A Review of Crohn's Disease, an Inflammatory ...

A Review of Crohn's Disease, an Inflammatory Bowel Disease A Mortal Affliction Manifestation and Therapy Progression

Author Name : K. Kirubakaran, G. Ramesh, M. Elakiya, R. Hariesh Kumar, R. Ruthicshaw, M.Kalaichandar

ABSTRACT

Crohn's disease is a chronic inflammatory bowel disease of unknown etiology associated with an impaired immune response, with periods of activity and remission. It is characterised by patchy and transmural lesions which can affect the entire gastrointestinal tract, from the mouth to the anus. The most frequent symptoms are abdominal pain and diarrhoea, which can seriously affect patients' quality of life. The increasing incidence and prevalence of the disease in our area has had a large impact on clinical practice, with the rapid development of diagnostic and therapeutic techniques. To reduce the risk of complications, primary care physicians and gastroenterologists should be familiar with the management of the disease.Considering epidemiological, genetic and immunological data, we can conclude that the inflammatory bowel diseases are heterogeneous disorders of multifactorial etiology in which hereditability and environment interact to produce the disease. It is probable that patients have a genetic predisposition for the development of the disease coupled with disturbances in immunoregulation. Several genes have been so far related to the diagnosis of Crohn’s disease. Those genes are related to innate pattern recognition receptors, to epithelial barrier homeostasis and maintenance of epithelial barrier integrity, to autophagy and to lymphocyte differentiation. So far, the most strong and replicated associations with Crohn’s disease have been done with NOD2, IL23R and ATG16L1 genes. Many genes have so far been implicated in prognosis of Crohn’s disease and many attempts have been made to classify genetic profiles in Crohn’s disease. CARD15 Seems Not only a susceptibility gene, but also a disease-modifier gene for Crohn’s disease.

Keywords: Crohn’s disease,Endoscopic Retrograde Cholangiopancreatography,IBD,anti-saccharomycol cerevisiae antibodies,stricturoplasties,NOD2, IL23R.certolizumab, Natalizumab, Ustekinumab, Vedolizumab.s