Podcast
Questions and Answers
What is the primary characteristic of Irritable Bowel Syndrome (IBS)?
What is the primary characteristic of Irritable Bowel Syndrome (IBS)?
- A chronic inflammatory condition of the bowel.
- Always associated with rectal bleeding.
- A functional GI disorder with altered bowel habits and no significant structural inflammation. (correct)
- Exclusively an allergic response to dairy products.
Which management strategies are commonly used for Irritable Bowel Syndrome (IBS)?
Which management strategies are commonly used for Irritable Bowel Syndrome (IBS)?
- Radical bowel surgery.
- Low FODMAP diet and antispasmodics. (correct)
- Biologic therapy.
- High-dose steroids.
What is Orofacial Granulomatosis (OFG)?
What is Orofacial Granulomatosis (OFG)?
- Exclusively a viral infection of the gums.
- Unrelated to any immune factors.
- A granulomatous condition affecting orofacial tissues, sometimes mimicking Crohn’s in the mouth. (correct)
- A fungal disease of the sinuses.
Which of the following might be included in a typical treatment approach for Orofacial Granulomatosis (OFG)?
Which of the following might be included in a typical treatment approach for Orofacial Granulomatosis (OFG)?
What is Sarcoidosis?
What is Sarcoidosis?
What is a common treatment for symptomatic sarcoidosis?
What is a common treatment for symptomatic sarcoidosis?
How does erythema nodosum typically manifest?
How does erythema nodosum typically manifest?
Which conditions can be associated with erythema nodosum?
Which conditions can be associated with erythema nodosum?
Which of the following statements best describes pyoderma gangrenosum?
Which of the following statements best describes pyoderma gangrenosum?
A patient presents with Gastro-Oesophageal Reflux Disease (GORD). Initial management should include what?
A patient presents with Gastro-Oesophageal Reflux Disease (GORD). Initial management should include what?
How do proton pump inhibitors (PPIs) like omeprazole reduce gastric acid secretion?
How do proton pump inhibitors (PPIs) like omeprazole reduce gastric acid secretion?
What constitutes standard triple therapy for Helicobacter pylori infection?
What constitutes standard triple therapy for Helicobacter pylori infection?
For which condition are anti-diarrheal or anti-spasmodic agents most commonly prescribed?
For which condition are anti-diarrheal or anti-spasmodic agents most commonly prescribed?
What is the PRIMARY utility of faecal calprotectin testing in gastroenterology?
What is the PRIMARY utility of faecal calprotectin testing in gastroenterology?
The Urea Breath Test is the primary diagnostic tool for which gastrointestinal condition?
The Urea Breath Test is the primary diagnostic tool for which gastrointestinal condition?
A jejunal (small intestine) biopsy that shows villous atrophy is most indicative of:
A jejunal (small intestine) biopsy that shows villous atrophy is most indicative of:
Which lifestyle factor presents a paradoxical effect, potentially worsening Crohn’s disease but offering slight relief in ulcerative colitis?
Which lifestyle factor presents a paradoxical effect, potentially worsening Crohn’s disease but offering slight relief in ulcerative colitis?
What is a cornerstone of peptic ulcer disease prevention?
What is a cornerstone of peptic ulcer disease prevention?
What is a primary recommendation for GORD (Gastro-Oesophageal Reflux Disease) prevention?
What is a primary recommendation for GORD (Gastro-Oesophageal Reflux Disease) prevention?
In the context of Gastrointestinal health, which diagnostic approach offers the MOST comprehensive assessment of small intestinal pathology, surpassing conventional endoscopy and imaging techniques?
In the context of Gastrointestinal health, which diagnostic approach offers the MOST comprehensive assessment of small intestinal pathology, surpassing conventional endoscopy and imaging techniques?
Which of the following options BEST describes Inflammatory Bowel Disease (IBD)?
Which of the following options BEST describes Inflammatory Bowel Disease (IBD)?
Key factors implicated in the development of IBD include which of the following?
Key factors implicated in the development of IBD include which of the following?
Which of the following represents a cornerstone of IBD therapy for moderate-to-severe cases that are not adequately controlled by basic measures?
Which of the following represents a cornerstone of IBD therapy for moderate-to-severe cases that are not adequately controlled by basic measures?
What are the key characteristics of ulcerative colitis?
What are the key characteristics of ulcerative colitis?
Which of the following is a typical symptom of ulcerative colitis?
