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Related Concept Videos

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

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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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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Irritable Bowel Syndrome III: Medical and Nursing Management01:30

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Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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In Vivo Augmentation of Gut-Homing Regulatory T Cell Induction
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Optimizing Immunization Strategies in Patients with IBD.

Freddy Caldera1, Dana Ley2, Mary S Hayney3

  • 1Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin-Madison, School of Medicine & Public Health, Madison, WI.

Inflammatory Bowel Diseases
|April 2, 2020
PubMed
Summary
This summary is machine-generated.

Newer inflammatory bowel disease (IBD) treatments improve remission but increase infection risks. Optimizing adult immunization schedules is crucial for preventing vaccine-preventable diseases in IBD patients.

Keywords:
Crohn’s diseasepreventive careserious infectionsulcerative colitisvaccinationvaccines

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Area of Science:

  • Gastroenterology and Immunology
  • Infectious Disease Prevention
  • Pharmacology

Background:

  • Advanced therapies for inflammatory bowel disease (IBD), including immune modifiers and monoclonal antibodies (e.g., TNF alpha inhibitors, anti-integrins, JAK inhibitors, IL-12/23 inhibitors), offer improved clinical remission and mucosal healing compared to conventional treatments.
  • These potent immunosuppressive therapies significantly elevate the risk of infections, particularly vaccine-preventable diseases, posing a common adverse event for patients with IBD.

Purpose of the Study:

  • To review and highlight the importance of optimizing immunization strategies for patients with inflammatory bowel disease (IBD).
  • To guide gastroenterology providers on implementing the US Advisory Committee on Immunization Practices (ACIP) approved adult immunization schedule for IBD patients.
  • To mitigate the increased risk of vaccine-preventable infections associated with modern IBD immunosuppressive treatments.

Main Methods:

  • Review of current literature on IBD treatments and infection risks.
  • Analysis of recommendations from the US Advisory Committee on Immunization Practices (ACIP) for adult vaccinations.
  • Focus on practical implementation strategies for gastroenterologists regarding the adult immunization schedule in IBD patients.

Main Results:

  • Modern IBD therapies enhance remission and healing but carry a substantial risk of infection.
  • Vaccine-preventable diseases represent a significant threat to immunosuppressed IBD patients.
  • A structured approach to adult immunization is necessary to reduce infection-related morbidity.

Conclusions:

  • Gastroenterology providers must proactively manage immunization in IBD patients undergoing immunosuppressive therapy.
  • Adherence to the ACIP-recommended adult immunization schedule is essential for safeguarding IBD patients.
  • Optimized vaccination strategies are critical for improving the overall safety and outcomes of IBD treatment.