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Related Concept Videos

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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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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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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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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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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Polysubstance use in inflammatory bowel disease.

Kaleb Bogale1, Kent Vrana2, Wesley Raup- Konsavage2

  • 1Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.

Journal of Digestive Diseases
|November 1, 2021
PubMed
Summary
This summary is machine-generated.

Polysubstance use (PSU) is prevalent in inflammatory bowel disease (IBD) patients, often linked to extraintestinal manifestations and mental health medications. Screening for PSU is crucial, especially in IBD patients with these conditions.

Keywords:
antidepressant and/or anxiolytic useextraintestinal manifestationhealthcare resource utilizationinflammatory bowel diseasepolysubstance use

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Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Public Health

Background:

  • Inflammatory bowel disease (IBD) encompasses Crohn's disease and ulcerative colitis.
  • Polysubstance use (PSU), defined as the concurrent use of two or more substances, is a growing concern.
  • Understanding PSU in IBD is vital for comprehensive patient care.

Purpose of the Study:

  • To determine the incidence of polysubstance use (PSU) in patients with inflammatory bowel disease (IBD).
  • To identify predisposing factors associated with PSU in IBD.
  • To evaluate the impact of PSU on IBD patient outcomes and healthcare utilization.

Main Methods:

  • Retrospective analysis of 315 IBD patients from a single tertiary care center (2015-2019).
  • Collection of baseline characteristics, clinical data, and medication use (antidepressants/anxiolytics).
  • Multivariate logistic regression to identify factors associated with PSU.

Main Results:

  • PSU was identified in 21.0% of IBD patients (21.5% in Crohn's disease, 19.8% in ulcerative colitis).
  • Extraintestinal manifestations (EIM) and use of antidepressant/anxiolytic medications were significantly associated with PSU.
  • PSU correlated with an increased rate of IBD-associated imaging studies.

Conclusions:

  • Polysubstance use is a common comorbidity in patients with inflammatory bowel disease.
  • Independent predictors of PSU in IBD include EIM, psychotropic medication use, and increased imaging.
  • Routine screening for substance use is recommended for IBD patients, particularly those with EIM or on antidepressants/anxiolytics.