Inflammatory bowel disease (IBD) represents a group of intestinal disorders that cause prolonged inflammation of the digestive tract.
这digestive tractcomprises the:
- 嘴
- esophagus
- stomach
- small intestine
- large intestine
它负责：
- 分解食物
- extracting nutrients
- removing any unusable material and waste products
炎anywhere along the digestive tract interferes with this normal process. IBD can be very painful and disruptive. In rare cases, it may even be life threatening.
Learn all about IBD, including:
- 不同的类型
- what causes it
- 它的并发症
类型
这Crohn’s & Colitis Foundation of America (CCFA) estimates that
伞术中包括许多疾病。最常见的两个是：
- 溃疡性结肠炎（UC）。This involves inflammation of the large intestine — but only in the digestive tract. It can lead to other non-digestive issues.
- 克罗恩病。这可能会在消化道的任何部分引起炎症。但是，它主要影响小肠的尾端。
IBD的症状因炎症的位置和严重程度而异，但可能包括：
- diarrhea, which occurs when affected parts of the bowel cannot reabsorb water
- 流血溃疡, which may cause blood to show up in the stool (a condition known as血压）
- 胃痛，痉挛和腹胀bowel obstruction
- weight lossand贫血, which can cause延迟身体成长或发展in children
克罗恩病的人也可能会得到canker soresin their mouths. Sometimes溃疡and裂缝也出现在生殖区或肛门周围。
IBD can also be associated with problems outside of the digestive system, such as:
IBD的确切原因是未知的。
Family history and genetics
People who have a parent, sibling, or child with IBD are at a much higher risk of developing it themselves. This is why scientists believe IBD
免疫系统
免疫系统也可能在IBD中发挥作用。
免疫系统normally defends the body from pathogens, which are organisms that cause diseases and infections.
一个细菌或病毒感染消化道可以触发免疫反应。当身体试图对入侵者产生免疫反应时，消化道发炎。
在健康的免疫反应中，当感染消失时，炎症消失了。
但是，对于患有IBD的人，即使没有感染，消化道炎症也会发生。免疫系统改为攻击人体自己的细胞。这被称为自身免疫反应。
当感染治愈后炎症不会消失时，也可能发生IBD。炎症可能持续数月甚至数年。
抽烟
抽烟is主要危险因素之一for developing Crohn’s disease. Smoking also aggravates the pain and othersymptoms associated with Crohn’s disease。它增加了并发症too.
However, UC primarily affects nonsmokers and former smokers.
Ethnicity
IBD is present in all populations. However, according to研究, certain ethnic groups, including white people and一个shkenazi Jews，有较高的发展状况风险。
IBD rates are also rising among Black people in the United Kingdom, especially young people, according to a2011年研究由克罗恩（Crohn's）和英国结肠炎（Colitis）进行。该研究涉及16至24岁的年轻人，因为IBD症状往往在20％到25％的人中年轻。
年龄
IBD can happen at any age, but in most cases, it starts在35岁之前。
环境因素
根据，居住在城市地区和工业化国家的人患IBD的风险更高。
工业化国家的居民也倾向于吃更多的脂肪和加工过的食物，这已被证明与IBD的发展有关
IBD is also
Researchersreviewing the impact of environmental factors on IBD have also found that havinga sedentary lifestyle or jobincreases the risk of IBD.
另一方面，一些研究，包括
性别
IBD tends to affect men and women equally.
一个ccording to a2018 study在45岁以上的男性中，UC通常比同年龄段的女性更为普遍。
另一方面，克罗恩病在14岁以上的女孩和妇女中更为常见。
IBD的可能并发症包括：
- 营养不良导致减肥
- 结直肠癌
- fistulas, or tunnels that go through the bowel wall, creating a hole between different parts of the digestive tract
- 肠道破裂，也称为穿孔
- bowel obstruction
在极少数情况下，严重的IBD可以使您进入震惊。这可能是威胁生命的。冲击通常是由blood lossduring a long, sudden episode of bloody diarrhea.
To diagnose IBD, your doctor will first ask you questions about your family’s medical history and your排便。
然后可以进行一次或多次诊断测试。
粪便样品和血液检查
Stool samples血液检查可用于寻找感染和其他疾病。
血液检查有时也可以使用distinguish between UC and Crohn’s disease。但是，仅血液检查不能用于诊断IBD。
Barium enema
一个钡灌肠is an X-ray exam of the colon and small intestine. In the past, this type of test was often used, but now, other tests have largely replaced it.
灵活的乙状结肠镜检查和结肠镜检查
这些过程在薄而灵活的探测器的末端使用摄像头来查看结肠。
这camera is inserted through the anus. It allows your doctor to look for ulcers, fistulas, and other damage or abnormalities in the rectum and colon.
一个colonoscopycan examine the entire length of the large intestine. Asigmoidoscopyexamines only the last 20 inches of the large intestine — the乙状结肠结肠。
在这些过程中,一个是小样本sue inside the intestine will sometimes be taken. This is called abiopsy。可以在显微镜下检查该样品，并用于诊断IBD。
胶囊内窥镜检查
This test检查小肠，比大肠更难检查。对于测试，您吞下一个装有相机的小胶囊。
相机在小肠移动时拍照。一旦将相机通过凳子，就可以在计算机上看到图片。
仅当其他测试未能找到克罗恩病症状的原因时，才使用该测试。
纯电影或X射线
一个plainabdominal X-rayis used in emergency situations where intestinal rupture is suspected.
CT and MRI scans
CT scansare basically computerized X-rays. They create a more detailed image than a standard X-ray. This makes them useful for examining the small intestine. They can also detect complications of IBD.
