Abstract:
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.
journal_name
Dtsch Arztebl Intjournal_title
Deutsches Arzteblatt internationalauthors
Wehkamp J,Götz M,Herrlinger K,Steurer W,Stange EFdoi
10.3238/arztebl.2016.0072subject
Has Abstractpub_date
2016-02-05 00:00:00pages
72-82issue
5issn
1866-0452pii
arztebl.2016.0072journal_volume
113pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:A number of studies have revealed higher postoperative mortality after operations that were performed toward the end of the week. It is not yet known whether a day-of-the-week effect exists after visceral surgical procedures for cancer in Germany. METHODS:Data on resections of carcinomas of the colon, rectu...
journal_title:Deutsches Arzteblatt international
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journal_title:Deutsches Arzteblatt international
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journal_title:Deutsches Arzteblatt international
pub_type: 已发布勘误
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journal_title:Deutsches Arzteblatt international
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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