Inflammatory bowel disease: Description, Causes and Risk Factors:Abbreviation: IBD.Inflammatory bowel diseases are autoimmune illnesses, where the lining of the digestive tract become the site of the autoimmune attack and becomes inflamed. Diarrhea, bloody stool, cramping, and pain are common symptoms of IBD. IBD is extremely traumatic and distressing to live with and the therapies utilized are most often inadequate or toxic.IBD is generally a disease of young people because it most commonly develops between the ages of 10 and 30. However, a second smaller peak of developing Inflammatory bowel disease is seen between ages of 50 and 60.Ulcerative colitis and Crohn's disease are two types of Inflammatory bowel disease. The main difference between Crohn's disease and ulcerative colitis is the location of the disease. Crohn's disease can affect the digestive tract anywhere between the mouth and the anus, while ulcerative colitis only affects the large intestine (or colon). A second important difference is that in Crohn's disease, inflammation involves all layers of the intestinal wall, and ulcerative colitis affects only the inner lining.The exact cause of IBD is not known but is related to protective immune cells that are present in the lining of the intestines. This immune system normally turns on and off to fight harmful substances like bacteria and viruses that pass through intestines. In IBD it appears that there is an initial trigger such as an infection or something taken in from the diet or the surrounding environmental that activates the immune system. However, the difference in those who develop IBD is that the immune system does not turn off once this initial trigger is eliminated. This leads to uncontrolled inflammation and attack on normal intestinal cells. The exact contributions of such factors are poorly understood and are difficult to define.Genetics of IBD:NOD2/CARD15 gene on chromosome 16 identified by the linkage studies.NOD2/CARD15 gene:Encodes intracellular protein NOD2.
Innate immunity through NF-kB mechanism.
Involved in apoptosis (a type of cell death in which the cell uses specialized cellular machinery to kill itself; a cell suicide mechanism that enables metazoans to control cell number and eliminate cells that threaten the animal's survival).
It involved in recognition of microbes.
IBD is also associated with various MHC (major histocompatibility complex) loci.Microparticles used in processed foods such as baked goods, desserts, and pancake mixes are known excitatory triggers for IBD. Microparticles combine with bacterial components in the intestine and form antigenic particle. Sugar may adversely affect those with Inflammatory bowel disease.There are racial and ethnic differences in the risk for developing Inflammatory bowel disease. Whites have a higher risk of developing IBD than non-whites. Similarly persons of Jewish ethnic background have a higher risk of developing IBD than those of non-Jewish background. In addition, among persons of Jewish ethnic background, the risk of IBD is higher for those of Ashkenazi Jewish descent compared to those of Sephardic Jewish descent.Physicians prefer to maintain good nutrition for those diagnosed with IBD. If you are responding well to medical management you can often eat a reasonably unrestricted diet. A low-roughage diet is often suggested for those prone to diarrhea after meals. If you appear to be milk sensitive (lactose intolerant), you are advised to either avoid milk products or use milk to which the enzyme lactase has been added.Symptoms:Symptoms may include:Diarrhea.
A strong feeling that you need to have a bowel movement, but not being able to do so (called tenesmus).
Diagnosis:Your bowel movements may be tested for germs and the presence of blood. Your doctor will probably look inside your intestines with a sigmoidoscope or a colonoscope. In these procedures, the doctor uses a narrow flexible tube to look directly inside your intestines.While no blood test can prove you have IBD, your blood might show anemia, salt imbalance, vitamin deficiency or increased signs of inflammation. Your doctor also may order special x-rays or a procedure called endoscopy. Endoscopy lets your doctor look at your GI tract to check for ulcers by inserting a small scope into your body through your mouth or anus.Treatment:Various formulations of 5-ASA, a drug which has been used to treat IBD for over 50 years, are available as oral preparations, suppositories, and enemas. These are often one of the first drugs used to treat Inflammatory bowel disease.Corticosteroid therapy such as prednisone or hydrocortisone is given when the 5-ASA products are insufficient to control inflammation. These drugs can be given orally, rectally as suppositories or enemas, or intravenously. If you do not respond adequately to these programs, drugs which suppress the body's ability to make antibodies against the disease (known as anti-immune therapy) are used. Azathioprine and 6-mercaptopurine (6-MP) are the two most commonly used drugs for anti-immune therapy.Side effects of medications: Positive.Surgical Options:Crohn's disease of the small or large intestine can be treated surgically for complications such as obstruction, abscess, or failure to respond adequately to treatment. The disease may recur at some time after the operation.
Ulcerative colitis is cured after the entire colon is removed. This surgery, in the past, required an ileostomy (the lower small intestine is brought out to the abdominal wall and an appliance is worn to collect the output). A recent surgical procedure which avoids the need for an external appliance has become popular.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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