Inflammatory bowel disease (IBD) describes disorders that involve chronic inflammation of the digestive tract, including ulcerative colitis and Crohn's disease. The exact cause is unknown but is likely related to malfunctions of the immune system. Symptoms vary in severity from mild to severe and include diarrhea, abdominal pain, bleeding, and weight loss. Diagnosis involves blood tests, endoscopy, imaging, and ruling out other potential causes. Treatment aims to reduce inflammation and includes anti-inflammatory drugs, immunosuppressants, antibiotics, and surgery in some cases.

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UNIVERSIDAD TECNICA DE MACHALA
ACADEMIC UNIT OF CHEMICAL
SCIENCES AND HEALTH
MEDICINE SCHOOL
ENGLISH
INTESTINAL
INFLAMMATORY
DISEASE
STUDENTS
William Cruz
Kevin Herrera
TEACHER:
Mgs. Barreto Huilcapi Lina Maribel
CLASS:
EIGHTH SEMESTER ‘’A’’
Machala, El Oro
2018

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Intestinal Inflammatory Disease
Definition
Inflammatory bowel disease is a generic term that describes disorders that involve
chronic inflammation of the digestive tract. Some types of inflammatory bowel
disease are:
 Ulcerative colitis This disease causes lasting inflammation and sores (ulcers)
in the deeper lining of the large intestine (colon) and rectum.
 Crohn's disease. This type of inflammatory bowel disease is characterized by
inflammation of the lining of the digestive tract, which usually extends inward
to the affected tissues.
Both ulcerative colitis and Crohn's disease often have severe diarrhea, abdominal
pain, fatigue and weight loss.
Inflammatory bowel disease can be debilitating and, sometimes, cause complications
that can be life-threatening.

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Etiology
The exact cause of inflammatory bowel disease is still unknown. In the past, it was
suspected that it was related to diet and stress; Now, doctors know that these factors
can aggravate the disease, but they do not cause it.
Malfunction of the immune system is a possible cause. When the immune system
tries to fight off invading viruses or bacteria, an abnormal immune response causes it
to also attack the cells of the digestive tract. Hereditary factors also seem to influence,
since inflammatory bowel disease is more frequent in people who have family
members with this disease. However, most people with inflammatory bowel disease
have no family history.
Signs and symptoms
The symptoms of inflammatory bowel disease vary, depending on the severity of the
inflammation and the region where it appears. The symptoms can range from mild to
severe. You are likely to have periods of active disease followed by periods of
remission.
The common signs and symptoms of both Crohn's disease and ulcerative colitis can
be:
 Diarrhea
 Fever and fatigue
 Pain and abdominal cramps
 Blood in the stool
 Decreased appetite
 Unintentional thinning
Diagnosis
The doctor may diagnose inflammatory bowel disease only after ruling out other
possible causes of your signs and symptoms. To help confirm the diagnosis of

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inflammatory bowel disease, you may need one or more of the procedures and tests
listed below:
Blood test
Analysis for the detection of anemia or infections. The doctor may recommend that
you perform blood tests to detect anemia, a disorder in which there are not enough
red blood cells to transport an adequate level of oxygen to the tissues, or to look for
signs of infection by bacteria or viruses.
Stool occult blood test. You probably need to provide a stool sample so the doctor
can analyze it for hidden blood.
Endoscopic procedures
Colonoscopy This scan allows the doctor to visualize the entire colon through a thin
flexible tube with light that has a built-in camera. During the procedure, the doctor
can also take small samples of tissue (biopsy) for analysis in the laboratory.
Sometimes a sample of tissue can be used to help confirm a diagnosis.
Flexible sigmoidoscopy. The doctor uses a thin flexible tube of light to examine the
rectum and sigmoid, the last part of the colon. If the colon is very inflamed, the
doctor may perform this test instead of a complete colonoscopy.
Upper endoscopy. In this procedure, the doctor uses a thin, flexible, lighted tube to
examine the esophagus, stomach, and first part of the small intestine (duodenum).
Although it is rare that these areas are affected by Crohn's disease, this test can be
recommended if you have nausea and vomiting, difficulty eating or pain in the upper
abdomen.
Endoscopic capsule Sometimes, this test is used to help diagnose Crohn's disease that
affects the small intestine. You must swallow a capsule that has a camera inside it.
The images are transmitted to an engraver that you use in the belt, and then, the
capsule is removed from the body in the stool without causing pain. You may still
need a biopsy endoscopy to confirm the diagnosis of Crohn's disease.
Ball-assisted enteroscopy. In this test, an endoscope is used together with a device
called "overtube." In this way, the doctor can observe more deeply in the small

