IBD Overview

 

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This content does not have an Arabic version. Kids who are not growing well may need additional nutrition support. See your doctor if you experience a persistent change in your bowel habits or if you have any of the signs and symptoms of inflammatory bowel disease. More on this topic for: Ulcerative colitis affects the colon.

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IBD Blog Follow the discussion on the latest advances in treating Crohn’s disease and ulcerative colitis. Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that involve chronic inflammation of your digestive tract.

Similarly, the MDR1 gene, coding for multidrug resistance and transport of amphipathic substances through membranes, has shown increased susceptibility towards development of ulcerative colitis. Other than these, the gene ECM1 encoding for extracellular matrix protein 1 responsible for maintenance of skin integrity and homeostasis, has also been studied to have susceptibility loci when mutated or knocked out in animal models predisposing towards development of UC.

There have been a few studies among Japanese population which shows genetic mutations of some genes of the Human Leukocyte Antigen HLA , located on chromosome 6, responsible for antigen presentation and processing, increases risk for one type of IBD while decreasing the risk for the other type. Such instances however, have been rare in case of European populations. Genetic predispositions have been seen to affect children more than adults, in studies conducted across North America and Europe.

This might be because children have a developing immune system, which is more prone to damage than that in a fully formed adult. There has been a considerable rise in the number of cases of IBD in North America and Europe since the second half of the twentieth century. Places with a colder climate and urbanization tend to have a higher incidence of IBD.

Internationally, the prevalence for UC ranges from 0. The innate immune system forms the first line of defense against foreign pathogens, fighting against them depending on their chemical nature and not specificity. The cells of the innate immune system include mediators like cytokines, adhesion molecules, chemokines and lymphocytes, which are responsible for recruiting inflammatory cells to the site, regulating effector cell responses and presenting the antigens to the adaptive immune system through antigen presentation, for further processing and eventual destruction.

Studies have shown that the T lymphocytes in the effector pathways mostly T helper cells do not undergo apoptosis after activation, as anti-IL12 and anti-TNF antibodies are not secreted IL12 and Tumor Necrosis Factor being two of the most potent pro-inflammatory cytokines which again contributes to inflammation. The research pertaining to mutations of the NOD2 CARD15 gene, which is another trigger for regulating the innate immune system after attachment to pathogenic cell wall antigen, is another theory which enhances our understanding of the failure of the innate immune system in IBD patients.

The intestinal epithelium is another important part of the innate immune system, with the mucosal glands providing immunity against pathogens, maintaining mucosal homeostasis as well as forming the protective covering of the intestines. Genetic predispositions might affect the integrity of this barrier, which makes the intestine free to be invaded by commensal pathogens from other sites e.

This is because the epithelial cells have antigen presenting cells embedded all over, which get activated on exposure to fecal bacteria, cause faulty antigen presentation and lead to inflammation. As far as the effector immune responses are considered, the helper T lymphocytes fail to undergo apoptosis after their synthesis by the cytokines.

Also, an increase in the IL13 population has also been seen in some cases of UC. In fact, suppressing the IL13 receptors has been taken up as a therapeutic target to treat the inflammation caused in UC. On the other hand, it has been seen that anti-TNF antibodies and IL an anti-inflammatory cytokine could not cause remission of CD, which indicates involvement of mixed cytokine profiles in IBD.

Ulcerative colitis starts in the rectum and extends proximally till the colon might involve the entire large intestine at times. Other cases see an involvement of the distal terminal ileum, a condition known as backwash ileitis. The periods of acute inflammation are followed by comparatively longer remission periods than CD. Large mucosal ulcers with purulent exudates often harbor bacteria which cause worsening of the condition.

In extreme cases, the colon loses its muscularity and dilates indefinitely, to resemble the structure of a lead-pipe. This condition is called toxic or fulminant colitis, which might also lead to perforation of the colon in some cases.

People with UC are at an increased risk of developing colon cancer. CD mostly affects the distal ileum and the colon, with three distinct patterns of infection namely inflammation, strictures and fistulas. Although inflammatory bowel disease usually isn't fatal, it's a serious disease that, in some cases, may cause life-threatening complications. The exact cause of inflammatory bowel disease remains unknown. Previously, diet and stress were suspected, but now doctors know that these factors may aggravate but don't cause IBD.

One possible cause is an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.

Heredity also seems to play a role in that IBD is more common in people who have family members with the disease. However, most people with IBD don't have this family history.

Ulcerative colitis and Crohn's disease have some complications in common and others that are specific to each condition. Complications found in both conditions may include:. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Digestive system Crohn's disease and ulcerative colitis are both forms of inflammatory bowel disease.

Request an Appointment at Mayo Clinic. References Goldman L, et al. Accessed May 10, What is inflammatory bowel disease IBD? IBD is treated with medicines, changes in diet, and sometimes surgery. The goal of treatment is to relieve symptoms, prevent other problems, and prevent future flare-ups. Because some medicines make it harder to fight infections, it's important that your child be tested for tuberculosis and have all recommended vaccines before starting treatment. Poor appetite, diarrhea, and poor digestion of nutrients can make it hard for people with inflammatory bowel disease to get the calories and nutrients the body needs.

Children with IBD should eat a variety of foods, get plenty of fluids, and learn to avoid foods that make symptoms worse. Some children may need supplements, like calcium or vitamin D. Kids who are not growing well may need additional nutrition support.

Kids and teens with IBD can feel different and might not be able to do the things their friends can do, especially during flare-ups. Some struggle with a poor self-image, depression , or anxiety. They may not take their medicine or follow their diet.