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Encyclopedia > Inflammatory bowel disease

In medicine, inflammatory bowel disease (IBD) is a group of inflammatory conditions of the large intestine and, in some cases, the small intestine. It should not be confused with IBS, irritable bowel syndrome, which is an inconvenient yet more innocent disease. Medicine is the branch of health science and the sector of public life concerned with maintaining or restoring human health through the study, diagnosis, treatment and possible prevention of disease and injury. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... In anatomy of the digestive system, the colon, also called the large intestine or large bowel, is the part of the intestine from the cecum (caecum in British English) to the rectum. ... Diagram showing the small intestine In biology the small intestine is the part of the gastrointestinal tract between the stomach and the large intestine (colon). ...

Contents

Forms

The main forms of IBD are Crohn's disease and ulcerative colitis (UC). H&E section of non-caseating granuloma seen in the colon of a patient with Crohns disease. ...


Accounting for far fewer cases are other forms of IBD:

The main difference between Crohn's disease and UC is the location and nature of the inflammatory changes in the gut. Crohn's can affect any part of the gastrointestinal tract, from mouth to anus (skip lesions), although a majority of the cases start in the terminal ileum. Ulcerative colitis, in contrast, is restricted to the colon, and spares the anus. Collagenous colitis is an inflammatory colonic disease with peak incidence in the 7th decade of life, affecting women more than men. ... Lymphocytic colitis, a subtype of microscopic colitis, is a rare condition characterized by chronic non-bloody watery diarrhea. ... Ischemic colitis is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. ... This article or section does not cite its references or sources. ... Behçets disease (also known as Adamantiades-Behçets disease), is a chronic condition due to disturbances in the body’s immune system. ... The gastrointestinal tract or digestive tract, also referred to as the GI tract or the alimentary canal, (nourishment canal) or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and expels the remaining waste. ... Sagittal section of nose mouth, pharynx, and larynx. ... Female Human Anatomy Male Human Anatomy Anal redirects here. ... This page meets Wikipedias criteria for speedy deletion. ... Grays Fig. ... In anatomy of the digestive system, the colon, also called the large intestine or large bowel, is the part of the intestine from the cecum (caecum in British English) to the rectum. ...


Microscopically, ulcerative colitis is restricted to the mucosa (epithelial lining of the gut), while Crohn's disease affects the whole bowel wall. Microscopy is any technique for producing visible images of structures or details too small to otherwise be seen by the human eye. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ... Types of epithelium This article discusses the epithelium, an animal anatomical structure. ...


Finally, Crohn's disease and ulcerative colitis present with extra-intestinal manifestations (such as liver problems, arthritis, skin manifestations and eye problems) in different proportions.


In rare cases, patients have been diagnosed with both Crohn's disease and ulcerative colitis, though whether it is a combination or simply unidentifiable as one or another is uncertain.


Diagnosis

Although very different diseases, both may present with any of the following symptoms: abdominal pain, vomiting, diarrhea, hematochezia, weight loss and various associated complaints or diseases (arthritis, pyoderma gangrenosum, primary sclerosing cholangitis). Diagnosis is generally by colonoscopy with biopsy of pathological lesions. Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... Diarrhea or diarrhoea (see spelling differences) is a condition in which the sufferer has frequent watery, loose bowel movements (from the ancient Greek word διαρροή = leakage; literally meaning to run through). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8... Hematochezia is the passage of bright red blood from the rectum, with or without feces. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... this is a very painful thing my name is lauren!!!!! haha muaha muaha muahaha Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... Primary sclerosing cholangitis (PSC) is an inflammatory disease of the bile duct, which leads to cholestasis (blockage of bile transport to the gut). ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a fiber optic camera on a flexible tube passed through the anus. ... A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...


