Inflammatory Bowel Disease Questions & Answers

Updated: Oct 17, 2017
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

What is inflammatory bowel disease (IBD)?

What are the symptoms of inflammatory bowel disease (IBD)?

Which symptoms of inflammatory bowel disease (IBD) may be associated with inflammatory damage of the digestive tract?

Which physical findings are related to the severity of inflammatory bowel disease (IBD)?

What is the role of lab testing in the diagnosis and management of inflammatory bowel disease (IBD)?

What is the role of imaging in the evaluation of inflammatory bowel disease (IBD)?

What is the medical approach to treatment of inflammatory bowel disease (IBD)?

Which medications are used in the treatment of inflammatory bowel disease (IBD)?

What is the role of surgery in the management of inflammatory bowel disease (IBD)?

What are the surgical options for treatment of inflammatory bowel disease (IBD)?

What is inflammatory bowel disease (IBD)?

What is the overlap in extraintestinal symptoms of ulcerative colitis (UC) and Crohn disease (CD)?

What is the role of inflammation in the manifestation of inflammatory bowel disease (IBD)?

When is surgical intervention curative for inflammatory bowel disease (IBD)?

What is the pathophysiology of Crohn disease (CD)?

What is the role of genetics in the pathogenesis of inflammatory bowel disease (IBD)?

What is the role of inflammatory mediators in the pathogenesis of inflammatory bowel disease (IBD)?

How is inflammatory bowel disease (IBD) studied in animals?

How do the characteristics of inflammation vary between ulcerative colitis (UC) and Crohn disease?

What is the pathophysiology of ulcerative colitis (UC)?

How is the rectum involvement in Crohn disease (CD)?

Why is the incidence of gallstones and kidney stones increased in Crohn disease (CD)?

Which characteristics define the etiology of inflammatory bowel disease (IBD)?

What is the primary cause of inflammatory bowel disease (IBD)?

What are the environmental risk factors of inflammatory bowel disease (IBD)?

What are the genic risks of inflammatory bowel disease (IBD)?

Which genes are associated with inflammatory bowel disease (IBD)?

Which genetic loci are involved in the etiology of Crohn disease (CD)?

What is the role of the interlectin gene (ITLN1) in the etiology of Crohn disease (CD)?

What is the role of single nucleotide polymorphisms in the etiology of inflammatory bowel disease (IBD)?

Where are inflammatory bowel disease (IBD)-susceptibility genes?

What is the genetic predisposition for ulcerative colitis (UC)?

Where have susceptibility genetic loci been found for ulcerative colitis (UC)?

How much do genetic influences increase the risk for ulcerative colitis (UC)?

What is the role of smoking in the etiology of inflammatory bowel disease (IBD)?

How does the incidence of ulcerative colitis compare to Crohn disease?

What is the prevalence of inflammatory bowel disease (IBD) in the US?

What are the racial predilections for inflammatory bowel disease (IBD) in the US?

How does the prevalence of inflammatory bowel disease (IBD) vary by sex?

How does the incidence of inflammatory bowel disease (IBD) vary by age?

What is the global prevalence of inflammatory bowel disease (IBD)?

What are the extraintestinal complications of inflammatory bowel disease (IBD)?

What is the mortality rate for inflammatory bowel disease (IBD)?

What is the likelihood of malignancy in patients with inflammatory bowel disease (IBD)?

Where can more information on malignancy in inflammatory bowel disease (IBD) be found?

What are the morbidities associated with inflammatory bowel disease (IBD)?

What is the incidence of inflammatory bowel disease (IBD) in patients with asthma or COPD?

What are the risk factors for psychologic morbidity in inflammatory bowel disease (IBD)?

What is the recurrence rate of ulcerative colitis (UC)?

What is the probability of progression of ulcerative colitis (UC)?

What treatment is considered curative for ulcerative colitis (UC)?

What is the risk of colorectal cancer in patients with ulcerative colitis (UC)?