Which of the following is a typical symptom of ulcerative colitis?
Which treatment is most commonly used for acute flares of ulcerative colitis?
Which treatment is most commonly used for acute flares of ulcerative colitis?
Crohn’s disease can affect which part(s) of the gastrointestinal tract?
Crohn’s disease can affect which part(s) of the gastrointestinal tract?
What effect does smoking have on Crohn’s disease?
What effect does smoking have on Crohn’s disease?
Why is surgical removal of affected bowel segments NOT considered a curative approach for Crohn’s disease, unlike in some cases of ulcerative colitis?
Why is surgical removal of affected bowel segments NOT considered a curative approach for Crohn’s disease, unlike in some cases of ulcerative colitis?
A patient presents with chronic abdominal pain, bloating, and altered bowel habits (both diarrhea and constipation) but no visible signs of inflammation or structural abnormalities in the gastrointestinal tract. Which condition is MOST likely?
A patient presents with chronic abdominal pain, bloating, and altered bowel habits (both diarrhea and constipation) but no visible signs of inflammation or structural abnormalities in the gastrointestinal tract. Which condition is MOST likely?
What is the mechanism of action for Proton Pump Inhibitors (PPIs) like omeprazole?
What is the mechanism of action for Proton Pump Inhibitors (PPIs) like omeprazole?
Standard triple therapy for Helicobacter pylori infection includes which combination of medications?
Standard triple therapy for Helicobacter pylori infection includes which combination of medications?
For what purpose are anti-diarrheal or anti-spasmodic agents MOST commonly prescribed in the context of gastrointestinal disorders?
For what purpose are anti-diarrheal or anti-spasmodic agents MOST commonly prescribed in the context of gastrointestinal disorders?
A patient presents with gastrointestinal symptoms, and a faecal calprotectin test is ordered. Which of the following BEST describes the primary utility of this test?
A patient presents with gastrointestinal symptoms, and a faecal calprotectin test is ordered. Which of the following BEST describes the primary utility of this test?
Which of the following statements accurately describes the paradoxical effect of smoking on Inflammatory Bowel Disease (IBD)?
Which of the following statements accurately describes the paradoxical effect of smoking on Inflammatory Bowel Disease (IBD)?
Which of the following best characterizes the inflammation pattern seen in Ulcerative Colitis?
Which of the following best characterizes the inflammation pattern seen in Ulcerative Colitis?
What is the primary mechanism by which biologics like infliximab are thought to help in IBD?
What is the primary mechanism by which biologics like infliximab are thought to help in IBD?
A patient newly diagnosed with Crohn's disease asks about the long-term impact of smoking on their condition. What is the MOST accurate response?
A patient newly diagnosed with Crohn's disease asks about the long-term impact of smoking on their condition. What is the MOST accurate response?
Which of the following is LEAST likely etiology of Inflammatory Bowel Disease (IBD)?
Which of the following is LEAST likely etiology of Inflammatory Bowel Disease (IBD)?
In a patient experiencing a flare-up of ulcerative colitis, which of the following would be the MOST appropriate initial treatment?
In a patient experiencing a flare-up of ulcerative colitis, which of the following would be the MOST appropriate initial treatment?
Why is it generally accepted that surgery is often not a curative option for Crohn's Disease compared to Ulcerative Colitis?
Why is it generally accepted that surgery is often not a curative option for Crohn's Disease compared to Ulcerative Colitis?
A 30-year-old patient with a history of Crohn's disease presents with new-onset perianal fistulas and is currently on a stable dose of aminosalicylates. Which of the following would be the MOST appropriate next step in management?
A 30-year-old patient with a history of Crohn's disease presents with new-onset perianal fistulas and is currently on a stable dose of aminosalicylates. Which of the following would be the MOST appropriate next step in management?
In the context of IBD management, imagine a hypothetical scenario where researchers discover a novel gene, 'GutShield,' responsible for maintaining intestinal barrier integrity and regulating immune responses to commensal bacteria. Individuals with a homozygous recessive mutation in 'GutShield' exhibit severe, early-onset IBD, refractory to conventional therapies. Which of the following experimental approaches would MOST directly address the underlying genetic defect to restore normal immune function and intestinal homeostasis?
