Inflammatory bowel disease (IBD) involves chronic inflammation of all or part of your digestive tract. IBD primarily includes ulcerative colitis and Crohn's disease.Severe diarrhea, pain, fatigue and weight loss. IBD can be debilitating and sometimes leads to life-threatening complications.
Doctors use one of two approaches to treatment: "step-up," which starts with milder drugs first, versus "top-down," which gives people stronger drugs earlier in the treatment process.
A total of 698 patients (538 with CD and 160 with UC) were identified; 360 (52%) were men, the median age at IBD diagnosis was 14 years (12–16) and the median follow-up time was 11.5 years (7–15). During follow-up, the mortality rate was 0.84% (6/698) and did not differ from that in the reference population (SMR=1.4 (0.5–3.0); P=0.27). After a median follow-up of 15 years (10–17), 1.3% of patients (9/698) had a cancer: colon (n=2), biliary tract (cholangiocarcinoma; n=1), uterine cervix (n=1), prepuce (n=1), skin (basal cell carcinoma (n=2), hematological (acute leukemia; n=1), and small bowel carcinoid (n=1). There was a significantly increased risk of cancer regardless of gender and age (standardized incidence ratio=3.0 (1.3–5.9); P<0.02). Four out of nine patients who developed a cancer had received immunosuppressants or anti-tumor necrosis factor-α therapy (including combination therapy in three patients).
Compared with the general population, the incidence of CD in asthma and COPD patients was 27% and 55% higher, and the incidence of UC was 30% higher among those with COPD. Among children up to 10 years old in the asthma group and adults aged 50 to 59 in the COPD group, the incidence of CD was more than twice that seen in the general population.Surgery (not curative) most commonly performed in cases of disease complications of the disease; generally consists of conservative resection (eg, potential stricturoplasty vs resective surgery) to preserve bowel length in case future additional surgery needed.