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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...
306
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

227
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...
227
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

159
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...
159
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...
365
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

493
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...
493
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

205
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...
205

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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
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Clostridium difficile in inflammatory bowel disease.

Tamara Alhobayb1, Matthew A Ciorba

  • 1Inflammatory Bowel Diseases Center and Division of Gastroenterology, Washington University School of Medicine, Saint Louis, Missouri, USA.

Current Opinion in Gastroenterology
|June 2, 2023
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Summary

Clostridium difficile infection (CDI) is common in inflammatory bowel disease (IBD) patients, potentially worsening flares and prolonging hospital stays. Prompt diagnosis and treatment with vancomycin or fidaxomicin, alongside prevention strategies like fecal microbiota transplantation, are crucial.

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A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
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Area of Science:

  • Gastroenterology and Infectious Diseases
  • Microbiology and Immunology

Background:

  • Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are linked to a higher risk of symptomatic Clostridium difficile infection (CDI).
  • CDI can mimic IBD flares, complicating patient management and leading to increased morbidity.

Approach:

  • This review synthesizes current knowledge on the epidemiology, diagnosis, and treatment of CDI specifically within the IBD patient population.
  • It evaluates the impact of newer IBD therapeutics on CDI risk and discusses established and emerging strategies for CDI prevention and management.

Key Points:

  • CDI is prevalent in IBD patients, associated with disease flares, recurrent infections, and extended hospitalizations.
  • Newer IBD therapies like vedolizumab, ustekinumab, and tofacitinib appear to have a lower risk of causing severe CDI.
  • Prompt diagnosis using a two-step testing method and treatment with vancomycin or fidaxomicin are essential.
  • Preventive strategies for recurrent CDI (rCDI) include bezlotoxumab and fecal microbiota transplantation (FMT), which shows strong safety and efficacy.

Conclusions:

  • Vigilance in diagnosing and treating CDI in IBD patients is critical.
  • Modifiable risk factors for CDI in IBD include corticosteroid use, unnecessary antibiotics, and active intestinal inflammation.
  • Implementing improved infection control, utilizing advanced IBD medications, and employing effective CDI treatments can reduce the burden of severe CDI and its complications in IBD.