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Related Concept Videos

Gastritis-II: Pathophysiology01:17

Gastritis-II: Pathophysiology

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Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
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Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
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
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
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Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
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Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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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.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
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[Celiac disease : Pathogenesis, clinics, epidemiology, diagnostics, therapy].

Detlef Schuppan1,2

  • 1Institut für Translationale Immunologie, Zentrum für Zöliakie und Dünndarmerkrankungen und Forschungszentrum für Immuntherapie (FZI), Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstr.1, 55131, Mainz, Deutschland. detlef.schuppan@unimedizin-mainz.de.

Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
|June 9, 2016
PubMed
Summary

Celiac disease, an autoimmune disorder triggered by gluten, affects 1% of the global population. Current gluten-free diets are challenging, necessitating new therapeutic strategies for this common intestinal disease.

Keywords:
Autoimmune diseaseCeliac diseaseDiagnosisGlutenTherapy

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Area of Science:

  • Gastroenterology and Immunology
  • Autoimmune Diseases
  • Dietary Medicine

Background:

  • Celiac disease is a prevalent, chronic inflammatory intestinal disorder affecting approximately 1% of the global population, triggered by gluten consumption.
  • It presents with diverse symptoms including malabsorption, anemia, osteoporosis, and associated autoimmune conditions like type 1 diabetes.
  • The disease involves gluten peptides activating inflammatory T-cells in the intestinal mucosa, leading to villous atrophy, a process influenced by genetic predisposition (HLA-DQ2/DQ8) and tissue transglutaminase (TG2).

Purpose of the Study:

  • To provide a comprehensive overview of celiac disease, encompassing its pathogenesis, diagnosis, clinical manifestations, and current therapeutic limitations.
  • To highlight the significant underdiagnosis rate and the severe complications associated with untreated celiac disease.
  • To emphasize the urgent need for alternative and supportive pharmacological therapies beyond the gluten-free diet.

Main Methods:

  • Review of existing literature on celiac disease pathogenesis, diagnosis, and treatment.
  • Analysis of diagnostic markers, including serum antibodies to tissue transglutaminase (TG2) and endoscopic biopsies.
  • Discussion of the challenges and ineffectiveness of strict gluten-free diets.

Main Results:

  • Celiac disease is characterized by T-cell activation against gluten peptides, leading to intestinal villous atrophy.
  • Diagnosis is typically secured by a combination of TG2 antibody tests and endoscopic biopsies, yet 80-90% of cases remain undiagnosed.
  • Untreated celiac disease can lead to severe complications, including malabsorption, cancers (like T-cell lymphoma), and other autoimmune disorders.

Conclusions:

  • Celiac disease is a significant global health issue with complex pathogenesis and diagnostic challenges, leading to widespread underdiagnosis.
  • The current standard therapy, a strict gluten-free diet, is difficult to adhere to and not universally effective.
  • Development of novel pharmacological therapies is crucial to support patients and manage the complications of celiac disease.