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Inflammatory Bowel Disease (IBD), ., - Coggle Diagram
Inflammatory Bowel Disease (IBD)
What is IBD?
IBD is categorized by a group of autoimmune diseases that displays features of elements of the digestive system attacking the body's own immune system.
Two major conditions known as Crohn's Disease and Ulcerative Colitis (UC) come under a subgrouping of IBD
Crohn's can affect any part of the GI tract, whereas CU primarily affects the colon.
Clinical features
Abdominal Pain - Patients with UC may experience pain in the left lower quadrant whereas patients with Crohn's will complain of pain in the right lower quadrant.
UC may show symptoms of diarrhoea and rectal bleeding
Psychological stress can also participate in exacerbating the below symptoms.
Expressing feelings of helplessness or a poor quality of life
Onset usually occurs in adulthood. However, there has been an increase in children presenting with IBD
Individuals may present with malnutrition related issues or nutrient deficiencies due to poor absorption of nutrients.
Crohn's disease may show symptoms of swelling or thickening of the bowel wall
Osteopathic Management
Aim is to help patient remain functional and active
Moving the body will help improve circulation and improve lymphatic drainage, assisting in reducing inflammation and the removal of inflammatory mediators
By supporting, encouraging and educating the patient around IBD, we can help to improve mental health status
Osteopathic management can include soft tissue techniques to improve overall wellbeing and quality of life in patients with IBD, but does not have significant effects on pain in these individuals
Visceral techniques have shown ability to improve constipation in some individuals
Osteopathic management has been theorized to have a beneficial effect due to the influence it can have on the nervous system,
Aetiology
Changes in microbiome throughout the GI tract
Altered immune response/dysregulation
Genetic variations. More than 100 genes linked to IBD but some include T300A, ATG16L1 & NOD2 gene
Comorbidities are commonly associated with the onset and progression of IBD. This can include cardiovascular disease and respiratory conditions
Increased consumption of milk protein, animal protein & polyunsaturated fatty acids can increase the risk for IBD.
Smoking can also increase likelihood of developing IBD
Pathophysiology
A defect in the epithelial barrier affecting the integrity of tight junctions within the epithelial lining of the mucosa, allowing pathogenic molecules to slip through into the circulatory system
This defect in the epithelial barrier system allows for bacteria or external substances to translocate to other areas within the body, creating an immune response and inducing the release of proinflammatory cytokines.
Crohn's disease can affect any segment of the GI tract, where as UC is typically localized to the large intestine, specifically only the epithelial lining
UC can involve haemorrhage or inflammatory cells in the lamina propria, crypt abscesses
Increased cellular expression of Th1 cells, IL-1, IL-17, TNF-α.
Crohn's may show the presence of granuloma's, lesions or ulcerations
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