In the context of IBD management, imagine a hypothetical scenario where researchers discover a novel gene, 'GutShield,' responsible for maintaining intestinal barrier integrity and regulating immune responses to commensal bacteria. Individuals with a homozygous recessive mutation in 'GutShield' exhibit severe, early-onset IBD, refractory to conventional therapies. Which of the following experimental approaches would MOST directly address the underlying genetic defect to restore normal immune function and intestinal homeostasis?
What is the underlying cause of villous atrophy in coeliac disease?
What is the underlying cause of villous atrophy in coeliac disease?
What is the role of 5-ASA compounds like sulphasalazine in managing ulcerative colitis?
What is the role of 5-ASA compounds like sulphasalazine in managing ulcerative colitis?
In severe or steroid-dependent Inflammatory Bowel Disease (IBD), what is the primary reason for adding immunosuppressants like azathioprine to the treatment plan?
In severe or steroid-dependent Inflammatory Bowel Disease (IBD), what is the primary reason for adding immunosuppressants like azathioprine to the treatment plan?
Why is metronidazole used in Crohn’s disease, particularly when perianal disease or abscesses are present?
Why is metronidazole used in Crohn’s disease, particularly when perianal disease or abscesses are present?
What is the primary mechanism by which biologic agents like infliximab and adalimumab work in treating Inflammatory Bowel Disease (IBD)?
What is the primary mechanism by which biologic agents like infliximab and adalimumab work in treating Inflammatory Bowel Disease (IBD)?
In the context of proctocolitis, which diagnostic method is MOST likely to be used to determine the etiology and severity of the inflammation?
In the context of proctocolitis, which diagnostic method is MOST likely to be used to determine the etiology and severity of the inflammation?
What is the MOST SPECIFIC pathological feature that differentiates Crohn’s disease from ulcerative colitis?
What is the MOST SPECIFIC pathological feature that differentiates Crohn’s disease from ulcerative colitis?
Which of these factors is LEAST likely to trigger or exacerbate orofacial granulomatosis (OFG)?
Which of these factors is LEAST likely to trigger or exacerbate orofacial granulomatosis (OFG)?
If a patient with erythema nodosum is suspected to have underlying sarcoidosis, which additional test would be MOST appropriate to order initially?
If a patient with erythema nodosum is suspected to have underlying sarcoidosis, which additional test would be MOST appropriate to order initially?
In a patient presenting with symptoms suggestive of Gastro-Oesophageal Reflux Disease (GORD), but who has failed to respond to a 4-week trial of a PPI, what would be the MOST appropriate next step in management?
In a patient presenting with symptoms suggestive of Gastro-Oesophageal Reflux Disease (GORD), but who has failed to respond to a 4-week trial of a PPI, what would be the MOST appropriate next step in management?
A patient presents with suspected peptic ulcer disease. After performing an endoscopy, biopsies are taken. Histological analysis reveals the presence of Helicobacter pylori. What is the PRIMARY treatment goal at this stage?
A patient presents with suspected peptic ulcer disease. After performing an endoscopy, biopsies are taken. Histological analysis reveals the presence of Helicobacter pylori. What is the PRIMARY treatment goal at this stage?
A 35-year-old patient is diagnosed with coeliac disease. Besides adhering to a strict gluten-free diet, what other nutritional deficiency is MOST likely to require monitoring and potential supplementation?
A 35-year-old patient is diagnosed with coeliac disease. Besides adhering to a strict gluten-free diet, what other nutritional deficiency is MOST likely to require monitoring and potential supplementation?
Which of the following is the MOST accurate statement regarding the extraintestinal manifestations of Inflammatory Bowel Disease (IBD)?
Which of the following is the MOST accurate statement regarding the extraintestinal manifestations of Inflammatory Bowel Disease (IBD)?
Consider a patient with longstanding Crohn's disease who has developed a fibrostenotic stricture in the ileum causing recurrent partial bowel obstructions. What is the MOST appropriate next step in management if medical therapies have failed to provide adequate relief?
Consider a patient with longstanding Crohn's disease who has developed a fibrostenotic stricture in the ileum causing recurrent partial bowel obstructions. What is the MOST appropriate next step in management if medical therapies have failed to provide adequate relief?
A patient with Ulcerative Colitis who is being treated with infliximab presents to the clinic with a persistent cough, shortness of breath, and a fever. Which opportunistic infection is MOST critical to exclude in this patient, given their immunosuppressed state?
A patient with Ulcerative Colitis who is being treated with infliximab presents to the clinic with a persistent cough, shortness of breath, and a fever. Which opportunistic infection is MOST critical to exclude in this patient, given their immunosuppressed state?
