How to best manage common bowel diseases

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In a new review study, researchers found the best way to manage Crohn’s disease.

Crohn’s disease is a type of inflammatory bowel disease (IBD).

It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.

The research was conducted by a team at Michigan Medicine.

On a global level, the rates of Crohn’s disease have been steadily growing over the last several years.

However, the pathogenesis of Crohn’s disease – or how it develops – still remains incompletely understood.

In the study, the team’s analysis included papers on the natural history of the disease, as well its management.

Overall, they analyzed a total of 88 studies, as well as guidelines, editorials and systemic reviews by experts.

Their review highlights that fecal calprotectin, which is a stool marker for inflammation, is a sensitive screening test for inflammatory bowel disease in symptomatic individuals.

Elevations in the calprotectin protein should prompt doctors to further evaluate patients via endoscopy.

They also found stricture formation is a distinct feature of the disease and can cause symptoms such as abdominal pain, cramping and bloating.

Individuals with Crohn’s disease may also have inflammation in their joints, or symptoms that affect their eyes, skin and/or bile ducts.

When a patient is diagnosed with the condition, assessing their risks of disease progression is very important.

Some notable risk factors for a more aggressive disease include (a young) age at diagnosis, smoking, fistula or abscess development, and history of intestinal surgeries.

The team says there have been significant advancements in the treatment of Crohn’s disease over the last several decades, with a number of therapies now widely available to patients to help achieve long-term remission.

Steroids are used on a short-term basis to achieve symptomatic control, but they are not proven to be effective maintenance medications.

There are many immune-suppressive therapies now available to achieve remission. In addition, a strategy of combination therapy is effective when it comes to individuals with moderate to severe disease.

Their review also recommends that clinicians monitor for adverse effects related to immune suppressive therapy, like lymphoma, skin cancer and/or serious infections.

One author of the study is Kelly Cushing, M.D., a clinical lecturer and gastroenterologist at Michigan Medicine.

The study is published in JAMA Network Open.

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