Inflammatory Bowel Disease Epidemiology
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Questions and Answers

What is the hygiene hypothesis related to the development of IBD?

  • Decreased food storage conditions leading to adequate development of regulatory processes
  • Improved food storage conditions leading to inadequate development of regulatory processes (correct)
  • Increased food contamination leading to inadequate development of regulatory processes
  • Increased gut microbiome composition leading to adequate development of regulatory processes

    • What is a potential explanation for the increased prevalence of IBD?

  • Decreased exposure to bacteria and viruses
  • Decreased consumption of preservatives in processed foods
  • Increased exposure to bacteria and viruses
  • Increased consumption of preservatives in processed foods (correct)

    • What is a characteristic of the genes linked to IBD?

  • High relative risk of developing disease
  • Low relative risk of developing disease (correct)
  • Associated with only IBD
  • Associated with autoimmune diseases other than IBD

    • What is a genetic risk factor associated with IBD?

    <p>All of the above</p> Signup and view all the answers

    What is a potential trigger for intestinal inflammation in Crohn's disease?

    <p>Defective immune responses to dietary antigens</p> Signup and view all the answers

    What is a therapeutic approach that has been shown to reduce inflammation in mice with intestinal inflammation?

    <p>Monoclonal antibodies to TNFa</p> Signup and view all the answers

    What is a cytokine that has been implicated in the pathogenesis of IBD?

    <p>IL-10</p> Signup and view all the answers

    What is a potential factor contributing to the pathogenesis of ulcerative colitis?

    <p>All of the above</p> Signup and view all the answers

    What is a common symptom of Crohn's disease?

    <p>Intermittent attacks of diarrhea</p> Signup and view all the answers

    What can trigger disease reactivation in Crohn's disease?

    <p>Specific dietary items</p> Signup and view all the answers

    What is a possible complication of colonic disease in Crohn's disease?

    <p>Iron deficiency anemia</p> Signup and view all the answers

    What is the primary source of transmission of intestinal microbiota?

    <p>Mother</p> Signup and view all the answers

    What is a characteristic of Crohn's disease?

    <p>Intermittent inflammation</p> Signup and view all the answers

    What is a possible presentation of Crohn's disease?

    <p>RLQ pain and fever</p> Signup and view all the answers

    What is the result of targeted disruption of genes for the T-cell receptor and cytokine IL-2?

    <p>GI tract disease resembling ulcerative colitis</p> Signup and view all the answers

    What is a factor that influences immune responses in adults?

    <p>Neonatal period</p> Signup and view all the answers

    Which of the following is a common extraintestinal manifestation of the disease?

    <p>Clubbing of the fingertips</p> Signup and view all the answers

    Which of the following is a nutritional deficiency that may result from extensive small bowel disease?

    <p>Vitamin B12 deficiency</p> Signup and view all the answers

    What is the characteristic appearance of the involved mucosa in the disease?

    <p>Cobblestone appearance</p> Signup and view all the answers

    Which of the following is a complication of the disease that may require surgical resection?

    <p>Fibrosing strictures</p> Signup and view all the answers

    Which of the following is a pathophysiologic feature of ulceration in the disease?

    <p>Areas of ulceration and inflammation occurring in a discontinuous fashion</p> Signup and view all the answers

    Which of the following is a type of arthritis that may occur as an extraintestinal manifestation of the disease?

    <p>Migratory polyarthritis</p> Signup and view all the answers

    What is the most common location of the disease in the GI tract?

    <p>Distal ileum</p> Signup and view all the answers

    Which of the following therapies may be used to manage the disease?

    <p>Anti-inflammatory agents</p> Signup and view all the answers

    Study Notes

    IBD Pathogenesis

    • Targeted disruption of genes for T-cell receptor and cytokine IL-2 in mice results in GI tract disease resembling ulcerative colitis

    Neonatal Period

    • Patterning activity of the immune system during the neonatal period influences immune responses in adulthood
    • Early exposure to intestinal microbiota may contribute to IBD pathogenesis
    • Maternal effects, including transmission of intestinal microbiota, are thought to contribute to GI disease

    Crohn's Disease

    • Clinical manifestations:
      • Intermitent attacks of diarrhea, fever, and abdominal pain
      • 20% of patients present acutely with RLQ pain, fever, and bloody diarrhea
      • Periods of active disease are interrupted by asymptomatic periods
      • Disease reactivation can be associated with physical or emotional stress, dietary items, and cigarette smoking
      • Iron deficiency anemia can occur due to blood loss in colonic disease

    Epidemiology

    • Exact causes of IBD are unknown
    • Hygiene hypothesis suggests that changes in gut microbiome composition contribute to IBD
    • Some mucosa-associated microbes trigger persistent inflammation in susceptible hosts
    • Other potential explanations include preservatives in processed foods inducing low-grade mucosal damage

    IBD Pathogenesis

    • Combination of genetic risk and environmental factors contributes to IBD
      • Genetic risk includes abnormalities in immune regulation, host-microbiome interactions, and epithelial barrier functions
      • Environmental factors include pathogenic microorganisms, dietary factors, smoking, and defective immune responses

    Crohn's Disease Pathophysiology

    • Defective modulation of inflammatory responses to dietary and microbial antigens may contribute to uncontrolled inflammation
    • Mice lacking interleukin-10 develop spontaneous intestinal inflammation, which can be reduced by monoclonal antibodies to tumor necrosis factor alpha (TNFa)

    Complications

    • Frequent complications include perforation, fistula formation, abscess formation, and small intestinal obstruction
    • Fibrosing strictures, particularly of the terminal ileum, are common and require surgical resection
    • Fistulae can develop between loops of bowel and involve the urinary bladder, vagina, and abdominal or perianal skin

    Extraintestinal Manifestations

    • Cutaneous nodules formed by granulomas
    • Uveitis, iritis
    • Migratory polyarthritis, sacroileitis, ankylosing spondylitis
    • Erythema nodosum, cutaneous granulomas
    • Autoimmune chronic active hepatitis, sclerosing cholangitis
    • Clubbing of the fingertips
    • Renal disorders, especially nephrolithiasis
    • Amyloidosis

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    Related Documents

    Pathophysiology of Inflammatory Bowel Disease PDF

    Description

    This quiz covers the epidemiology of inflammatory bowel diseases, including the hygiene hypothesis and its relation to improved food storage and changes in gut microbiome composition.

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