Inflammatory Bowel Disease Update
Pathogenesis, Diagnosis And Treatment
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IBD is a lifelong disease with periods of active disease alternating with periods of remission. IBD is thought to result from the interaction between genetic and environmental factors that influence the normal intestinal commensal flora to trigger an inappropriate mucosal immune response. Colonoscopy remains the gold stander for diagnosis of IBD. Wireless capsule endoscope and balloon enteroscopy show many advances in diagnosis of IBD. CT and MRI help to detect extent of disease and assess complications. Serological and fecal markers alone can not establish diagnosis of IBD but they have only ...
IBD is a lifelong disease with periods of active disease alternating with periods of remission. IBD is thought to result from the interaction between genetic and environmental factors that influence the normal intestinal commensal flora to trigger an inappropriate mucosal immune response. Colonoscopy remains the gold stander for diagnosis of IBD. Wireless capsule endoscope and balloon enteroscopy show many advances in diagnosis of IBD. CT and MRI help to detect extent of disease and assess complications. Serological and fecal markers alone can not establish diagnosis of IBD but they have only a prognostic value. 5-ASA agents are the mainstay in the treatment of both CD and UC. Steroids continue to be the first choice to treat active disease. 6-mercaptopurine and azathioprine are steroid-sparing immunomodulators effective in the maintenance of remission of both CD and UC while methotrexate may be used in both induction and maintenance of CD. Infliximab and adalimumab are anti-TNF agents approved for the treatment of CD and UC. Other new emerging therapies include antibiotics, prebiotics, probiotics, leucocyte apheresis, Interferon-alpha and helminth.
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