Patients who have...
a diagnosis of ulcerative colitis or Crohn's disease as confirmed by a clinician
experienced a flare within the past 24 months as determined by a clinician
had quiescent disease for at least 3 months as determined by a clinician

Optional blood, stool, and urine samples will be requested at various time points throughout the 12-month follow-up period. Optional biopsy samples can be collected at a standard-of-care endoscopic procedure.

Inflammatory Bowel Diseases

Ulcerative Colitis

Crohn Disease

Smart watch monitoring activity and movement, heart rate, sleep, and more

Fitbit Charge 3

Inflammatory Bowel Disease Tracker (IBD Tracker)

Patient-reported measure for ulcerative colitis referring to disease symptoms occurring over the last week. The point value from each answer is added up for a total score.
Over the past week, what is your average number of bowel movements during the day (not including night)? (0) 0-3 (1) 4-6 (2) 7-9 (3) >9
Over the past week, what is your average number of bowel movements at night? (0) 0 (1) 1-3 (2) >3
Over the past week, what has been your urgency of defecation? (0) No rush (1) Hurry (2) Immediately (3) Incontinence
Over the past week, what has been the amount and frequency of blood in your stool? (0) None (1) Small traces (2) Occasionally obviously bloody (3) Usually obviously bloody
General well being (0) Very well (1) Slightly below par (2) Poor (3) Very poor (4) Terrible
During the past week, have you had any of the following? (1 pt/answer) (1) Pyoderma gangrenosum (1) Erythema nodosum (1) Uveitis (1) Arthritis (0) None

Patient-reported measure for Crohn's disease referring to disease symptoms occurring over the last week. The point value from each answer is added up for a total score.
General well being (0) Very well (1) Slightly below par (2) Poor (3) Very poor (4) Terrible
In the past week, have you experienced any abdominal pain? (0) None (1) Mild (2) Moderate (3) Severe
How many liquid stools do you pass per day? (1 point per liquid stool)
Do you have an abdominal mass? (0) None (1) Dubious (2) Definite (3) Definite and tender
During the past week, have you had any of the following? (1 point per answer) (1) Pyoderma gangrenosum (oozing ulcers, usually on the leg) (1) Erythema nodosum (red, swollen bumps, on the skin (1) Uveitis (red, painful eyes) (1) Aphthous ulcers (mouth ulcers) (1) Arthritis (joint pain) (1) Anal fissue (1) New fistula (1) Perianal abscess (0) None of the above

Patient-reported measure of current stress level measured on a scale of 1 (1 = no stress) to 5 (5 = highest stress possible)

Patient-reported measure of diet over the last 24 hours. The survey can be found here: https://asa24.nci.nih.gov/demo/

Metabolite content will be determined by monitoring patients via regular blood draws over the 12-month study period. By analyzing metabolite content in periods of health (remission), disease (flare), and the transition period in between, investigators hope to identify unique biomarkers that indicate the earliest stages of a flare. The investigators do not know each specific metabolite that will be measured. The objective of this outcome is to identify any and all possible biomarkers and metabolites that may be present in these samples.

Cytokine profile will be determined by monitoring patients via regular blood draws over the 12-month study period. By analyzing cytokine profile in periods of health (remission), disease (flare), and the transition period in between, investigators hope to identify unique biomarkers that indicate the earliest stages of a flare. The investigators do not know each specific biomarker and cytokine that will be measured. The objective of this outcome is to identify any and all cytokines that may be present in these samples.

T-cell receptor sequence profiles will be determined by monitoring patients via regular blood draws over the 12-month study period. By analyzing T-cell receptor sequence profiles in periods of health (remission), disease (flare), and the transition period in between, investigators hope to identify unique biomarkers that indicate the earliest stages of a flare.

Patients will submit weekly stool samples for analysis and monitoring. The investigators will analyze the gut microbiome composition by characterizing the microbial DNA content and tracking changes throughout the 12-month study period. The investigators do not know each microbe that will be assessed. The objective of this outcome is to identify any and all microbes that may be present in these samples.

The investigators will analyze the bacterial, fungal, and viral constituents at enrollment and and track changes throughout the 12-month study period to identify biomarkers of importance. These will be assessed with stool wipe samples, glycerol-preserved stool, and fresh and ethanol-preserved stool samples. Stool samples will either collected by patients at home or collected in-clinic and flash frozen.

The investigators will measure the degree of intestinal inflammation by quantifying Fecal Calprotectin (a biomarker) levels in patients' weekly stool samples and tracking changes throughout the 12-month study period. This will be measured using stool wipe samples and fresh stool samples.

The investigators will use urine samples collected throughout the study to analyze each subject's urine metabolite content and track changes throughout the 12-month study period in an attempt to identify biomarkers potentially indicative of a flare. The investigators do not know each specific metabolite that will be measured. The objective of this outcome is to identify any and all possible biomarkers and metabolites that may be present in these samples.

Investigators will measure any existing correlations between the microbiome timeseries and the identified blood and stool metabolites over the 12-month study period to determine if there are any associations between the two variables.

Investigators will measure any existing correlations between the microbiome composition and fecal calprotectin levels identified in the primary outcomes over the 12-month study period to determine if there are any associations between the two variables.

Investigators will measure any existing correlations between the identified blood and stool metabolites and the microbiome composition over the 12-month study period to determine if there are any associations between the two variables.

Investigators will measure any existing correlations between the identified blood metabolites and the identified stool metabolites and the microbiome composition over the 12-month study period to determine if there are any associations between the two variables.

Ashwin Ananthakrishnan

Assistant Professor of Medicine

Massachusetts General Hospital

Massachusetts Institute of Technology

University Medical Center Groningen

Participants are identified through relevant diagnostic codes in ICD-10(Q 42) and ICD-9(75.120, 75.121) in patients which underwent surgery for ARM in the years 1985-2005 are included if informed consent is obtained.
Relevant questionnaires regarding symptoms and QoL are completed before the following examinations:anorectal manometry, endoanal ultrasonography, pudendal nerve conduction velocity, colon transit time, Magnetic resonans(MR)-scan of the pelvis and uroflowmetry.

fecal incontinence/demam

Inflammatory Bowel Disease Tracker (IBD Tracker)

Long-term Outcome in Patients With Anorectal Malformations

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