Non-medical reasons for colectomy among ulcerative colitis patients

atmire.migration.oldid2298
dc.contributor.advisorBarkema, Herman
dc.contributor.advisorKaplan, Gil
dc.contributor.authorNegron, Maria E.
dc.date.accessioned2014-07-10T15:51:01Z
dc.date.available2014-11-17T08:00:36Z
dc.date.issued2014-07-10
dc.date.submitted2014en
dc.description.abstractApproximately 16% of ulcerative colitis (UC) patients will have a colectomy within 10 years of their diagnosis of UC. Due to the high morbidity and mortality associated with colectomy procedures, clinicians and patients strive to avoid surgery. The decline of colectomy rates over the last 6 decades has been mainly attributed to advances in medical management of UC. Clostridium difficile infection and colorectal neoplasia have also been associated with driving the risk of colectomy. This dissertation focuses on describing the effect of C. difficile and colorectal neoplasia on the risk of colectomy for UC patients. Chapters 2 and 3 establish the cumulative risk of acquiring C. difficile infection after the diagnosis of UC and demonstrated that C. difficile infections increase the short- and long-term risk of colectomy. Further, both Chapters 2 and 3 demonstrate that C. difficile infections increased the risk of postoperative complications following colectomy for UC. Chapter 4 demonstrate that the incidence of colectomy for colorectal dysplasia and cancer has remained stable over time, and showed that the observed decrease in colectomy rates is most likely due to a decrease in colectomies from medically refractory disease. Finally, Chapter 5 determined the cost-effectiveness of different surveillance colonoscopy intervals for colorectal dysplasia among a subgroup of inflammatory bowel disease (IBD) patients with a higher risk of developing colorectal dysplasia and cancer; i.e., patients with IBD and primary sclerosing cholangitis (PSC).en_US
dc.identifier.citationNegron, M. E. (2014). Non-medical reasons for colectomy among ulcerative colitis patients (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/27121en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/27121
dc.identifier.urihttp://hdl.handle.net/11023/1615
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.facultyVeterinary Medicine
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectEpidemiology
dc.subject.classificationUlcerative Colitisen_US
dc.subject.classificationClostridium difficileen_US
dc.subject.classificationColorectal neoplasiaen_US
dc.subject.classificationColectomyen_US
dc.titleNon-medical reasons for colectomy among ulcerative colitis patients
dc.typedoctoral thesis
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameDoctor of Philosophy (PhD)
ucalgary.item.requestcopytrue
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