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Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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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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Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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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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Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

290
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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Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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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:
168
Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents01:24

Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents

556
In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
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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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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
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Recurrent Multidrug-Resistant Clostridium difficile Infection Secondary to Ulcerative Colitis a Case Report.

Arturo P Jaramillo1, Javier Castells2, Sabina Ibrahimli3

  • 1General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, CA 94534, USA.

Medical Sciences (Basel, Switzerland)
|August 22, 2023
PubMed
Summary
This summary is machine-generated.

Recurrent Clostridioides difficile infection (rCDI) poses a significant challenge, especially in patients with inflammatory bowel disease (IBD). This case highlights the complexity of managing multidrug-resistant CDI (mdCDI) and the need for new treatment guidelines.

Keywords:
Clostridium difficile infectionClostridium difficile infection therapyCrohn’s diseaseinflammatory bowel diseaseulcerative colitis

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), primarily affects the large bowel.
  • Clostridioides difficile infection (CDI) is a common complication, often secondary to UC or antibiotic use.
  • Persistent CDI can result from chronic gut dysbiosis and low antibody levels against C. difficile toxins.

Observation:

  • This case report details a young woman with multidrug-resistant CDI (mdCDI).
  • The patient underwent extensive treatment including antibiotics, anti-inflammatories, corticosteroids, vedolizumab, fecal microbiota transplant (FMT), and immunomodulators.
  • Despite multiple therapies, the patient experienced persistent, treatment-resistant CDI.

Findings:

  • Multidrug-resistant CDI (mdCDI) presents a complex clinical challenge due to its resistance to various therapeutic agents.
  • The management of mdCDI requires prolonged treatment courses, impacting both hospital and outpatient healthcare systems.
  • Treatment efficacy is variable, with significant time required to achieve dose-response and time-response.

Implications:

  • The case underscores the urgent need for robust clinical trials and meta-analyses to establish definitive therapeutic guidelines for mdCDI.
  • Developing standardized treatment protocols is crucial for improving patient outcomes and optimizing healthcare resource allocation.
  • Further research into the mechanisms of CDI resistance and host-pathogen interactions is warranted.