Inflammatory bowel disease (IBD)

Inflammatory bowel disease (IBD) is an immune-mediated chronic intestinal condition. Ulcerative colitis (UC) and Crohn’s disease (CD) are the two major types of IBD.

Ulcerative colitis. This condition involves inflammation and ulcers along the superficial lining of large intestine (colon) and rectum.

Crohn’s disease. This type of IBD is characterized by inflammation of the lining of digestive tract, which often can involve the deeper layers of the digestive tract.

CAUSES

·         Family history. You’re at higher risk if you have a close relative — such as a parent, sibling or child — with the disease.

·         Cigarette smoking.

·         Alcohol

·         Tobacco chewing

·         Allopathic antibiotics

·         Nonsteroidal anti-inflammatory medications. These include ibuprofen, naproxen sodium ,diclofenac sodium

·         Allopathic pain killer drugs

·         INSECTICIDE,PESTICIDE,RODENTICIDE,WEEDICIDE

·         ORGANOPHOSPHORUS  POISON(OP POISON)-Malathoin, Tetron, Parathion,Chlorthoin,Diazion(Tik 20)

·         ORGANO CHLORINES-DDT,Aldrin,Endrin,Endosulfan,Benzene Hexa Chloride

·         Eating chemical pesticide, chemical fertilizer, sprayed vegetables, fruits.

·         Oral contraceptives

PATHOGENESIS

Humans are born sterile and acquire their commensal microbiota initially from the mother during egress through the birth canal and subsequently from environmental sources. A stable configuration of up to 1000 species of bacteria that achieves a biomass of 10^12 colony-forming units per gram of feces is achieved by 3 years of age, which likely persists into adult life

Under physiologic conditions, homeostasis normally exists between the commensal microbiota, epithelial cells that line the interior of the intestines (intestinal epithelial cells) and immune cells within the tissues.

An integrated “supraorganism” (microbiota, intestinal epithelial cells, and immune cells) are affected by specific environmental (e.g., smoking, antibiotics,  NSAIDs, enteropathogens) and genetic factors that, in a susceptible host.

Importantly, the normal, uninflamed intestines contain a large number of immune cells that are in a unique state of activation, in which the gut is restrained from full immunologic responses to the commensal microbiota and dietary antigens by very powerful regulatory pathways that function within the immune system (e.g., T-regulatory cells that express the FoxP3 transcription factor and suppress inflammation).

The mucosal immune system does not normally elicit an inflammatory immune response to luminal contents due to oral (mucosal) tolerance.

Oral tolerance may be responsible for the lack of immune responsiveness to dietary antigens and the commensal microbiota in the intestinal lumen. In IBD this suppression of inflammation is altered, leading to uncontrolled inflammation.

Symptoms

·         Diarrhoea

·         Rectal bleeding

·         Tenesmus(urgency with a feeling of incomplete evacuation)

·         Passage of mucus

·         Crampy abdominal pain

·         Loss of weight

·         Loss of appetite

·         Fever

EXTRAINTESTINAL MANIFESTATIONS

1. Joint: Peripheral arthritis—parallels activity of bowel disease; ankylosing spondylitis and sacroiliitis

2. Skin: Erythema nodosum, aphthous ulcers, pyoderma gangrenosum, cutaneous Crohn’s disease.

3. Eye: Conjunctivitis, episcleritis, iritis, uveitis.

4. Liver: Fatty liver, “pericholangitis” (intrahepatic sclerosing cholangitis), primary sclerosing cholangitis, cholangiocarcinoma, chronic hepatitis.

5. Others: Autoimmune hemolytic anemia, phlebitis, pulmonary embolus (hypercoagulable state), kidney stones, metabolic bone disease.

Prevention

•                    Avoid chemical pesticides, chemical fertilizer for farming

•                    Avoid  herbicides

•                    Avoid weedicides

•                    Avoid rodenticide

•                    Eat organic fruits, vegetable

•                    Regular exercise

•                    Avoid smoking

•                    Eating foods high in fiber

•                    Drinking an adequate amount of fluids

•                    Avoid alcohol

•                    Avoid tobacco

DIAGNOSIS

·         Blood-CBC,CRP

·         Fecal lactoferrin

·         Fecal calprotectin

·         Perinuclear antineutrophil cytoplasmic antibodies (pANCA)

·         Anti-Saccharomyces cerevisiae antibodies (ASCAs)

·         Stool analysis

·         Colonoscopy

·         MRI Abdomen

TREATMENT

HOMEOPATHY MANAGEMENT, MEDICINE