inflammatory bowel disease
ABBR: IBD
Any of a number of chronic, relapsing inflammatory diseases of the gastrointestinal tract of unknown cause. The two most common types are ulcerative colitis and Crohn disease.
Pathology: Ulcerative colitis is limited to the superficial layers of the wall of the colon; Crohn disease may involve all layers of the bowel wall, from the oropharynx to the anus. In ulcerative colitis, the inflammation is continuous throughout the affected bowel, producing a raw, ulcerated, or effaced lumen; Crohn disease is characterized by patchy areas of granulomatous inflammation, creating a cobblestoned mucosal surface that may develop deep fissures or a thickened, rubbery texture. Also, in Crohn disease but not ulcerative colitis, fistulas to adjacent sections of the bowel, vagina, and bladder may develop.
Symptoms and Signs: Symptoms include abdominal pain, e.g., in the right lower quadrant in Crohn disease; in the rectum in ulcerative colitis, oral or gastrointestinal ulcers, GI bleeding, or fistula formation.
Diagnosis: Upper and lower gastrointestinal endoscopy is used to identify inflamed tissue, which is confirmed by biopsy. Barium swallow or enemas may suggest the presence of the illness.
Treatment: First-line treatments include antiinflammatory drugs, such as mesalamine or corticosteroids. When disease does not respond to antimetabolic treatment, antimetabolic drugs, such as azathioprine or methotrexate are used, or patients use potent biological therapies, such as antitumor necrosis factor agents or monoclonal antibody therapies, e.g., infliximab.
Patient Care:
SEE: Crohn disease and ulcerative colitis for patient care concerns..