What is the clinical course of Crohn disease (CD)?

What is the rate of remission in patients with Crohn disease (CD)?

When is surgery indicated for Crohn disease (CD)?

What is the likelihood of recurrence of perianal fistulas in Crohn disease (CD)?

What is the quality of life in patients with Crohn disease (CD) compared to those with ulcerative colitis?

What are the intestinal complications of inflammatory bowel disease (IBD)?

What are the rates of the most common extraintestinal complications inflammatory bowel disease (IBD)?

What are the extraintestinal complications of inflammatory bowel disease (IBD) in Swiss patients?

What are the benefits of patient education about inflammatory bowel disease (IBD)?

What is the Crohn's & Colitis Foundation of America and how can it assist patients with inflammatory bowel disease (IBD)?

Presentation

What are the clinical manifestations of inflammatory bowel disease (IBD)?

What are the systemic symptoms associated with inflammatory bowel disease (IBD)?

How are symptoms of inflammatory bowel disease (IBD) associated with inflammatory damage?

What are the physical findings characteristic of inflammatory bowel disease (IBD)?

What are the physical findings characteristic of Crohn disease (CD)?

What should be included in the physical exam of patients with inflammatory bowel disease (IBD)?

DDX

What is the involvement of the small intestine in inflammatory bowel disease (IBD)?

Why should eating disorders be included in the differential diagnoses of inflammatory bowel disease (IBD)?

Why are so many conditions included in the differential diagnoses of inflammatory bowel disease (IBD)?

When is Crohn disease (CD) frequently diagnosed?

Which conditions should be included in the differential diagnoses of inflammatory bowel disease (IBD) when diarrhea is a dominant symptom?

Which conditions should be included in the differential diagnoses of inflammatory bowel disease (IBD) when abdominal pain, GI bleeding, and/or intestinal ulceration are predominant symptoms?

What are the differential diagnoses for Inflammatory Bowel Disease?

Workup

What is the role of lab studies in the evaluation of inflammatory bowel disease (IBD)?

What tests should be included in the evaluation of inflammatory bowel disease (IBD) in patients who are immunosuppressed or from developing countries?

What is the role of CBC count in the diagnosis of inflammatory bowel disease (IBD)?

What is the diagnostic significance of anemia in the evaluation of inflammatory bowel disease (IBD)?

What is the diagnostic significance of vitamin B12 deficiency in the evaluation of inflammatory bowel disease (IBD)?

What is the role of serum iron studies in the evaluation of inflammatory bowel disease (IBD)?

When are folate supplements indicated in the management of inflammatory bowel disease (IBD)?

How is nutritional status assessed in patients with inflammatory bowel disease (IBD)?

What is the role of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of fecal calprotectin levels in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of perinuclear antineutrophil cytoplasmic antibodies (pANCA) in the diagnosis of inflammatory bowel disease (IBD)?

What is the diagnostic significance of positive perinuclear antineutrophil cytoplasmic antibodies (pANCA) results in the evaluation of inflammatory bowel disease (IBD)?

What is the significance of a greater number of positive anti-Saccharomyces cerevisiae antibodies (ASCA) in the evaluation of inflammatory bowel disease (IBD)?

What is the role of stool culture in the diagnosis of inflammatory bowel disease (IBD)?

When is the assessment of cytomegalovirus colitis indicated in the evaluation of inflammatory bowel disease (IBD)?

What is the most common cause of acute terminal ileitis in inflammatory bowel disease (IBD)?

What is the role of radiography in the diagnosis of inflammatory bowel disease (IBD)?

What is toxic megacolon in inflammatory bowel disease (IBD)?

What is the role of barium enema imaging for the diagnosis of inflammatory bowel disease (IBD)?

How are abnormalities of inflammatory bowel disease (IBD) described on barium studies?

What are findings of barium enema suggestive of inflammatory bowel disease (IBD)?

What radiographs findings are characteristic of inflammatory bowel disease (IBD)?

