RT Book, Section
A1 Levine, Jonathan S.
A1 Burakoff, Robert
A2 Greenberger, Norton J.
A2 Blumberg, Richard S.
A2 Burakoff, Robert
SR Print(0)
ID 55955162
T1 Chapter 3. Inflammatory Bowel Disease: Medical Considerations
T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176848-1
LK accessmedicine.mhmedical.com/content.aspx?aid=55955162
RD 2024/04/24
AB Crohn  disease  and  ulcerative  colitis  are  chronic  inflammatory  diseases  with  well-described  epidemiologic  and  clinical  features.Genetic  factors,  immune  dysregulation,  and  microbial  gut  flora  all  influence  disease  susceptibility.No  single  symptom,  physical  finding,  or  test  result  can  diagnose  inflammatory  bowel  disease  (IBD);  the  diagnosis  is  a  clinical  one  based  on  consistent  findings  obtained  from  the  history,  physical  examination,  and  laboratory,  endoscopic,  histologic,  and  radiologic  studies.Multiple  conditions  can  mimic  IBD;  infectious  pathogens  are  a  particular  concern.Intestinal  complications  commonly  occur  in  IBD,  many  of  which  are  predictable  on  the  basis  of  disease  type,  location,  severity,  or  duration;  extraintestinal  complications  also  occur,  typically  in  association  with  active  disease.Patients  with  long-standing  colitis  are  at  increased  risk  of  developing  colorectal  cancer  (CRC)  and  should  be  evaluated  for  dysplastic  changes  predictive  of  subsequent  or  synchronous  malignancy.5-Aminosalicylates,  steroids,  antibiotics,  and  immunomodulators  have  been  mainstays  of  therapy;  the  choice  of  appropriate  medication  is  based  on  multiple  variables,  including  disease  type,  location,  and  severity.Biologic  medications  offer  multiple  powerful  therapeutic  options;  the  optimal  time  to  apply  these  medications  remains  to  be  clarified.