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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.
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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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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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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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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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Interventions for fatigue in inflammatory bowel disease.

Dawn Farrell1, Micol Artom2, Wladyslawa Czuber-Dochan2

  • 1Institute of Technology Tralee, Department of Nursing and Healthcare Sciences, Tralee, County Kerry, Ireland.

The Cochrane Database of Systematic Reviews
|April 17, 2020
PubMed
Summary

The efficacy of treatments for fatigue in inflammatory bowel disease (IBD) remains uncertain. More high-quality research is needed to determine the benefits and harms of various interventions for managing IBD-related fatigue.

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Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Evidence Synthesis

Background:

  • Inflammatory bowel disease (IBD) encompasses chronic digestive tract inflammatory disorders like Crohn's disease and ulcerative colitis.
  • Fatigue is a prevalent, burdensome symptom in IBD, often complicating management due to its subjective nature.
  • Existing evidence on the efficacy and safety of fatigue interventions in IBD lacks comprehensive systematic review.

Purpose of the Study:

  • To systematically evaluate the efficacy and safety of pharmacological and non-pharmacological interventions for fatigue in IBD.
  • To compare these interventions against no treatment, placebo, or active comparators.
  • To synthesize evidence from randomized controlled trials (RCTs) assessing fatigue outcomes in IBD patients.

Main Methods:

  • Conducted a systematic literature search across major databases (Embase, MEDLINE, Cochrane Library, etc.) up to October 2019.
  • Included RCTs in adults and children with IBD where fatigue was a primary or secondary outcome.
  • Independently screened studies, extracted data, and assessed risk of bias using Cochrane methodology.

Main Results:

  • Included 14 studies (3741 participants); nine focused on pharmacological and five on non-pharmacological interventions.
  • Evidence for electroacupuncture, cognitive behavioral therapy, solution-focused therapy, and physical activity advice showed low to very low certainty regarding fatigue improvement.
  • Adalimumab showed potential for fatigue reduction in Crohn's disease with moderate certainty for reduced serious adverse events, while ferric maltol might slightly increase fatigue.

Conclusions:

  • The overall efficacy and safety of interventions for managing fatigue in IBD are currently uncertain.
  • No definitive conclusions can be drawn due to the low to very low certainty of evidence for most interventions.
  • Further high-quality, large-scale studies are essential to clarify the benefits and risks of fatigue management strategies in specific IBD populations.