What are findings of a small bowel radiography series characteristic of inflammatory bowel disease (IBD)?

Why must independent confirmation of the diagnosis of inflammatory bowel disease (IBD) be sought after barium enema?

When is a small bowel radiography series used for the diagnosis of inflammatory bowel disease (IBD)?

What is the role of small bowel enteroclysis in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of fistulographic studies in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of ultrasonography in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of CT scanning in the diagnosis of inflammatory bowel disease (IBD)?

When is CT scanning used in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of MRI in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of CT enterography in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of a colonoscopy in the diagnosis of inflammatory bowel disease (IBD)?

What are the colonoscopy or sigmoidoscopy findings characteristic of inflammatory bowel disease (IBD)?

What is the accuracy of a colonoscopy with ileoscopy in the assessment of Crohn disease (CD)?

What is the role of colonoscopy in the treatment of inflammatory bowel disease (IBD)?

What are the complications associated with endoscopic procedures for the evaluation of inflammatory bowel disease (IBD)?

What is the role of colonoscopy in the surveillance of inflammatory bowel disease (IBD)?

What is the role of flexible sigmoidoscopy in the diagnosis of inflammatory bowel disease (IBD)?

What is the role of esophagogastroduodenoscopy (EGD) in the diagnosis of inflammatory bowel disease (IBD)?

How is capsule enteroscopy used for the diagnosis of inflammatory bowel disease (IBD)?

What is the major risk associated with enteroscopy for the diagnosis of inflammatory bowel disease (IBD)?

What is double balloon enteroscopy and how is it used in the diagnosis of inflammatory bowel disease (IBD)?

Where is inflammation seen in ulcerative colitis (UC)?

What are the histologic characteristics of ulcerative colitis (UC)?

What is involved in the inflammation of the colon in inflammatory bowel disease (IBD)?

What are the typical histologic findings of ulcerative colitis (UC)?

What is the histology of Crohn disease (CD)?

What are the histologic findings characteristic of Crohn disease (CD)?

Treatment

What are the goals of therapy for inflammatory bowel disease (IBD)?

What are the treatment options for inflammatory bowel disease (IBD)?

What are the benefits of deep mucosal healing in the treatment of inflammatory bowel disease (IBD)?

What is included in the symptomatic therapy of inflammatory bowel disease (IBD)?

How should corticosteroid therapy for inflammatory bowel disease (IBD) flares be administered?

When are immunomodulators and biologic agents indicated in the treatment of inflammatory bowel disease (IBD)?

What are the treatment options for low bone density in inflammatory bowel disease (IBD)?

What is the best approach for the treatment of mild to moderate inflammatory bowel disease (IBD?)

What is the first step in medication therapy for inflammatory bowel disease (IBD)?

What is the second step in medication therapy for inflammatory bowel disease (IBD)?

When are immune modifying agents indicated in the treatment of inflammatory bowel disease (IBD)?

When is a step-down approach used in the treatment of inflammatory bowel disease (IBD)?

Why is weaning off steroid therapy a priority in the treatment of inflammatory bowel disease (IBD)?

What are the oral aminosalicylates used in the US for the treatment of inflammatory bowel disease (IBD)?

What is the role of oral aminosalicylates in the treatment of inflammatory bowel disease (IBD)?

Which probiotic agents are used in the diagnosis of inflammatory bowel disease (IBD)?

What are the most commonly used antibiotics in the treatment of inflammatory bowel disease (IBD)?

What is the role of antibiotics in the treatment of inflammatory bowel disease (IBD)?

What are the potential adverse effects of antibiotics in the treatment of inflammatory bowel disease (IBD)?

When are corticosteroids indicated for treatment of inflammatory bowel disease (IBD)?

How are corticosteroids administered for the treatment of inflammatory bowel disease (IBD)?

What are the potential complications of corticosteroid in the treatment of inflammatory bowel disease (IBD)?

When should patients be weaned off of corticosteroid therapy for inflammatory bowel disease (IBD)?

