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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Fluorescence-mediated Tomography for the Detection and Quantification of Macrophage-related Murine Intestinal Inflammation
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Update imaging in inflammatory bowel diseases.

Hans Herfarth1

  • 1Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, N.C., USA.

Digestive Diseases (Basel, Switzerland)
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Summary
This summary is machine-generated.

This review covers advances in imaging for inflammatory bowel diseases (IBD). It details computed tomography enterography, magnetic resonance enterography, and capsule endoscopy for IBD diagnosis and management.

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Area of Science:

  • Gastroenterology
  • Radiology
  • Medical Imaging

Background:

  • Imaging is crucial for diagnosing and managing inflammatory bowel diseases (IBD).
  • Accurate assessment of IBD requires effective visualization of the gastrointestinal tract.
  • Various imaging techniques are employed to evaluate suspected and established cases of IBD.

Purpose of the Study:

  • To review recent advancements in commonly used IBD imaging modalities.
  • To compare the advantages and disadvantages of different imaging protocols.
  • To provide context for diagnostic algorithms in IBD.

Main Methods:

  • Review of current literature on imaging in IBD.
  • Focus on computed tomography enterography (CTE).
  • Focus on magnetic resonance enterography (MRE).
  • Focus on capsule endoscopy (CE).

Main Results:

  • CTE offers detailed cross-sectional imaging but involves radiation.
  • MRE provides excellent soft-tissue contrast without radiation, ideal for assessing inflammation.
  • Capsule endoscopy allows direct visualization of the small bowel mucosa but has limitations in assessing transmural disease.
  • Each modality has specific strengths and weaknesses depending on the clinical scenario.

Conclusions:

  • The choice of imaging modality in IBD depends on the clinical question, patient factors, and local expertise.
  • CTE, MRE, and CE are valuable tools in the diagnostic armamentarium for IBD.
  • Integrating these imaging techniques into diagnostic algorithms can optimize patient care and outcomes.