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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

850
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...
850
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

699
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...
699
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

780
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...
780
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...
565
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

387
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...
387
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

403
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...
403

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Chronic Salmonella Infection Induced Intestinal Fibrosis
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The Complex Interplay Between Inflammatory Bowel Disease and Malignancy.

Jessica Kimmel1, Jordan Axelrad2

  • 1Division of Gastroenterology, Department of Medicine, New York University School of Medicine, New York, NY, USA. kimmeljessica@gmail.com.

Current Gastroenterology Reports
|February 15, 2020
PubMed
Summary
This summary is machine-generated.

Inflammatory bowel disease (IBD) treatments like vedolizumab and ustekinumab appear safe regarding malignancy risk. Immunosuppression is generally safe for IBD patients with current or prior cancer, but long-term data is needed.

Keywords:
CancerCrohn’s diseaseInflammatory bowel diseaseMalignancyUlcerative colitis

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Area of Science:

  • Gastroenterology
  • Oncology
  • Immunology

Background:

  • Chronic inflammation in inflammatory bowel disease (IBD) and its treatments can elevate malignancy risk.
  • An increasing number of cancer patients require IBD treatment, creating complex management scenarios.

Purpose of the Study:

  • To review the interplay between immunosuppressive therapy for IBD and cancer risk.
  • To assess the safety of emerging IBD treatments in patients with current or prior malignancies.

Main Methods:

  • Review of current literature on IBD treatments and malignancy risk.
  • Analysis of data regarding specific IBD medications (vedolizumab, ustekinumab, tofacitinib) and cancer incidence.
  • Evaluation of IBD patient tolerance to chemotherapy.

Main Results:

  • Vedolizumab and ustekinumab show no increased malignancy risk.
  • Tofacitinib data is conflicting; transplant data suggests a potential risk, while rheumatoid arthritis data does not.
  • IBD patients tolerate chemotherapy, particularly cytotoxic over hormonal.
  • Immunosuppression appears safe for IBD patients with existing or past cancer, though they face higher risks of new/recurrent cancers.

Conclusions:

  • Emerging IBD treatments have acceptable safety profiles concerning malignancy risk.
  • Immunosuppression seems safe for IBD patients with cancer history.
  • Further long-term data is required to fully assess malignancy risks, especially with novel therapies.