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intestine, where the standard endoscope does not reach. This technique is useful when
a capsular endoscopy shows abnormalities, but the diagnosis is still in doubt.
Imaging procedures
X-rays If you have severe symptoms, your doctor may use a standard abdominal
radiograph to rule out serious complications, such as a colon perforation.
Computed tomography (CT) scan. You may have a CT scan, a special X-ray
technique that provides more detail than a standard x-ray. With this test, the whole
intestine is observed, as well as the tissues that are outside it. Computed tomography
enterography is a special scan that provides better images of the small intestine. This
test replaced barium radiographs in many medical centers.
Magnetic resonance imaging (MRI). An MRI machine uses a magnetic field and
radio waves to create detailed images of organs and tissues. Magnetic resonance
imaging is especially useful for evaluating a fistula around the anal area (pelvic
magnetic resonance) or the small intestine (magnetic resonance enterography). Unlike
what happens in a CT scan, there is no radiation exposure with magnetic resonance
imaging.
Treatment
The goal of treatment of inflammatory bowel disease is to reduce the inflammation
that causes the signs and symptoms. At best, this not only relieves symptoms, it can
also lead to long-term remission and can reduce the risk of complications. In the
treatment for inflammatory bowel disease, medications or surgery are usually used.
Anti-inflammatory drugs
The administration of anti-inflammatory drugs is usually the first measure for the
treatment of inflammatory bowel disease. These drugs include corticosteroids and
aminosalicylates, such as mesalazine (Asacol HD, Delzicol and others), balsalazide
(Colazal) and olsalazine (Dipentum). The medication you should take will depend on
the area of the colon that is affected.
Inhibitors of the immune system

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These drugs work in different ways to inhibit the immune response that releases
chemicals that cause inflammation of the intestinal lining. For some people, the
combination of these medications works better than just one medication.
Some examples of immunosuppressive drugs are: azathioprine (Azasan, Imuran),
mercaptopurine (Purinethol, Purixan), cyclosporine (Gengraf, Neoral, Sandimmune)
and methotrexate (Trexall).
A class of drugs, called "alpha tumor necrosis factor inhibitors" or "biological drugs,"
works by neutralizing a protein that the immune system produces. For example,
infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi). Other
biological treatments that can be used are natalizumab (Tysabri), vedolizumab
(Entyvio) and ustekinumab (Stelara).
Antibiotics
Antibiotics may be used in addition to other medications or when the infection is
disturbing; for example, in case of perianal Crohn's disease. The antibiotics that are
often prescribed include ciprofloxacin (Cipro) and metronidazole (Flagyl).
Other medications and supplements
In addition to controlling inflammation, some medications can help relieve signs and
symptoms, but always check with your doctor before taking any over-the-counter
medication. Depending on the severity of the inflammatory bowel disease, the doctor
may recommend one or more of the following medications:
Antidiarrheal medications. A fiber supplement, such as plantago powder (Metamucil)
or methylcellulose (Citrucel), may help relieve mild to moderate diarrhea by
increasing the volume of stool. For more intense diarrhea, loperamide (Imodium A-
D) can be effective.
Analgesics. For mild pain, the doctor may recommend acetaminophen (Tylenol and
others). However, ibuprofen (Advil, Motrin IB and others), naproxen sodium (Aleve)
and diclofenac sodium (Voltaren) are likely to worsen symptoms and may even make
the disease worse.

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Iron supplements If you have chronic bowel bleeding, you may have iron deficiency
anemia and need iron supplements.
Calcium and vitamin D supplements. Crohn's disease and the use of steroids to treat it
may increase the risk of osteoporosis, so you may need to take a calcium supplement
with additional vitamin D content.
Prevention
Some of the consequences of Inflammatory Bowel Disease are weight loss, anemia
and malnutrition, caused by the reduced intake of food (in case of suffering
abdominal pain), problems of assimilation of nutrients and increased caloric
expenditure because Inflammation is a process that consumes a lot of energy
(calories). The new diet has, therefore, as its objective to prevent and correct these
problems.
As a general rule, patients should have a diet as varied as possible, paying special
attention to the adequate intake of protein, iron and calcium. There are no scientific
endorsements that show that food can trigger an outbreak so that a priori you should
not stop consuming any of them. However, during the period of an outbreak, special
care must be taken with the intake of milk and fiber if they increase their symptoms
(diarrhea, intestinal obstruction) and limit their consumption.
Bibliography
 Gassull MA, Gomollón F, Obrador A, Hinojosa J, eds. Intestinal
Inflammatory Disease, 2nd edition. Ergon. Madrid, 2002
 Khor B, Gardet A, Xavier RJ. Genetics and pathogenesis of inflammatory
bowel disease. Nature 2011; 474: 307-317
 Aldhous MC, Nimmo ER, Satsangi J. NOD2 / CARD15 and the Paneth cell:
another piece in the genetic jigsaw of inflammatory bowel disease. Gut 2003;
52: 1533-1535.