Crohns & Colitis - 4 Flashcards
What is Crohn’s disease?
A type of inflammatory bowel disease affecting the intestines
It can affect both the small and large intestines.
What symptoms did Allison experience that led to her diagnosis?
Progressive abdominal cramps, rectal bleeding, and diarrhea
She also had a painful swelling near the anus that was drained as an abscess.
What is the role of genetics in Crohn’s disease?
Genetic factors may contribute to the development of Crohn’s disease
Allison’s brother has Crohn’s disease, suggesting a potential genetic link.
What are common research methods used to study IBD?
Experiments include:
* Test tube studies
* Animal studies
* Genetic sample analysis
* Bacterial studies
* Treatment testing in humans
* Environmental factor studies
What are the proposed theories about the cause of IBD?
Theories include:
* Infection
* Immune deficiency
* Autoimmunity
* Environmental factors
* Genetic disorder
What are nonspecific inflammatory bowel diseases?
Diseases like Crohn’s and ulcerative colitis with unknown causes
They differ from inflammatory disorders with known causes.
What are some possible infectious causes of IBD?
Infections by:
* Bacteria (e.g., salmonella, E. coli)
* Viruses (e.g., Norwalk virus)
* Parasites (e.g., giardia)
What is the significance of Clostridium difficile in IBD?
It is found in IBD patients during flares but does not cause IBD
IBD may create conditions for its growth.
What is Mycobacterium paratuberculosis associated with?
Johne’s disease in cattle, which resembles Crohn’s disease
Some researchers suggest it may infect humans and cause Crohn’s.
What hypothesis involves viruses as a cause of IBD?
Some researchers speculate about undetected viruses causing IBD
No direct viral link has been consistently found.
What environmental factors are suspected to influence IBD?
Factors include:
* Toxins
* Diet
* Smoking
* Medication use
* Geography
What does twin studies suggest about the cause of IBD?
Environmental factors interact with genetic susceptibility
One twin may develop IBD while the other does not.
What dietary factors may influence the risk of developing IBD?
High intake of:
* Red meat
* Refined sugars
No specific food has been definitively linked to IBD.
Fill in the blank: IBD is often referred to as _______ inflammatory bowel diseases.
nonspecific
True or False: The exact cause of Crohn’s disease is conclusively determined.
False
What is the potential protective factor against IBD in children?
Breastfeeding
It may lower the risk compared to formula feeding.
What has been observed about IBD incidence in developed versus developing countries?
Higher incidence in developed countries
This suggests environmental exposures in developed regions may contribute to IBD.
What are the two main types of inflammatory bowel disease (IBD)?
Crohn’s disease and ulcerative colitis
These are intestinal disorders that can affect different parts of the digestive tract.
What dietary factors may increase the risk of developing IBD?
High in red meat or refined sugars
Specific foods have not been consistently identified as triggers, but certain diets may contribute to risk.
Can dietary changes improve symptoms of IBD?
Yes, modifying the diet may improve disease activity and symptoms once IBD is established
Altering dietary intake does not cause IBD but can affect existing conditions.
What is the hygiene hypothesis in relation to IBD?
Increased cleanliness leads to less exposure to infections, potentially causing an overactive immune response
This hypothesis suggests that lack of exposure to pathogens may contribute to autoimmune diseases.
Do psychological factors play a role in causing IBD?
No, stress and psychological factors have not been shown to cause ulcerative colitis or Crohn’s disease
Many patients report flares associated with stress, but causation has not been established.
What environmental factors are being explored in relation to IBD?
Airborne environmental pollutants and toxins from industrial activities
The impact of these pollutants on the immune system is still under investigation.
How does smoking relate to IBD?
Ulcerative colitis patients are often nonsmokers or former smokers, while Crohn’s disease patients are more likely to be smokers
The interaction of smoking with IBD risk factors is not fully understood.
What medications are known to cause irritation to the intestinal tract?
Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)
These drugs can cause ulcers and damage to the intestinal lining.