MRIs使用磁场形成身体的图像。由于它们不需要辐射，因此比X射线更安全。MRI特别有助于检查软组织和检测瘘管。
CT扫描和MRI可以用来确定IBD如何影响大部分肠。
这re are a number of different treatments for IBD.
Medications
一个nti-inflammatory drugs are the first step in IBD treatment. These drugs help decrease inflammation of the digestive tract. However, they have many side effects.
Corticosteroids
糖皮质激素，一个子类别corticosteroids, are examples of anti-inflammatory drugs used for IBD. They include:
- 布德索尼（UCERIS）
- 泼尼松（泼尼松浓缩，rayos）
- 泼尼松龙（毫米，预言）
- 甲基丙糖酮（Medrol，Depo-Medrol）
这se drugs are available in a variety of forms, including:
- oral tablets
- injections
- 直肠泡沫
它们通常以最短的时间为最低剂量。
5-ASA药物（氨基水杨酸酯）
5-ASA药物（氨基水杨酸酯）也会减少炎症，主要在小肠的最后一部分和结肠。他们包括：
- 巴尔萨拉齐德（Colazal）
- mesalamine (Apriso，Asacol HD，Canasa，Pentasa）
- olsalazine（Dipentum），仅作为品牌药物可用
- 磺胺嗪（azulfidine）
在2019年，美国胃肠病学协会（AGA）针对广泛轻度至中度UC的成年人的释放治疗指南。对于这个小组，他们强烈建议：
- standard-dose oral mesalamine
- diazo-bonded 5-ASA drugs, such as balsalazide and olsalazine
AGA更喜欢低剂量的美赛胺，磺胺丙嗪或根本没有治疗。但是，AGA还说，只要您知道它带来更严重的副作用的风险，就可以服用磺胺嘧啶。
People who do not respond to standard-dose mesalamine or diazo-bonded 5-ASA drugs should try a combination of rectal mesalamine and high-dose oral mesalamine.
Immunomodulators
如果皮质类固醇和5-ASA药物不够，免疫调节剂可能是一个有效的选择。它们防止免疫系统攻击肠并引起炎症。
他们包括：
- 甲氨蝶呤（Otrexup，Trexall，Rasuvo）
- azathioprine(Azasan, Imuran)
- 胃嘌呤（purixan）
这Food and Drug Administration (FDA) has not approved these drugs for the treatment of IBD. However, your doctor may prescribe them anyway. They refer to this asoff-label drug use。
OFF-LABEL DRUGUSEOff-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that hasn’t yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat medical conditions in their patients.
因此，您的医生可以开药，但是他们认为最适合您的护理。
生物制剂
生物制剂是遗传设计的药物，可能是中度至重度IBD患者的选择。
一些生物制剂block tumor necrosis factor (TNF)。肿瘤坏死因子是一个inflammation-triggering化学物质the immune system produces. Excess TNF in the blood is normally blocked, but in people with IBD, higher levels of TNF can lead to more inflammation.
TNF-alpha inhibitors include:
其他生物制剂包括：
生物制剂are not available as generic drugs. Biosimilars, which are cheaper and have been reverse-engineered to produce the same results as biologics, are available for some of these drugs, though.
In 2020, theAgareleased treatment guidelines for people with moderate to severe UC. The guidelines recommend that people who’ve never tried a biologic before opt for infliximab or vedolizumab over adalimumab. Adalimumab is less effective.
You can self-administer adalimumab, which may make it more convenient than the other drugs. If convenience is a concern, it’s fine to choose adalimumab instead.
Other drugs
Other drugs block separate pathways causing inflammation and include:
- 这UCdrug tofacitinib (Xeljanz).这Agarecommends taking this oral drug only if you’ve tried taking tumor necrosis factor α (TNF-α) inhibitors and they aren’t successful for resolving symptoms. However, the FDA has ruled that manufacturers of this drug class, Janus kinase (JAK) inhibitors, must inform JAK inhibitor users of the severe side effects including cardiac events, cancers, and blood clots.
- 抗生素。这些杀死细菌在小肠中可能引发或加剧克罗恩的症状。
- 一个ntidiarrheal medications and laxatives.这些可以帮助您保持肠道的规律。
生活方式的选择
生活方式的选择are important when you have IBD.
- 喝很多液体。This helps you make up for fluids lost in your stool.
- 一个voiding triggers, like dairy products and stressful situations.This can help improve symptoms and reduce flare-ups.
- Exercising and if you smoke, quitting smoking.这se actions can help preserve your health if you have IBD.
Supplements
维生素和矿物质补充剂可以帮助营养缺乏症。例如，铁补充剂可以帮助治疗贫血。
在饮食中添加任何新补品之前，请与您的医生交谈。
手术
手术can sometimes be necessary for people with IBD. Some IBD surgeries include:
- 狭窄成形术以扩大狭窄的肠
- 闭合或去除瘘管
- removal of affected portions of the intestines-for people with Crohn’s disease
- 去除整个结肠和直肠 -for severe cases of UC）
Your doctor will likely recommend a routine colonoscopy to monitor for colorectal cancer, since those with IBD have较高的风险开发它。
您无法阻止IBD的遗传原因。但是您可能能够降低患IBD的风险或通过以下方式防止症状复发：
IBD can cause some discomfort, but actively following your doctor-advised treatment plan, you can manage the disease and live a healthy, active lifestyle.
IBD 雷竞技app官网Healthline是一个免费的应用程序，可通过一对一的消息传递和实时组聊天将您与与IBD一起使用的其他人联系起来，同时还可以访问有关管理IBD的专家批准的信息。
Download the app foriPhone或Android。
您也可以参观Crohn’s & Colitis Foundation有关IBD的资源和更多信息，包括UC和Crohn病。
与了解您正在经历的事情的其他人交谈也很有帮助。