Treatment

Depending on the level of severity, IBD may require immunosuppression to control the symptoms. such as azathioprine, methotrexate, or 6-mercaptopurine. More commonly, treatment of IBD requires a form of mesalazine. Often, steroids are used to control disease flares and were once acceptable as a maintenance drug. In use for several years in Crohns disease patients and recently in patients with Ulcerative Colitis, biologicals has been used such as the intravenously administered Remicade. Severe cases may require surgery, such as bowel resection, strictureplasty or a temporary or permanent colostomy or ileostomy. Alternative medicine treatments for bowel disease exist in various forms, however such methods concentrate on controlling underlying pathology in order to avoid prolonged steroidal exposure or surgical excisement[1]. Immunosuppression is the medical suppression of the immune system. ... Azathioprine is a chemotherapy drug, now rarely used for chemotherapy but more for immunosuppression in organ transplantation, autoimmune disease such as rheumatoid arthritis or inflammatory bowel disease such as Crohns disease. ... Methotrexate (rINN) (IPA: ), abbreviated MTX and formerly known as amethopterin, is an antimetabolite drug used in treatment of cancer and autoimmune diseases. ... Mercaptopurine (also called 6-MP or by its brand name Purinethol®) is an immunosuppressive drug used to treat leukemia. ... Pentasa (TM) Mesalazine is one of the newer Aminosalicylates, a class of drug used as an anti-inflammatory. ... Steroid skeleton. ... The anti-tumor necrosis factor α monoclonal antibody infliximab is a mainstay of the biological therapy for inflammatory bowel disease Biological therapy refers to the use of medication that is tailored to specifically target an immune or genetic mediator of disease. ... Intraoperative X-Ray of a Humerus fixated by Kirschner wires Surgery (from the Greek meaning hand work) is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. ... A bowel resection is a surgical procedure in which a part of the large or small intestine is removed. ... This article or section does not cite its references or sources. ... An ileostomy is a stoma that has been constructed by bringing the end of the small intestine (the ileum) out onto the surface of the skin. ... Alternative medicine describes practices used in place of conventional medical treatments. ...


Usually the treatment is started by administering drugs with high anti-inflammatory affects, such as Prednisone. Once the inflammation is successfully controlled, the patient is usually switched to a lighter drug to keep the disease in remission, such as Asacol, a mesalazine. If unsuccesful, a combination of the aforementioned immunosurpression drugs with a mesalazine (which may also have an anti-inflammatory effect) may or may not be administered, depending on the patient. Prednisone is a synthetic corticosteroid drug which is usually taken orally and can be used for a large number of different conditions. ... Mesalamine, also known as 5-aminosalicylic acid (5-ASA), is an anti-inflammatory drug used to treat inflammation of the rectum, mild to moderate ulcerative colitis and inflammation of the lower colon. ... Pentasa (TM) Mesalazine is one of the newer Aminosalicylates, a class of drug used as an anti-inflammatory. ... Pentasa (TM) Mesalazine is one of the newer Aminosalicylates, a class of drug used as an anti-inflammatory. ...


Prognosis

While IBD can limit quality of life due to pain, vomiting, diarrhea, and other socially unacceptable symptoms, it is rarely fatal on its own. Fatalities due to complications such as toxic megacolon, bowel perforation and surgical complications are also rare. Toxic megacolon (megacolon toxicum) is a life-threatening complication of other intestinal conditions. ... A bowel perforation is a complete penetration of the intestinal wall resulting in the potential for bacterial contamination of the abdominal cavity (a condition known as peritonitis). ...


While patients of IBD do have an increased risk of colorectal cancer this is usually caught much earlier than the general population in routine surveillance of the colon by colonoscopy, and therefore patients are much more likely to survive. Colorectal cancer, also called colon cancer or bowel cancer, includes cancerous growths in the colon, rectum and appendix. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a fiber optic camera on a flexible tube passed through the anus. ...


After treatment, the patient is usually switched to a lighter drug with fewer side effects. Every so often an acute resurgence of the original symptoms may appear: this is known as a "flare-up". Depending on the circumstances, it may go away on its own or require medication. The time between flare-ups may be anywhere from weeks to years, and varies wildly between patients - a few have never experienced a flare-up.