Flashcards
Inflammatory Bowel Disease (IBD)
Inflammatory Bowel Disease (IBD)
A group of chronic inflammatory conditions affecting the GI tract, primarily ulcerative colitis and Crohn’s disease.
IBD Development Factors
IBD Development Factors
Development involves genetic predisposition, immune system issues, environmental factors, and changes in the gut microbiome.
IBD Therapy (Moderate-to-Severe)
IBD Therapy (Moderate-to-Severe)
Therapy includes biologics that target inflammatory mediators.
Ulcerative Colitis
Ulcerative Colitis
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Ulcerative Colitis Symptom
Ulcerative Colitis Symptom
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Ulcerative Colitis Flare Treatment
Ulcerative Colitis Flare Treatment
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Crohn’s Disease
Crohn’s Disease
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Smoking and Crohn’s Disease
Smoking and Crohn’s Disease
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Surgery & Crohn's Disease
Surgery & Crohn's Disease
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Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS)
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IBS Management Strategies
IBS Management Strategies
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Orofacial Granulomatosis (OFG)
Orofacial Granulomatosis (OFG)
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OFG Treatment
OFG Treatment
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Sarcoidosis
Sarcoidosis
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Sarcoidosis Treatment
Sarcoidosis Treatment
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Erythema Nodosum
Erythema Nodosum
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Erythema Nodosum Associations
Erythema Nodosum Associations
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Pyoderma Gangrenosum
Pyoderma Gangrenosum
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Pyoderma Gangrenosum Treatment
Pyoderma Gangrenosum Treatment
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How PPIs Work
How PPIs Work
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H. pylori Triple Therapy
H. pylori Triple Therapy
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Anti-diarrheals/Spasmodics
Anti-diarrheals/Spasmodics
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Fecal Calprotectin Test
Fecal Calprotectin Test
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Urea Breath Test Use
Urea Breath Test Use
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Jejunal Biopsy Finding
Jejunal Biopsy Finding
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Smoking Effect on IBD
Smoking Effect on IBD
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Peptic Ulcer Prevention
Peptic Ulcer Prevention
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GORD Prevention Advice
GORD Prevention Advice
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Why do Faecal calprotectin testing?
Why do Faecal calprotectin testing?
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Key factors implicated in IBD
Key factors implicated in IBD
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Cornerstone of IBD therapy
Cornerstone of IBD therapy
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Ulcerative colitis is characterized by
Ulcerative colitis is characterized by
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A typical symptom of ulcerative colitis
A typical symptom of ulcerative colitis
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Treatments for ulcerative colitis flares
Treatments for ulcerative colitis flares
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Crohn’s disease can affect
Crohn’s disease can affect
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Smoking effect on Crohn’s disease
Smoking effect on Crohn’s disease
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Common IBS strategies
Common IBS strategies
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Typical OFG treatment
Typical OFG treatment
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Symptomatic sarcoidosis treament
Symptomatic sarcoidosis treament
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Erythema nodosum presentation
Erythema nodosum presentation
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Proctocolitis refers to...
Proctocolitis refers to...
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Causes of Proctocolitis
Causes of Proctocolitis
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GORD presentation
GORD presentation
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Initial GORD treatment
Initial GORD treatment
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Peptic ulcer location
Peptic ulcer location
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Study Notes
Inflammatory Bowel Disease (IBD)
- IBD is a group of chronic inflammatory disorders affecting the GI tract, mainly ulcerative colitis and Crohn’s disease.
- Key factors implicated in IBD development are multifactorial: genetic predisposition, immune dysregulation, environmental factors, and gut microbiome.
- Biologics (e.g., infliximab) targeting inflammatory mediators are a cornerstone of IBD therapy for moderate-to-severe cases not controlled by basic measures.
Ulcerative Colitis
- Ulcerative colitis is characterized by mucosal inflammation limited to the colon/rectum with continuous lesions.
- A typical symptom of ulcerative colitis is bloody diarrhoea.
- 5-ASA derivatives (e.g., sulphasalazine) or steroids are commonly used treatments for ulcerative colitis flares.
Crohn’s Disease
- Crohn’s disease can affect any part of the GI tract, often with “skip lesions.”
- Smoking tends to worsen Crohn’s disease.
- Surgery is not curative for Crohn’s disease because the disease often reappears in other segments of the bowel.