What are the risks of long-term use of corticosteroids for the treatment of inflammatory bowel disease (IBD)?

How often should bone mineral density be assessed in patients with inflammatory bowel disease (IBD)?

What is the role of IV corticosteroids in the treatment of inflammatory bowel disease (IBD)?

What is the optimal dosing of oral corticosteroids for the treatment of inflammatory bowel disease (IBD)?

What is the role of budesonide in the treatment of inflammatory bowel disease (IBD)?

What is the role of topical corticosteroids in the treatment of inflammatory bowel disease (IBD)?

When are corticosteroid suppositories indicated the treatment of inflammatory bowel disease (IBD)?

What is the effectiveness of immune modifiers in the treatment of inflammatory bowel disease (IBD)?

What is the role of 6-mercaptopurine (6-MP) and azathioprine (AZA) in the treatment of inflammatory bowel disease (IBD)?

What is the role of intramuscular MTX in the treatment of inflammatory bowel disease (IBD)?

What are the American Gastroenterological Association (AGA) recommendations for the use of 6-mercaptopurine (6-MP) and azathioprine (AZA) in the treatment of inflammatory bowel disease (IBD)?

What are possible hematologic adverse effects of immune modifiers for the treatment of inflammatory bowel disease (IBD)?

What monitoring is needed during immune modifier therapy for inflammatory bowel disease (IBD)?

What are possible adverse effects of immune modifiers for the treatment of inflammatory bowel disease (IBD)?

What is the role of infliximab (Remicade) in the treatment of inflammatory bowel disease (IBD)?

What is the effectiveness of anti-TNF-alpha agents for the treatment of inflammatory bowel disease (IBD)?

Which patients are most likely to benefit for anti-TNF-alpha monoclonal antibodies for the treatment of inflammatory bowel disease (IBD)?

What are the risk factors for relapse of inflammatory bowel disease (IBD) following cessation of infliximab therapy?

What is the role of infliximab in the treatment Crohn disease fistula?

What are the adverse effects of infliximab for the treatment of inflammatory bowel disease (IBD)?

Which anti-TNF-alpha agents are used in the treatment of inflammatory bowel disease (IBD)?

What is the role of natalizumab in the treatment of inflammatory bowel disease (IBD)?

What is the role of vedolizumab in the treatment of inflammatory bowel disease (IBD)?

Which experimental agents have shown efficacy in the treatment of inflammatory bowel disease (IBD)?

When is inpatient treatment indicated for inflammatory bowel disease (IBD)?

How is suspected bowel obstruction managed in inflammatory bowel disease (IBD)?

What needs to be considered prior to performing a colonoscopic evaluation in hospitalized patients with inflammatory bowel disease (IBD)?

Which treatment modifications are made upon clinical improvement of hospitalized patients with inflammatory bowel disease (IBD?)

What treatments should be considered for hospitalized patients with inflammatory bowel disease (IBD) who have not progressed with initial therapy?

What are the discharge requirements for patients with inflammatory bowel disease (IBD)?

When should step-down therapy be considered in the management of inflammatory bowel disease (IBD)?

What are the treatment options for refractory inflammatory bowel disease (IBD)?

What is the role of monoclonal antibodies in the treatment of refractory inflammatory bowel disease (IBD)?

How does smoking cessation affect patients with inflammatory bowel disease (IBD)?

What is included in the top-down approach to the treatment of inflammatory bowel disease (IBD)?

What are common comorbidities in older patients with inflammatory bowel disease (IBD)?

How are adverse medication interactions managed in older patients with inflammatory bowel disease (IBD)?

Which drugs commonly used to treat cardiovascular and rheumatologic disorders may trigger inflammatory bowel disease (IBD) flares?

When are anti-TNF agents contraindicated in the treatment of inflammatory bowel disease (IBD)?

What is the role of surgery in the treatment of inflammatory bowel disease (IBD)?

When is colectomy indicated in the treatment of inflammatory bowel disease (IBD)?

