Inflammatory bowel disease

Summary
Inflammatory Bowel Disease (IBD) is a group of diseases, including ulcerative colitis (UC) and Crohn's disease (CD) 1. Commonly seen in young people, 15 to 25 years is the peak age of onset. IBD is a chronic disease that requires long-term treatment. Epidemiological data show that the prevalence of UC in China is about 11.6/105 (2009) 2; And the prevalence of CD in China is about 2.29/105 (1950-2007) 3. In recent years, the incidence of IBD has been increasing globally 4.
Causes

There is no clear pathogenesis of IBD, which is determined by both genetic and environmental factors. IBD is not contagious but is familial clustered, with approximately 14% of IBD patients having a family history of the disease 5. Studies have shown that imbalances in immune homeostasis, leading to excessive tumor necrosis factor-a (TNF-α) production, play an important role in the pathogenesis of IBD6.

Symptions

There are some differences in the common clinical manifestations between CD and UC patients. The gastrointestinal manifestations of CD are mainly diarrhea and abdominal pain, which may have bloody stool1. The gastrointestinal manifestations of UC are mainly persistent or recurrent diarrhea, mucopurulent blood with abdominal pain, tenesmus 1. In addition, patients with CD and UC are also accompanied by various systemic complications such as blurred vision, joint pain, and rash.

Treatment

IBD cannot be cured, the current treatment goal is to achieve better disease control. Treatments for IBD include aminosalicylates, adrenocorticotropic hormone, azathioprine, cyclosporine, biologics etc7. Patients with CD with high risk may be treated directly with anti-TNFα agents.
  

1.  中华医学会消化病学分会炎症性肠病学组. 炎症性肠病诊断与治疗的共识意见（2012年·广州）[J]. 中华消化杂志，2013 ，32（12）：796-813.
2.  欧阳钦. 重症溃疡性结肠炎的处理策略与技巧[J]. 医学新知杂志，2009,19（2）:75-79.
3.  Zheng JJ, Zhu XS, Huangfu Z, et al. Prevalence and incidence rates of Crohn's disease in mainland China: a meta-analysis of 55 years of research[J]. J Dig Dis, 2010, 11(3):161-6.
4.  Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review[J]. Gastroenterology, 2012, 142(1):46-54.
5.  Hodson R. Inflammatory bowel disease[J]. Nature, 2016, 540(7634):S97.
6.  Brand S. Crohn's disease: Th1, Th17 or both? The change of a paradigm: new immunological and genetic insights implicate Th17 cells in the pathogenesis of Crohn's disease[J]. Gut, 2009, 58(8):1152-67.
7.  中华医学会消化病学分会炎症性肠病学组. 炎症性肠病诊断与治疗的共识意见（2018年·北京）[J]. 中华消化杂志，2018 ，38（5）：292-311.

CP-86271 Approved date 2019-4-10