Review: Current trends in inflammatory bowel disease: the natural history

Abstract

The description of the prognosis of inflammatory bowel disease (IBD) is based on systematic follow-up of population-based cohorts. A steady increase in incidence of IBD has occurred. The distribution of ulcerative colitis (UC) is fairly uniform with a preponderance of left-sided disease. One-third of Crohn's disease (CD) patients present with colonic disease, one-third with ileocolonic disease and one-third with small bowel disease. IBD is associated with extra-intestinal manifestations (EIMs) in up to 36% of patients. Uveitis and episcleritis are the most common. The cumulative probability of a relapsing course in UC is 90% after 25 years. In CD disease behaviour varies substantially with time. At diagnosis behaviour is inflammatory in 70% of patients. At follow-up there is a change to either stricturing or penetrating disease. Most patients with CD will eventually require surgery. Risk factors for CD recurrence after surgery include penetrating/fistulizing disease behaviour, young age, short duration of disease before first surgery and ileocolonic disease. The incidence of colorectal cancer (CRC) in UC seems to be decreasing. The risk of CRC in CD seems to be equivalent to the risk in UC. Patients with small bowel CD are also at increased risk of small bowel adenocarcinoma. CD is associated with a mortality rate 2070% higher than expected, whereas mortality in UC is equivalent to that of the general population. The improved prognosis of IBD, especially UC, could be due to a chemopreventive effect of the medications used. Further studies are needed to develop the best strategy for the reduction of mortality and cancer risk in IBD.

Epidemiology of inflammatory bowel diseases: New insights from a French population-based registry (EPIMAD)

“…Leur évolution se fait par poussées entrecoupées de périodes de rémissions plus ou moins longues (28)(29)(30). La diversité des manifestations digestives, la présence de lésions extra-intestinales (oculaires, articulaires, cutanées), le risque inéluctable de complications liées notamment à la fibrose et à la dégénérescence cancéreuse (X18 après 20 ans d'évolution d'une maladie atteignant tout le côlon) en font des maladies difficiles à diagnostiquer et à prendre en charge (31)(32)(33)(34).…”

Efficacy and Safety of Adalimumab Versus Infliximab in Patients Suffered From Moderate to Severe Active Ulcerative Colitis

“…The previous studies have suggested that improvement in mucosal healing rates is associated with better long-term outcomes, improved quality of life, and reduced rates of colectomy [27,28,31]. Using data from ACT1 and ACT2 trials, a subsequent study demonstrated that patients treated with IFX had a significantly lower rate of colectomy and hospitalizations by week 54 than those treated with placebo [32].…”

Methacrylic acid-co-butylmethacrylate copolymers: design, characterization and evaluation as encapsulating material for colon targeted formulations

“…Taking the aforementioned information into account, attempts have been made to synthesize copolymers of methacrylic acid and butyl methacrylate in different molar ratios and study the swelling and erosion of the copolymers in simulated gastrointestinal pH condition followed by characterization of the selected copolymers by FTIR, 1 H NMR, PXRD, and DSC. gel permeation chromatography was used to determine the average molecular weights of copolymers.…”

“…In CD, there is transmural inflammation of the entire gastrointestinal tract; while in UC, there are ulcers and inflammation, mainly in the mucosa and submucosa of the colon. [1,2] IBD, which are possible risk factor for colon cancer, are increasing rapidly worldwide and account for almost 15% of all deaths. [3][4][5] The incidence of IBD is increasing mainly in the developing countries and its prevalence in Asia and Middle Eastern countries is 4.9-168.3 per 100,000 persons.…”