Inflammatory Bowel Disease.
Background: Inflammatory bowel diseases are common in Europe, with prevalences as high as 1 in 198 persons (ulcerative colitis) and 1 in 310 persons (Crohn's disease). Methods: This review is based on pertinent articles retrieved by a search in PubMed and in German and European guidelines and Cochra...
| Publicado en: | Deutsches Ärzteblatt International Vol. 113; no. 5; pp. 72 - 87 |
|---|---|
| Autores principales: | , , , , |
| Formato: | Journal Article |
| Publicado: |
Deutscher Aerzte-Verlag GmbH
2/5/2016
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113369473&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113369473 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18660452 5F0N jtl: Deutsches Ärzteblatt International issn: 18660452 maglogo: N pubinfo: dt: 2/5/2016 vid: 113 iid: 5 pid: 25312 pub: Deutscher Aerzte-Verlag GmbH artinfo: ui: 113369473 10.3238/arztebl.2016.0072 113369473 ppf: 72 ppct: 15 formats: fmt: @attributes: type: P tig: atl: Inflammatory Bowel Disease. aug: au: Wehkamp, Jan Götz, Martin Herrlinger, Klaus Steurer, Wolfgang Stange, Eduard F. affil: Department of Internal Medicine I - Gastroenterology, Hepatology, Infectiology, University Hospital of Tübingen sug: ab: Background: Inflammatory bowel diseases are common in Europe, with prevalences as high as 1 in 198 persons (ulcerative colitis) and 1 in 310 persons (Crohn's disease). Methods: This review is based on pertinent articles retrieved by a search in PubMed and in German and European guidelines and Cochrane reviews of controlled trials. Results: Typically, the main clinical features of inflammatory bowel diseases are diarrhea, abdominal pain, and, in the case of ulcerative colitis, peranal bleeding. These diseases are due to a complex immunological disturbance with both genetic and environmental causes. A defective mucosal barrier against commensal bowel flora plays a major role in their pathogenesis. The diagnosis is based on laboratory testing, ultrasonography, imaging studies, and, above all, gastrointestinal endoscopy. Most patients with Crohn's disease respond to budesonide or systemic steroids; aminosalicylates are less effective. Refractory exacerbations may be treated with antibodies against tumor necrosis factor (TNF) or, more recently, antibodies against integrin, a protein of the cell membrane. In ulcerative colitis, aminosalicylates are given first; if necessary, steroids or antibodies against TNF-α or integrin are added. Maintenance therapy to prevent further relapses often involves immunosuppression with thiopurines and/or antibodies. Once all conservative treatment options have been exhausted, surgery may be necessary. Conclusion: The treatment of chronic inflammatory bowel diseases requires individually designed therapeutic strategies and the close interdisciplinary collaboration of internists and surgeons. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|