Epidemiology and the natural course of inflammatory bowel disease. Gastroenterol Clin North Am 28(vii):255-281

ArticleinGastroenterology Clinics of North America 28(2):255-81, vii · July 1999with11 Reads
DOI: 10.1016/S0889-8553(05)70056-X · Source: PubMed
Abstract
Ulcerative colitis and Crohn's disease are inflammatory disorders of the gastrointestinal tract that are distributed unevenly within populations and throughout the world. Although the exact causes of inflammatory bowel disease (IBD) remain unknown, study of the epidemiology of IBD has provided insight into pathogenesis. This article examines the geographic, ethnic, and other trends of IBD; risk factors (including genetic and environmental); and the natural history of IBD.
    • "In addition, given that IBD presents its higher incidence in young adulthood (Andres & Friedman, 1999), a time when the construction of intimate relationships and sexuality are particularly important, body image issues emerge with special relevance. Young women, in particular, tend to over evaluate physical appearance in the definition of their personal and social value (Ferreira, Pinto-Gouveia, & Duarte, 2013), especially in modern Western cultures where societies emphasize thinness and muscle tonification as crucial aspects for the definition of female attractiveness (Grogan, 2008; Thompson et al., 2004). "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: Inflammatory bowel diseases (IBD) and their treatment are known to negatively impact on patients' body image, especially female patients. However, although there are broad evidences of body image impairment in female IBD patients, its negative impact on the quality of life (QoL) of non-operated women is not clearly and specifically studied. The aim of the current study was therefore to analyse, in a sample of non-operated female IBD patients, the factors that contribute to body image impairment and its impact on QoL. Methods: Ninety-six non-operated women (39.7 % with CD and 60.3 % with UC), aged between 18 and 40 years old, completed an online survey with validated self-report measures, which included the Body Image Scale and the WHO Brief Quality of Life Assessment Scale. Results: Negative body image was correlated with lower psychological and physical QoL and increased corticosteroids use, associated medical complications, body mass index (BMI), and IBD symptomatology. Regression analyses revealed that BMI and IBD symptomatology significantly predicted body image impairment. Furthermore, results from path analyses indicated that BMI and IBD symptomatology's effect on psychological and physical QoL was mediated through the negative effects of body image impairment. This model explained 31 % of psychological QoL and 41 % of physical QoL. Conclusions: These findings suggest that non-operated female patients are subject to pervasive and harmful effects of body image impairment on psychological and physical functioning. Therefore, psychological interventions aiming to target body dissatisfaction should be implemented in the health care of IBD, independently of patients' operative status.
    Full-text · Article · Jul 2016
    • "While CD can involve any area of the gastrointestinal tract allowing patches of healthy bowel in between the affected areas, UC is limited to the large intestine and comprises a continuous area of inflammation (Ordás et al., 2012). The onset of these conditions usually occurs between 15 and 30 years of age, with a second smaller peak between 50 and 70 years (Andres and Friedman, 1999). Although the aetiology is unknown, IBD seems to result from a combination between genetic and environmental factors (Crohn's & Colitis Foundation of America (CCFA), 2005a) and is most prevalent in North America and Europe, in urban areas, and among individuals of Jewish descent (Fauci et al., 2008; Loftus and Sandborn, 2003; Soon et al., 2012). "
    [Show abstract] [Hide abstract] ABSTRACT: This study aimed to test the effects of inflammatory bowel disease symptomatology and associated medical complications on physical and psychological quality of life and to explore whether these relationships are mediated by experiential avoidance. A total of 200 inflammatory bowel disease patients reported demographic and medical data and completed self-report instruments. Results revealed that the tested model presented an excellent fit, explaining 51 per cent of physical quality of life and 53 per cent of psychological quality of life. Inflammatory bowel disease-associated complications directly impacted on physical quality of life, and experiential avoidance significantly mediated the relationships between inflammatory bowel disease symptomatology and physical and psychological quality of life. These results highlight the importance of implementing psychological interventions for inflammatory bowel disease patients. © The Author(s) 2015.
    Full-text · Article · Jun 2015
    • "IBD is due to a dysregulated mucosal innate immune response to the enteric flora, leading to a chronically activated adaptive response (Bouma and Strober 2003 ). Current effective biologic treatments targeting adaptive immune activation, inevitably lead to systemic immunosuppression and antimicrobial resistance (Andres and Friedman 1999). Natural products, including medicinal herbs, have provided approximately half of the drugs developed for clinical use over the past 20 years and they have low toxicity even if given in high quantity. "
    [Show abstract] [Hide abstract] ABSTRACT: Dioscoreaceae, a kind of yam plant, has been recommended for treatment of chronic inflammatory conditions. However, the mechanisms are poorly defined. Methyl protodioscin (MPD) is one of the main bioactive components in Dioscoreaceae. Here, we aim to determine the mechanisms by which MPD ameliorates intestinal inflammation. Surgical intestinal specimens were collected from inflammatory bowel diseases (IBD) patients to perform organ culture. Experimental colitis was induced in mice by dextran sulfate sodium (DSS) or Citrobacter rodentium, and was then treated with MPD. NF-κB activation, expression of mucosal pro-inflammatory cytokines, disease severity, and epithelial proliferation/apoptosis were determined. Mouse crypts and Caco-2 monolayers were cultured to observe the effect of MPD upon intestinal epithelial differentiation and barrier function. We found that MPD increased the percentage of survival from high-dose DSS-(4%) treated mice, and accelerated mucosal healing and epithelial proliferation in low-dose DSS-(2.5%) treated mice characterized by marked reduction in NF-κB activation, pro-inflammatory cytokines expression and bacterial translocation. Consistently, MPD protected colonic mucosa from C. rodentium-induced colonic inflammation and bacterial colonization. In vitro studies showed that MPD significantly increased crypt formation and restored intestinal barrier dysfunction induced by pro-inflammatory cytokines. In conclusion, MPD ameliorates the intestinal mucosal inflammation by modulating the intestinal immunity to enhance intestinal barrier differentiation. MPD could be an alternative for treating chronic intestinal inflammatory diseases.
    Full-text · Article · Mar 2015
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