Editorial Note on Inflammatory Bowel Disease

Ahmet Eskezan^*
*Correspondence: Ahmet Eskezan, Department of Internal Medicine, Istanbul University, Istanbul, Turkey, Email:

Description

Inflammatory Bowel Disease is a group of inflammatory colon and small intestine diseases. Ulcerative colitis and Crohn’s Disease are the two main components of the IBD. Ulcerative colitis is the disorder of the colon (large intestine). Crohn’s Disease can affect any part of the digestive system from mouth to anus.

Symptoms associated with IBD are abdominal pain, cramps, swelling, bloody diarrhea, weight loss and extreme tiredness. IBD is treated with aminosalicylates, immunosuppressants, biologics, antibiotics. About 60% of Crohn’s Disease is treated with surgical interventions.

Irritable bowel syndrome affects the large intestine. Causative factors underlying IBS are bacterial and viral infections resulting in diarrhea, muscle contractions in the intestine, changes of microflora in the gut. Symptoms associated with IBS are abdominal pain, diarrhea, changes in bowel movements, constipation.

Food, stress, hormones are the causative triggers of IBS symptoms. IBS is diagnosed by colonoscopy, upper endoscopy, stool tests, blood tests, and tests for lactose intolerance. IBS treatment is managed by lifestyle changes and medication.

Inflammatory Bowel Disease (IBD) is a group of inflammatory conditions of the colon and small intestine. Crohn's disease and ulcerative colitis are the principal types of inflammatory bowel disease. Crohn's disease affects the small intestine and large intestine, as well as the mouth, esophagus, stomach and the anus, whereas ulcerative colitis primarily affects the colon and the rectum.

IBD also occurs in dogs and is thought to arise from a combination of host genetics, intestinal microenvironment, environmental components and the immune system. There is an ongoing discussion, however, that the term "Chronic Enteropathy" might be better to use than "inflammatory bowel disease' in dogs because it differs from IBD in humans in how the dogs respond to treatment. For example, many dogs respond to only dietary changes compared to humans with IBD, who often need immunosuppressive treatment. Some dogs may also need immunosuppressant or antibiotic treatment when dietary changes are not enough. After having excluded other diseases that can lead to vomiting, diarrhea, and abdominal pain in dogs, intestinal biopsies are often performed to investigate what kind of inflammation is occurring In dogs, low levels of cobalamin in the blood have been shown to be a risk factor for negative outcome.

In spite of Crohn's and UC being very different diseases, both may present with any of the following symptoms: abdominal pain, diarrhea, rectal bleeding, severe internal cramps/muscle spasms in the region of the pelvis and weight loss. Anemia is the most prevalent extraintestinal complication of inflammatory bowel disease. Associated complaints or diseases include arthritis, pyoderma gangrenosum, primary sclerosing cholangitis, and Nonthyroidal Illness Syndrome (NTIS). Associations with Deep Vein Thrombosis (DVT) and Bronchiolitis Obliterans Organizing Pneumonia (BOOP) have also been reported. Diagnosis is generally by assessment of inflammatory markers in stool followed by colonoscopy with biopsy of pathological lesions.

IBD is a complex disease which arises as a result of the interaction of environmental and genetic factors leading to immunological responses and inflammation in the intestine.

As a result of microbial symbiosis and immunity, alterations in the gut microbiome may contribute to inflammatory gut diseases. IBD-affected individuals have been found to have 30-50 percent reduced biodiversity of commensal bacteria, such as decreases in Firmicutes and Bacteroidetes. Further evidence of the role of gut flora in the cause of inflammatory bowel disease is that IBD-affected individuals are more likely to have been prescribed antibiotics in the 2-5 year period before their diagnosis than unaffected individuals. The enteral bacteria can be altered by environmental factors, such as concentrated milk fats or oral medications such as antibiotics and oral iron preparations.

Conclusion

TLoss of integrity of the intestinal epithelium plays a key pathogenic role in IBD. Dysfunction of the innate immune system as a result of abnormal signaling through immune receptors called toll-like receptors which activates an immune response to molecules that are broadly shared by multiple pathogens contributes to acute and chronic inflammatory processes in IBD colitis and associated cancer.