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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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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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Pulmonary Tuberculosis I01:29

Pulmonary Tuberculosis I

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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
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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...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

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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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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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Chronic Salmonella Infection Induced Intestinal Fibrosis
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Tuberculosis and inflammatory bowel disease.

Lucía Madero1, Iria Bastón2, Eduard Brunet-Mas3

  • 1Hospital General Dr. Balmis, Alicante, España; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España.

Gastroenterologia Y Hepatologia
|October 16, 2025
PubMed
Summary
This summary is machine-generated.

Inflammatory bowel disease (IBD) patients on immunosuppressants face higher tuberculosis (TB) risks. Screening for latent TB infection (LTBI) before therapy is crucial to prevent reactivation and guide treatment safely.

Keywords:
BiologicsBiológicosCribadoEnfermedad inflamatoria intestinalIGRAImmunosuppressionInflammatory bowel diseaseInmunosupresiónPPDScreeningTratamientoTreatmentTuberculosis

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Immunology

Background:

  • Inflammatory bowel disease (IBD) encompasses ulcerative colitis and Crohn's disease.
  • IBD patients, especially those on immunosuppressive therapies like anti-TNF agents, have an elevated risk of developing tuberculosis (TB).
  • The risk of TB reactivation is influenced by the type of immunosuppressive drug, with combinations of agents potentially increasing this risk.

Purpose of the Study:

  • To highlight the increased risk of tuberculosis in patients with inflammatory bowel disease.
  • To emphasize the necessity of screening for latent tuberculosis infection (LTBI) prior to initiating immunosuppressive therapy in IBD patients.
  • To provide guidance on diagnostic approaches and management strategies for LTBI and active TB in this patient population.

Main Methods:

  • Review of current guidelines and literature regarding TB risk in IBD patients.
  • Discussion of diagnostic modalities for LTBI, including tuberculin skin test (TST) and interferon-gamma release assays (IGRA).
  • Consideration of imaging techniques like chest X-rays and management protocols for LTBI and active TB.

Main Results:

  • Immunosuppressive therapies for IBD, including anti-TNF agents, immunomodulators, anti-integrins, IL-12/23 inhibitors, and JAK inhibitors, are associated with a variable risk of TB reactivation.
  • Screening for LTBI is recommended at IBD diagnosis or before advanced therapy, with dual testing advised for immunocompromised individuals.
  • Chemoprophylaxis for LTBI is recommended before immunosuppression; active TB requires treatment cessation and antituberculous therapy.

Conclusions:

  • Proactive screening and management of latent tuberculosis infection are essential for the safe treatment of inflammatory bowel disease patients.
  • Immunosuppressive therapy should be carefully considered, with risk stratification and potential reintroduction based on individual patient factors.
  • Live vaccines, such as BCG, are contraindicated in IBD patients undergoing immunosuppressive treatment.