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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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

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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...
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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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Inflammatory Bowel Disease V: Surgical Management01:21

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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.
Here are some common surgical interventions for IBD:
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Inflammatory Bowel Diseases Before and After 1990.

Brindusa Truta1, Ferdouse Begum1,2, Lisa Wu Datta1

  • 1Division of Gastroenterology, Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Gastro Hep Advances
|January 23, 2023
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Summary

Increased inflammatory bowel disease (IBD) incidence post-1990 is linked to rising ex-smoking rates in ulcerative colitis (UC) and potential unidentified factors in Crohn's disease (CD). Smoking risk decreased, yet CD incidence rose, suggesting other environmental or diagnostic influences.

Keywords:
Environmental RisksGeneticIBDSmoking

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Area of Science:

  • Gastroenterology
  • Epidemiology
  • Genetics

Background:

  • Inflammatory bowel disease (IBD) incidence, particularly in North America, has increased since 1990.
  • Genetic and environmental factors are known contributors to IBD development.

Purpose of the Study:

  • To investigate the determinants of the rising incidence of IBD, specifically Crohn's disease (CD) and ulcerative colitis (UC), in North America after 1990.
  • To evaluate the roles of clinical features, smoking status, and genetic risk scores (GRS) in IBD diagnosis age and incidence trends.

Main Methods:

  • Utilized generalized linear models to analyze data from the National Institutes of Diabetes, Digestion and Kidney Diseases IBD Genetics Consortium database.
  • Assessed clinical features, smoking status, and Crohn's disease GRS (CD-GRS) and IBD-GRS in patients diagnosed before and after 1990.

Main Results:

  • Smoking at diagnosis significantly declined post-1990 for both UC and CD.
  • Ex-smoking rates increased significantly in UC but not in CD post-1990.
  • CD-GRS and IBD-GRS were associated with earlier diagnosis, Jewish ethnicity, family history, and surgery; CD-GRS showed a borderline decrease post-1990, influenced by a decrease in CD surgery.

Conclusions:

  • Increased ex-smoking correlates with UC incidence post-1990.
  • The rising CD incidence post-1990, despite decreased smoking risk and a trend towards lower CD-GRS (when surgery is excluded), suggests other factors like diet, obesity, antibiotic use, hygiene, or improved detection of milder cases.
  • Unaccounted environmental factors or diagnostic changes likely contribute to the increased CD incidence.