Inflammatory bowel syndrome

PURPOSE OF REVIEW: This review aims at summarizing the current knowledge of A20 haploinsufficiency and other paediatric inflammatory disorders with mucosal involvement. RECENT FINDINGS: A20 haploinsufficiency is a newly described autoinflammatory disease caused by loss-of-function mutations in TNFAIP3 that result in the activation of the nuclear factor (NF)-kB pathway. Patients may present with dominantly inherited, early-onset systemic inflammation and a Behçet-like disease, or a variety of autoinflammatory and autoimmune features...

OBJECTIVES: Wheat avoidance in the absence of celiac disease (CD) is common but occurrence of concurrent functional gastrointestinal disorders (FGIDs) in this group is uncertain. The aims of this study were to determine the prevalence of self-reported wheat or gluten sensitivity and doctor diagnosed CD in an Australian population, define the associated gastrointestinal (GI) symptoms and FGIDs, and determine the relationship between self-reported wheat sensitivity, demographic and medical factors...

BACKGROUND AND PURPOSE: Serine proteases are suggested as important players in visceral pain. We investigated their effect by using newly developed serine protease inhibitors with a well-characterized inhibitory profile in a post-inflammatory IBS rat model. EXPERIMENTAL APPROACH: Colitis rats received intrarectal TNBS and controls 0.9% NaCl. Colonoscopies were performed on day 3, to confirm colitis, and later on until mucosal healing. Visceral hypersensitivity was quantified by visceromotor responses (VMR) to colorectal distension, 30 min after intraperitoneal injection of the serine protease inhibitors nafamostat, UAMC-00050 or UAMC-01162...

BACKGROUND: Online psychotherapy has been successfully used as supportive treatment in many chronic illnesses. However, there is a lack of evidence on its role in the management of gastrointestinal (GI) diseases. AIMS: To examine whether online psychological interventions improve mental and physical outcomes in gastrointestinal diseases. METHODS: We searched CINAHL Plus, MEDLINE, EMBASE, Health Management Information Consortium, PsycINFO, British Nursing Index, Cochrane Library, a specialised register of the IBD/FBD Cochrane Group, MEDLINE (PubMed) WHO International Clinical Trial Registry, ClinicalTrials...

Sweet syndrome is a common extraintestinal manifestation in inflammatory bowel disease (IBD). In this research, a 42-year-old man case with colon Crohn's disease is been described. After failure with two anti-TNF therapies, in treatment with azathioprim, it was decided to start a therapeutic target change to Vedolizumab due to a severe outbreak refractory to corticosteroids. 24 hours after the infusion of the new drug, skin lesions appear along with leukocytes with neutrophilia, all suggestive of sweet syndrome later confirmed by histology...

Hypogonadism may be suspected if puberty is delayed. Pubertal delay may be caused by a normal physiological variant, by primary ovarian insufficiency (Turner syndrome), or reflect congenital hypogonadotropic hypogonadism (HH; genetic) or acquired HH (brain lesions). Any underlying chronic disease like inflammatory bowel disease, celiac disease, malnutrition (anorexia or orthorexia), or excessive physical activity may also result in functional HH. Thus, girls with delayed puberty should be evaluated for an underlying pathology before any treatment, including oral contraception, is initiated...

Diverticulosis of the colon is a common condition, and about one fourth of those people develop symptoms, which is called "diverticular disease" (DD). Since there are still some concerns about the diagnosis of diverticular disease, the aim of this review was to analyse current and evolving advances in its diagnosis. Area covered: Analysis of clinical, radiology, laboratory and endoscopic tools to pose a correct diagnosis of DD was performed according to current PubMed literature. Expert commentary: A combination of clinical characteristic of the abdominal pain and fecal calprotectin expression may help to differentiate between Symptomatic Uncomplicated Diverticular Disease (SUDD) and Irritable Bowel Syndrome (IBS)...

Ulcerative colitis (UC) is a chronic inflammatory bowel disease with an age of onset that affects young people during the peak of their reproductive years. Management of flares of disease during pregnancy can be complex and there are few case reports of pregnant women with acute severe ulcerative colitis (ASUC). We present the case of a 31-year-old pregnant woman who at 16 weeks gestation developed ASUC in the context of primary non-response to infliximab therapy. She subsequently underwent an emergency laparoscopic colectomy after failing to respond to hydrocortisone and cyclosporine salvage therapy...

Background: Evidence suggests a role of intestinal microbiota-host interactions in the pathophysiology and symptoms of irritable bowel syndrome (IBS). Objective: The objective of this article is to assess the effects of Lactobacillus paracasei CNCM I-1572 on clinical and gut microbiota-related factors in IBS. Methods: We conducted a multicenter, randomized, double-blind, cross-over, 18-week, placebo-controlled, pilot trial assessing the effect of Lactobacillus paracasei CNCM I-1572 on symptoms, gut microbiota composition, fecal short chain fatty acid (SCFA), immunoglobulin A, and cytokines in IBS...

Background/Aims: The aim of present study is to estimate the effects of Melissa officinalis L. (MO) on visceral hypersensitivity (VH), defecation pattern and biochemical factors in 2 experimental models of irritable bowel syndrome (IBS) and the possible role of nitric oxide. Methods: Two individual models of IBS were induced in male Wistar-albino rats. In the acetic acid model, the animals were exposed to rectal distension and abdominal withdrawal reflex, and the defecation patterns were determined...

