development of such a resource.
The database allows us to rapidly analyse these patients for a number of different features including their age at diagnosis, how many have required immunosuppressive medication (such as azathioprine/Imuran) or how many have required surgery.
For example, based on a subgroup of 800 patients from the database, we can tell you that the average age at diagnosis of CD in our population is 29 years, and that for UC is 34 years. About 50% of patients with CD are treated with immunosuppression and overall 60% will require surgery at some stage. For UC, 25% may require immunosuppression and a similar number will have surgery for their disease.
One of the most exciting discoveries in recent times has been the identification of the appendix as a potentially important risk factor in the development of UC and possibly CD. Our research group are leading the way in trying to investigate the role of the appendix in patients with IBD and whether taking out the appendix (appendicectomy) may help patients with UC.
We have a major publication in the medical journal "GUT" appearing in December on this topic, and have now completed 9 patients in our study of laparoscopic (keyhole) appendicectomy for patients with difficult or persistent colitis.
The results of appendicectomy so far have been very encouraging, with a significant improvement in symptoms (including bleeding) in 8 of the 9 patients, and we hope to continue this study throughout next year.
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