Irritable Bowel Syndrome (IBS)
- Irritable Bowel Syndrome (IBS) is primarily a functional GI disorder with altered bowel habits and no significant structural inflammation.
- Common management strategies for IBS include a low FODMAP diet and antispasmodics.
Orofacial Granulomatosis (OFG)
- Orofacial granulomatosis (OFG) is a granulomatous condition affecting orofacial tissues, sometimes mimicking Crohn’s in the mouth.
- A typical treatment approach for OFG might include removal of dietary triggers, topical/systemic steroids, or immunosuppressants.
Sarcoidosis
- Sarcoidosis is a multisystem granulomatous disorder often involving the lungs and lymph nodes.
- In symptomatic sarcoidosis, the mainstay of treatment is often steroids (e.g., prednisolone).
Erythema Nodosum
- Erythema Nodosum commonly presents as tender red nodules on the shins.
- IBD (Crohn’s/UC), infections, or unknown triggers can be associated with erythema nodosum.
Pyoderma Gangrenosum
- Pyoderma gangrenosum is a rare neutrophilic skin ulcer often linked to IBD.
- Treatment of pyoderma gangrenosum typically involves local and systemic immunosuppression (e.g., steroids, immunosuppressants).
Proctocolitis
- Proctocolitis refers to inflammation of the rectum and colon.
- Causes of proctocolitis include radiation, infections, ulcerative colitis, and Crohn’s disease.
Gastro-Oesophageal Reflux Disease (GORD)
- Gastro-oesophageal reflux disease (GORD) most commonly presents with heartburn due to acid reflux and possible oesophagitis.
- A key initial treatment for GORD is lifestyle changes (weight loss, dietary modification) and proton pump inhibitors.
Peptic Ulcer Disease
- Peptic ulcer disease involves ulceration typically in the stomach or duodenum.
- Common causes of peptic ulcers include Helicobacter pylori infection, NSAIDs, alcohol, and smoking.
- Eradication therapy for H. pylori–related peptic ulcer usually involves triple therapy (PPI + two antibiotics).
Helicobacter Pylori Infection
- Helicobacter pylori is a bacterium that colonizes the stomach and is linked to gastritis and peptic ulcers.
- Preventive measures against H. pylori infection include good hygiene practices and possibly screening in high-risk areas.
Coeliac Disease
- Coeliac disease is an autoimmune disorder triggered by gluten, causing small bowel villous atrophy.
- The mainstay of treatment for coeliac disease is a lifelong gluten-free diet.
Drug/Treatment Questions
- Prednisolone (a corticosteroid) is commonly used short-term to control acute IBD flares.
- 5-ASA compounds (e.g., sulphasalazine) are primarily used for mild/moderate ulcerative colitis.
- In more severe or steroid-dependent IBD, immunosuppressants (e.g., azathioprine) are commonly added
- Metronidazole is an antibiotic especially used in Crohn’s disease when there is perianal disease or abscesses (anaerobic infection).
- Biologic agents (infliximab, adalimumab) work by blocking TNF-α or other specific inflammatory mediators.
- Proton Pump Inhibitors (PPIs) such as omeprazole act by blocking the H⁺/K⁺-ATPase in gastric parietal cells to reduce acid secretion.
- Standard triple therapy for H. pylori infection includes PPI + clarithromycin + amoxicillin/metronidazole.
- Anti-diarrheal or anti-spasmodic agents are typically used for symptomatic relief in IBS or mild IBD.
Diagnostic/Investigation Questions
- Faecal calprotectin testing is used to differentiate IBD from IBS by measuring intestinal inflammation.
- The Urea Breath Test is primarily used to diagnose Helicobacter pylori infection.
- A jejunal biopsy confirming villous atrophy is key to diagnosing coeliac disease.
Optional Bonus Questions (Prevention & Other Aspects)
- Smoking can worsen Crohn’s disease but might slightly help ulcerative colitis.
- In peptic ulcer disease, a key prevention strategy is avoiding unnecessary NSAIDs and addressing H. pylori infection.
- For GORD prevention, patients are often advised to elevate the head of the bed and lose weight if obese.
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Description
Overview of Inflammatory Bowel Disease (IBD), including ulcerative colitis and Crohn’s disease. Key factors include genetic predisposition, immune dysregulation, environmental factors. Biologics are a cornerstone of IBD therapy.