David S. Rampton - Fast Facts: Inflammatory Bowel Disease

Fast Facts

Fifth edition

Declaration of Independence

This book is as balanced and as practical as we can make it. The views we state are our own, as far as possible evidence-based and entirely independent of any sponsorship, advertising or other support the book may receive from the pharmaceutical industry or other sources.

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Fast Facts: Inflammatory Bowel Disease

First published 2000; second edition 2006; third edition 2008,

reprinted 2009 and 2010; fourth edition 2014

Fifth edition April 2016

Text 2016 David S Rampton, Fergus Shanahan

2016 in this edition Health Press Limited

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ISBN 978-1-910797-13-6

eISBN 978-1-910797-17-4

Rampton DS (David)

Fast Facts: Inflammatory Bowel Disease/

David S Rampton, Fergus Shanahan

Medical illustrations by Dee McLean, London, UK.

Typesetting by Thomas Bohm, User design, UK.

5-ASA: 5-aminosalicylate

AS: ankylosing spondylitis

ASCA: anti-Saccharomyces cerevisiae antibody

ATI: antibodies to infliximab

ATLG 16L1: autophagy-related 16-like 1 gene

BMI: body mass index

CARD15: caspase-activating recruitment domain, member 15 (also known as NOD2)

CDAI: Crohns Disease Activity Index

CMV: cytomegalovirus

COX: cyclo-oxygenase

CRP: C-reactive protein

CT: computed tomography

CUTE: colitis of uncertain type or etiology

ERCP: endoscopic retrograde cholangiopancreatography

GWAS: genome-wide association scan

HACA: human antichimeric antibodies, now known as ATI

HLA: human leukocyte antigen

IBD: inflammatory bowel disease

IFN: interferon

Ig: immunoglobulin

IL: interleukin

IRGM: immunity-related GTPase family, M gene

JAK: Janus kinase

MAP: mitogen-activated protein

MP: mercaptopurine

MRCP: magnetic resonance cholangiopancreatography

MRI: magnetic resonance imaging

NF-B: nuclear [transcription] factor B

NOD2: nucleotide-binding oligomerization domain containing 2; other name for CARD15

NSAIDs: non-steroidal anti-inflammatory drugs

pANCA: perinuclear antineutrophil cytoplasmic antibody

PPAR: peroxisome proliferator-activated receptor

SeHCAT: 75selenium-labeled homocholic acid taurine

TB: tuberculosis

99Tc-HMPAO: 99technetium-labeled hexamethylpropyleneamine oxime

TGF: transforming growth factor

TGN: thioguanine nucleotide

Th: T helper cell

TNF: tumor necrosis factor

TPMT: thiopurine methyltransferase

Treg: regulatory T cells

Inflammatory bowel disease (IBD) comprises two idiopathic chronic relapsing and remitting inflammatory disorders of the gastrointestinal tract: ulcerative colitis and Crohns disease. The swift pace of advances in knowledge, understanding and innovation in the treatment of IBD has driven the need for this new edition.

Here, we continue to emphasize the disturbances of host immune and environmental interactions in the etiopathogenesis of these disorders, in particular the genetically determined disturbances of hostmicrobe interactions. We also highlight recent improvements in our understanding of how best to use immunomodulatory and biological drugs, alone and in combination, and include the most recent innovations in this area.

In the future, increasing efforts will be made to offer personalized treatment to each patient. The selection of specific drugs only after detailed assessment of the genotype and other features of the individual will help us to identify who will respond well and who will respond badly, and thus enable us to use therapeutic agents more appositely.

We must also continue to embrace the holistic approach to management of these chronic diseases. Doctors often used to overlook problems such as anemia, mood disturbance, fatigue and osteoporosis, yet each of these is a common if not always easily reversible cause of impaired quality of life for patients with IBD. In this time of increasing specialization, high technology diagnostics, molecular therapeutics and evidence-based everything, the doctorpatient relationship will come under increasing scrutiny and change. Technology helps to clarify the objective aspects of the disease but not the subjective experience the illness which is unique to each patient.