Recent findings

A recent hypothesis posits that some IBD cases are caused by an overactive immune system attacking various tissues of the digestive tract because of the lack of traditional targets such as parasites and worms. The number of people being diagnosed with IBD has increased as the number of infections by parasites, such as roundworm and human whipworms, has fallen, and the condition is still rare in countries where parasitic infections are common. This is similar to the hygiene hypothesis applied to allergies. The immune system is composed of a complex constellation of cells, organs and tissues, arranged in an elaborate and dynamic communications network and equipped to optimize the response against invasion by pathogenic organisms. ... A parasite is an organism that spends a significant portion of its life in or on the living tissue of a host organism and which causes harm to the host without immediately killing it. ... Classes Adenophorea    Subclass Enoplia    Subclass Chromadoria Secernentea    Subclass Rhabditia    Subclass Spiruria    Subclass Diplogasteria The roundworms or nematodes (Phylum Nematoda from Gr. ... In medicine, the hygiene hypothesis says that an excessively hygienic environment in early childhood may predispose some people towards asthma, allergies, and other autoimmune diseases. ... An allergy can refer to several kinds of immune reactions including Type I hypersensitivity in which a persons body is hypersensitised and develops IgE type antibodies to typical proteins. ...


Initial reports (Summers et al 2003) suggest that "helminthic therapy" may not only prevent but even cure (or control) IBD: a drink with roughly 2,500 ova of the Trichuris suis helminth taken twice monthly decreased symptoms markedly in many patients. It is even speculated that an effective "immunization" procedure could be developed—by ingesting the cocktail at an early age. Helminthic therapy is currently considered the most promising alternative treatment amongst those suffering from Crohns_disease and Ulcerative colitis. ...


Prebiotics and probiotics are showing increasing promise as treatments for IBD (Furrie, 2005) and in some studies have proven to be as effective as prescription drugs (Kruis, 2004).


References

  • Furrie, E. Biotic Therapy Cuts Inflammation in Ulcerative Colitis. Gut 2005;54:242-249.
  • Kruis, W., P Fric, J Pokrotnieks, M Lukás, B Fixa, M Kascák, M A Kamm, J Weismueller, C Beglinger, M Stolte, C Wolff, and J Schulze. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut 2004; 53: 1617-1623.
  • Summers RW, Elliott DE, Qadir K, Urban JF Jr, Thompson R, Weinstock JV. Trichuris suis seems to be safe and possibly effective in the treatment of inflammatory bowel disease. Am J Gastroenterol 2003;98:2034-41. PMID 14499784.

External links

  • IBD Forum A website designed for use by Doctors and other healthcare professionals specialising in the management of Inflammatory Bowel Disease
  • CrohnsZone.org - Self-help organisation for sufferers of colitis and Crohn's disease- UK
  • Crohn's and Colitis Foundation of America
  • National Association for Colitis & Crohn's disease (NACC)- UK
Health science - Medicine - Gastroenterology - edit
Diseases of the esophagus - stomach
Halitosis | Nausea | Vomiting | GERD | Achalasia | Esophageal cancer | Esophageal varices | Peptic ulcer | Abdominal pain | Stomach cancer | Functional dyspepsia | Gastroparesis | Abdominal angina 
Diseases of the liver - pancreas - gallbladder - biliary tree
Hepatitis | Cirrhosis | NASH | PBC | PSC | Budd-Chiari | Hepatocellular carcinoma | Acute pancreatitis | Chronic pancreatitis | Hereditary pancreatitis | Pancreatic cancer | Gallstones | Cholecystitis
Diseases of the small intestine
Peptic ulcer | Intussusception | Malabsorption (e.g. Coeliac, lactose intolerance, fructose malabsorptionWhipple's) | Lymphoma
Diseases of the colon
Diarrhea | Appendicitis | Diverticulitis | Diverticulosis | IBD (Crohn'sUlcerative colitis) | IBS | Constipation | Colorectal cancer | Hirschsprung's | Pseudomembranous colitis

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Inflammatory Bowel Disease (1535 words)
Inflammatory bowel disease may also cause a delay in puberty or growth problems for some kids and teens with the condition, because it can interfere with a person getting nutrients from the foods he or she eats.
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Inflammatory bowel disease is a serious condition, but with proper treatment and medical care, your child can enjoy a productive, normal life.
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IBD is a lifelong disease with periods of active disease alternating with periods of disease control (remission).
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