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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

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Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
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Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
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Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Amoebiasis masquerading as inflammatory bowel disease.

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A patient with ulcerative colitis (UC) experienced persistent symptoms despite standard treatments. Diagnosis of concurrent amoebiasis, treated with metronidazole, led to complete symptom resolution and long-term remission.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
  • Treatment resistance in UC can stem from various factors, including concurrent infections.
  • Accurate diagnosis is crucial for effective management of gastrointestinal disorders.

Observation:

  • A 60-year-old Japanese man with a history of UC presented with bloody diarrhea, anorexia, and weight loss.
  • Despite multiple treatments for UC, including mesalazine, his symptoms persisted.
  • Colonoscopies confirmed UC, but treatment failures suggested an underlying, undiagnosed condition.

Findings:

  • Negative stool cultures and Clostridium difficile toxin tests ruled out common infections.
  • Positive Entamoeba histolytica antibodies indicated amoebiasis.
  • A 14-day course of metronidazole resolved all symptoms.

Implications:

  • Concurrent amoebiasis can mimic or exacerbate ulcerative colitis symptoms.
  • Diagnostic evaluation for infectious causes is essential in refractory UC cases.
  • Prompt treatment of Entamoeba histolytica can lead to remission in patients with co-existing UC.