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Related Concept Videos

Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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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.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
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Irritable Bowel Syndrome I: Introduction01:17

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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.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
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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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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.
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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.
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

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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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Small Bowel Transplantation In Mice
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NSAIDs and the small bowel.

Foong Way David Tai1, Mark E McAlindon

  • 1Academic Department of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.

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|February 14, 2018
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Summary
This summary is machine-generated.

Nonsteroidal anti-inflammatory drug (NSAID) enteropathy is common, affecting the small bowel as much as the stomach. Proton pump inhibitor use worsens NSAID enteropathy, but prostaglandin repletion and probiotics may help protect the small bowel.

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Internal Medicine

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used but can cause significant gastrointestinal toxicity.
  • NSAID-induced small bowel injury (enteropathy) is as prevalent as gastroduodenal injury.
  • Capsule endoscopy has improved the diagnosis and understanding of NSAID enteropathy.

Purpose of the Study:

  • To review the effects of NSAID gastrointestinal toxicity on the small bowel.
  • To highlight the role of capsule endoscopy in diagnosing and managing NSAID enteropathy.
  • To discuss novel treatment strategies for NSAID-induced small bowel injury.

Main Methods:

  • Review of current literature on NSAID enteropathy.
  • Emphasis on findings from capsule endoscopy studies.
  • Analysis of pathogenetic mechanisms and treatment strategies.

Main Results:

  • NSAID enteropathy is common, often subclinical, with anemia as a frequent presentation.
  • Proton pump inhibitor (PPI) use exacerbates NSAID enteropathy, potentially due to intestinal dysbiosis.
  • Dual cyclo-oxygenase (COX) inhibition and gram-negative antigen presentation contribute to NSAID enteropathy pathogenesis.

Conclusions:

  • NSAID enteropathy is a significant clinical issue, often underdiagnosed.
  • PPIs worsen NSAID enteropathy; COX-2 inhibitors without PPIs may be safer for high-risk patients.
  • Small bowel mucosal protection strategies include prostaglandin repletion, augmenting intestinal flora (probiotics), and mucoprotective agents.