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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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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.
Pharmacologic...
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Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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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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Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

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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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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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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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Interventions for treating lymphocytic colitis.

Nilesh Chande1, Noor Al Yatama, Tania Bhanji

  • 1London Health Sciences Centre - Victoria Hospital, Room E6-321A, 800 Commissioners Road East, London, ON, Canada, N6A 5W9.

The Cochrane Database of Systematic Reviews
|July 14, 2017
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This summary is machine-generated.

Budesonide appears effective for treating lymphocytic colitis, a cause of chronic diarrhea. Further large-scale trials are needed to confirm these findings and evaluate other treatments like mesalazine and beclometasone dipropionate.

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Pharmacology

Background:

  • Lymphocytic colitis is a subtype of microscopic colitis causing chronic watery diarrhea.
  • Its etiology remains unknown, and treatment relies on limited evidence.
  • This review updates previous findings on lymphocytic colitis therapies.

Purpose of the Study:

  • To evaluate the efficacy and safety of medical treatments for active lymphocytic colitis.
  • To synthesize evidence from randomized controlled trials (RCTs).

Main Methods:

  • Searched MEDLINE, PubMed, EMBASE, and clinical trial registries up to August 2016.
  • Included RCTs assessing medical therapy for biopsy-proven lymphocytic colitis.
  • Extracted data independently, analyzed outcomes including clinical and histological response, and assessed risk of bias and GRADE criteria.

Main Results:

  • Five RCTs (149 participants) were included, assessing budesonide, mesalazine, bismuth subsalicylate, and beclometasone dipropionate.
  • Budesonide showed significantly higher clinical (88% vs 38%) and histological response rates compared to placebo (GRADE = low).
  • Mesalazine and beclometasone dipropionate showed no significant differences versus comparators, with variable long-term remission rates.

Conclusions:

  • Low-quality evidence suggests budesonide may be effective for active lymphocytic colitis, requiring confirmation via large placebo-controlled trials.
  • Evidence for mesalazine and beclometasone dipropionate is also limited and needs further investigation.
  • Further trials are warranted to establish optimal treatments for lymphocytic colitis.