Human immunodeficiency virus (HIV) infection progressively destroys CD4+ mononuclear cells leading to profound cellular immune deficiency that manifests as life threatening opportunistic infections and malignancies, i.e., the acquired immune deficiency syndrome (AIDS). Gut microbiota play key roles in the modulation of host metabolism and gene expression, maintenance of epithelial integrity, and mediation of inflammatory and immunity. Hence, the normal intestinal microbiota plays a major role in the maintenance of health and disease prevention...

Salmonelloses are bacterial infections of the faecal peril; they are endemic in some regions of the world. They can colonize almost any organ hematogenously, hence, severe forms may be observed. We report a case of typhoid fever in a 16-year old young adolescent with no medical history, sexually transmitted diseases or sexual intercourses, presenting with necrotic scrotal ulcerations evolving over the past 3 weeks in a context of fever, diarrhoea, weight loss and alteration of the general state. Paraclinical assessment showed 7g/dl hypochromic microcyticanemia with target cells in blood smear and normal hemoglobin electrophoresis, biologic inflammatory syndrome, malabsorption syndrome, cytolysis and hepatic cholestasis 20 times above the normal, hepatosplenomegaly, normal viral serologic testing (HBV, HCV, HIV, EBV and CMV) and positive testing for salmonella...

The central nervous system and gastrointestinal tract form the primary targets of chemotherapy-induced toxicities. Symptoms associated with damage to these regions have been clinically termed chemotherapy-induced cognitive impairment and mucositis. Whilst extensive literature outlines the complex etiology of each pathology, to date neither chemotherapy-induced side-effect has considered the potential impact of one on the pathogenesis of the other disorder. This is surprising considering the close bidirectional relationship shared between each organ; the gut-brain axis...

The aim of this study was to investigate the influence of NUDT15 R139C , thiopurine S-methyltransferase ( TPMT ), and 6-TGN on azathioprine (AZA) induced leukopenia in Chinese autoimmune patients. Among 87 enrolled patients, 23 (26.4%) had leukopenia. The NUDT15 R139C variant was associated with leukopenia ( p = 1.86 × 10-7 ; OR: 7.59; 95% CI: 3.16-18.21). However, TPMT genotype was not shown to be correlated with the incidence of leukopenia ( p = 0.95). There was no significant difference of 6-TGN concentration between patients with or without leukopenia ( p = 0...

Although examination of the stool for ova and parasites times three (O&P ×3) is routinely performed in the United States (US) for the evaluation of persistent and/or chronic diarrhea, the result is almost always negative. This has contributed to the perception that parasitic diseases are nearly non-existent in the country unless there is a history of travel to an endemic area. The increasing number of immigrants from third-world countries, tourists, and students who present with symptoms of parasitic diseases are often misdiagnosed as having irritable bowel syndrome or inflammatory bowel disease...

Psoriasis is a chronic, immune-mediated disorder that affects approximately 7.5 million people in the United States. Individuals with psoriasis may develop cutaneous, articular, and systemic manifestations, which are a source of significant morbidity, heighted risk of mortality. Moreover, and adversely impact patient-reported quality of life. Psoriasis is now recognized as a risk factor for cardiovascular disease, metabolic syndrome, and peripheral vascular disease, inflammatory bowel disease, malignancies and renal disease...

Teduglutide is an analog of glucagon-like peptide 2 (GLP-2) which is approved for the treatment of patients with short bowel syndrome (SBS) who are dependent on parenteral support. Areas covered: Short bowel syndrome is a rare condition that can result from extensive resection of small bowel, congenital abnormalities, or inflammatory conditions that leads to poor nutrient processing capacity of the intestine. In this review, the safety reported in controlled clinical trials and real-world experience with teduglutide are presented in depth...

Peripheral sensitisation of nociceptors during disease has long been recognised as a leading cause of inflammatory pain. However, a growing body of data generated over the last decade has led to the increased understanding that peripheral sensitisation is also an important mechanism driving abdominal pain in highly prevalent functional bowel disorders, in particular irritable bowel syndrome (IBS). As such, the development of drugs that target pain-sensing nerves innervating the bowel, has the potential to be a successful analgesic strategy for the treatment of abdominal pain in both organic and functional gastrointestinal diseases...

Vitiligo is a common skin disorder characterized by idiopathic, progressive cutaneous hypomelanosis. Vitiligo is associated with several comorbid autoimmune, systemic, and dermatological diseases, primarily thyroid disease, alopecia areata, diabetes mellitus, pernicious anemia, systemic lupus erythematosus, rheumatoid arthritis, Addison's disease, inflammatory bowel disease, Sjögren's syndrome, dermatomyositis, scleroderma, ocular and audiological abnormalities, psoriasis, and atopic dermatitis. It is essential to increase awareness of these comorbidities in order to improve the disease burden and quality of life of patients with vitiligo...

BACKGROUND: Serum levels of pro-inflammatory cytokines tend to be increased in irritable bowel syndrome (IBS) patients, or subgroups thereof. Still, the link between cytokine levels and IBS symptoms is unclear. We aim to determine systemic cytokine levels in IBS patients and healthy subjects (HS), confirm the presence of a subset of patients with an increased immune activity and to establish if cytokines are linked to IBS symptoms and pathophysiological factors. METHODS: Serum levels of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF), and IL-10 were measured...