What role do antibiotics play in the development of IBD?
Use of antibiotics in early childhood is associated with an increased risk of developing IBD later
Antibiotics may alter the gut microbiome, impacting disease risk.
Do aspirin and NSAIDs cause Crohn’s disease or ulcerative colitis?
No, these drugs have not been shown to cause either disease
They can cause tissue damage but are not direct causes of IBD.
What is the genetic risk factor for IBD?
Approximately 10% to 20% of individuals with IBD have another affected family member
Family history significantly increases the risk of developing IBD.
What is the significance of the NOD-2 gene in Crohn’s disease?
Mutations in the NOD-2 gene can increase the risk of developing Crohn’s disease significantly
Abnormalities in this gene may affect immune response to bacteria in the intestines.
What is the likelihood of siblings developing IBD if one sibling has the disease?
Approximately 1 in 12 chance for Crohn’s disease and 1 in 20 for ulcerative colitis
The risk varies based on the type of IBD present in the family.
What is the risk of children developing IBD if a parent has it?
1 in 15 for Crohn’s disease and 1 in 25 for ulcerative colitis
The risk is higher if the affected parent has Crohn’s disease.
Is there a way to prevent a child from developing IBD if a parent has it?
No effective prevention strategies exist due to unknown triggers
Genetic and environmental interactions are complex and not fully understood.
What do twin studies suggest about the inheritance of IBD?
Identical twins have a higher likelihood of both having IBD compared to fraternal twins
This indicates a strong genetic component in disease susceptibility.
Are Crohn’s disease and ulcerative colitis inherited in a simple manner?
No, multiple genes and factors contribute to the risk of developing IBD
The inheritance pattern is complex and not straightforward like some other genetic traits.
What is the inheritance pattern of Crohn’s disease and ulcerative colitis?
Not passed from parent to child in a simple way; involves multiple genes
Unlike single-gene diseases, IBD requires variations in multiple genes for increased susceptibility.
What has contributed to the increased understanding of IBD in recent years?
Research into genetic factors
Major successes in genetic research are expected to improve understanding and treatment of IBD.
What is recommended before undergoing predictive genetic testing?
Counseling from an expert physician or genetic counselor
This is important to understand the implications of the test results.
What is the risk of developing IBD among first-degree relatives?
Highest risk compared to other family members
The risk is greater for those with Crohn’s disease than ulcerative colitis.
Is genetic testing for IBD currently reliable for routine predictions?
No, it is not sensitive enough for routine use
Results may not be valuable for treatment and could lead to unnecessary anxiety.
What is a potential consequence of a positive genetic test for IBD?
Increased anxiety about symptoms
Family members may become overly vigilant about early signs of the disease.
What is pharmacogenomics?
Use of genetic testing to predict response to medications
It can identify who may respond well to a medication or who may experience side effects.
How can treatments for IBD be tailored to individuals?
Based on their genetic profile
Understanding drug metabolism through genetic factors can guide treatment decisions.
What role does the thiopurine methyltransferase (TPMT) enzyme play in IBD treatment?
Determines how drugs like azathioprine are metabolized
Testing TPMT levels can help predict risk for complications from medication.
What is the unified theory regarding the causes of IBD?
IBD occurs in genetically susceptible individuals triggered by environmental factors
There is no single cause or pathway identified for Crohn’s disease or ulcerative colitis.
What environmental factor has considerable evidence supporting its role in IBD?
Intestinal bacteria
Animal models show IBD does not develop without normal intestinal bacteria.
What is a possible treatment for IBD based on environmental factors?
Antibiotic therapy
This approach may alter the composition of the normal intestinal bacterial population.
What may happen once uncontrolled intestinal inflammation is initiated in a genetically susceptible person?
It may not be possible to completely shut down or decrease the inflammation
This results in intestinal damage and symptoms of IBD becoming evident.
What can be done to manage IBD successfully?
Diet, counseling, medications, and surgery
Ongoing research aims to provide a complete picture of IBD causes.