What are the most common surgical options for the treatment of inflammatory bowel disease (IBD)?

What is the role of ileal pouch/anal anastomosis (IPAA) in the treatment of inflammatory bowel disease (IBD)?

What is the major complication of the ileal pouch/anal anastomosis (IPAA) in the treatment of inflammatory bowel disease (IBD)?

What are the surgical options for fulminant colitis in inflammatory bowel disease (IBD)?

What are risk factors for postoperative complications in inflammatory bowel disease (IBD)?

What are the surgical options for patients with inflammatory bowel disease (IBD) who plan on becoming pregnant?

What are the indications for surgical intervention in Crohn disease (CD)?

What are the limitations to surgical treatment of Crohn disease (CD)?

What is the role of segmental resection in the treatment of inflammatory bowel disease (IBD)?

What is the role of bowel-sparing stricturoplasty in the treatment of inflammatory bowel disease (IBD)?

What are the indications for ileostomy or colostomy in the treatment of inflammatory bowel disease (IBD)?

How are symptomatic enteroenteric fistulas treated in inflammatory bowel disease (IBD)?

What are contraception options for women with inflammatory bowel disease (IBD)?

Which medications should be minimized prior to surgery for inflammatory bowel disease (IBD)?

What are the World Gastroenterology Organization (WGO) recommendations for tapering corticosteroids prior to surgery for inflammatory bowel disease (IBD)?

What is the role of dietary or lifestyle changes in the treatment of inflammatory bowel disease (IBD)?

Which dietary modifications may be beneficial in the management of inflammatory bowel disease (IBD)?

What is the role of vitamin supplementation in the management of inflammatory bowel disease (IBD)?

What is the role of activity modification in the management of inflammatory bowel disease (IBD)?

How is inflammatory bowel disease (IBD) managed during pregnancy?

How is fertility affected in women with inflammatory bowel disease (IBD)?

Which agent is contraindicated in women with inflammatory bowel disease (IBD) who are considering pregnancy?

How does sulfasalazine affect the fertility of men with inflammatory bowel disease (IBD)?

How does parental inflammatory bowel disease (IBD) affect infant health?

Which treatments are considered safe for pregnant patients with inflammatory bowel disease (IBD)?

When is effective contraception required during the treatment of inflammatory bowel disease (IBD)?

What is the effect of abdominal colectomy with ileal pouch/anal anastomosis (IPAA) for inflammatory bowel disease (IBD) on fertility?

When should women with inflammatory bowel disease (IBD) plan conception?

What causes reduced effectiveness of oral contraceptives in women with inflammatory bowel disease (IBD)?

Which agents used to treat inflammatory bowel disease (IBD) can be detected in breast milk?

What are the options for infant feeding in women taking immune modifiers for inflammatory bowel disease (IBD)?

Which antibiotics are contraindicated in breast-feeding women with inflammatory bowel disease (IBD)?

Which anti-TNF agents are not found in the breast milk of women with inflammatory bowel disease (IBD)?

What is the significance of topical agents excreted in breast milk of women with inflammatory bowel disease (IBD)?

Which specialist consultations are needed for the diagnosis and treatment of inflammatory bowel disease (IBD)?

Medications

Which experimental treatments hold promise in the treatment of inflammatory bowel disease (IBD)?

What is the effectiveness of treatments for Crohn disease (CD)?

What is the stepwise approach to treating inflammatory bowel disease (IBD)?

Which medications in the drug class Anticholinergic, Antispasmodic Agents are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class Antidiarrheals are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class Proton Pump Inhibitors are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class Histamine H2 Antagonists are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class Alpha 4 Integrin Inhibitors are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class TNF Inhibitors are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class Immunosuppressants are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class Corticosteroids are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class Antibiotics, Other are used in the treatment of Inflammatory Bowel Disease?

Which medications in the drug class 5-Aminosalicylic Acid Derivatives are used in the treatment of Inflammatory Bowel Disease?