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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 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, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
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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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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
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The gastrointestinal tract is susceptible to various disorders. If the lower esophageal sphincter is damaged, stomach acid can flow back into the esophagus, causing irritation and inflammation of the lining. This condition is called gastroesophageal reflux disease (known as heartburn) and may cause chest pain and difficulty swallowing. In the stomach, prolonged use of nonsteroidal anti-inflammatory drugs like aspirin, chronic alcohol consumption, bacterial infections such as Helicobacter...
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[Extra-intestinal manifestations associated with Crohn's disease].

Ibrahim Ayada1, Michiel P van Wijk1, Nanne K de Boer2

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Extra-intestinal manifestations (EIM) can be the first sign of Crohn's disease (CD), delaying diagnosis. Prompt identification and treatment of EIM are crucial for managing both symptoms and underlying Crohn's disease.

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Area of Science:

  • Gastroenterology
  • Rheumatology
  • Dermatology
  • Ophthalmology

Background:

  • Extra-intestinal manifestations (EIM) are common in Crohn's disease (CD).
  • EIM can precede, coincide with, or follow gastrointestinal symptoms.
  • These manifestations impact patient quality of life and require timely diagnosis.

Purpose of the Study:

  • To highlight the significance of EIM as early indicators of Crohn's disease.
  • To present cases where EIM led to delayed CD diagnosis.
  • To review the epidemiology and clinical presentation of prevalent EIM.

Main Methods:

  • Case series analysis of three patients (two pediatric, one adult).
  • Review of literature on EIM prevalence, epidemiology, and symptoms in Crohn's disease.
  • Analysis of diagnostic timelines in relation to EIM onset.

Main Results:

  • EIM preceded the diagnosis of Crohn's disease in all presented cases.
  • Commonly affected areas include joints, skin, and eyes.
  • EIM can occur independently of active gastrointestinal disease activity.

Conclusions:

  • EIM are critical diagnostic clues for Crohn's disease, even before GI symptoms appear.
  • Early recognition of EIM is essential for prompt CD diagnosis and management.
  • A comprehensive approach is needed to address both EIM and underlying CD.