Inflammatory bowel disease

Summary
Inflammatory Bowel Disease (IBD) is a group of diseases, including ulcerative colitis (UC) and Crohn's disease (CD) 1. Commonly seen in young people, 15 to 25 years is the peak age of onset. IBD is a chronic disease that requires long-term treatment. Epidemiological data show that the prevalence of UC in China is about 11.6/105 (2009) 2; And the prevalence of CD in China is about 2.29/105 (1950-2007) 3. In recent years, the incidence of IBD has been increasing globally 4.
Causes
There is no clear pathogenesis of IBD, which is determined by both genetic and environmental factors. IBD is not contagious but is familial clustered, with approximately 14% of IBD patients having a family history of the disease 5. Studies have shown that imbalances in immune homeostasis, leading to excessive tumor necrosis factor-a (TNF-α) production, play an important role in the pathogenesis of IBD6.
Symptions
There are some differences in the common clinical manifestations between CD and UC patients. The gastrointestinal manifestations of CD are mainly diarrhea and abdominal pain, which may have bloody stool1. The gastrointestinal manifestations of UC are mainly persistent or recurrent diarrhea, mucopurulent blood with abdominal pain, tenesmus 1. In addition, patients with CD and UC are also accompanied by various systemic complications such as blurred vision, joint pain, and rash.
Treatment
IBD cannot be cured, the current treatment goal is to achieve better disease control. Treatments for IBD include aminosalicylates, adrenocorticotropic hormone, azathioprine, cyclosporine, biologics etc7. Patients with CD with high risk may be treated directly with anti-TNFα agents.
 
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2.  歐陽欽. 重癥潰瘍性結腸炎的處理策略與技巧[J]. 醫學新知雜志,2009,19(2):75-79.
3.  Zheng JJ, Zhu XS, Huangfu Z, et al. Prevalence and incidence rates of Crohn's disease in mainland China: a meta-analysis of 55 years of research[J]. J Dig Dis, 2010, 11(3):161-6.
4.  Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review[J]. Gastroenterology, 2012, 142(1):46-54.
5.  Hodson R. Inflammatory bowel disease[J]. Nature, 2016, 540(7634):S97.
6.  Brand S. Crohn's disease: Th1, Th17 or both? The change of a paradigm: new immunological and genetic insights implicate Th17 cells in the pathogenesis of Crohn's disease[J]. Gut, 2009, 58(8):1152-67.
7.  中華醫學會消化病學分會炎癥性腸病學組. 炎癥性腸病診斷與治療的共識意見(2018年·北京)[J]. 中華消化雜志,2018 ,38(5):292-311.
CP-86271 Approved date 2019-4-10