Chapters authored
Difficulties in the Differential Diagnosis of Crohn’s Disease
Currently, the main difficulty in the accurate diagnosis of inflammatory bowel disease (IBD) is associated with the high prevalence of infectious, allergic and autoimmune diseases leading to intestinal lesions mimicking IBD. In geographical regions where there is endemicity for certain infections, in particular tuberculosis, timely verification of the diagnoses of ulcerative colitis (UC) and Crohn’s disease (CD) is a serious problem. Some infectious, allergic and autoimmune pathologies can not only imitate the clinical and endoscopic picture of IBD, but also complicate the course of an existing IBD, as a result of which there is resistance to the prescribed basic therapy in patients with UC and CD. Unfortunately, the complexity and limited possibilities of diagnostic methods can often be the reason for the belated establishment of an accurate diagnosis. Thus, in all these diseases, the main fecal markers for verifying the diagnosis of IBD, fecal calprotectin and lactoferrin, often have elevated values.
Part of the book: Crohn’s Disease
Predictors of Non-Response to Ongoing Conservative Therapy in Patients with Inflammatory Bowel Disease
Crohn’s disease (CD) and ulcerative colitis (UC), which are part of the group of inflammatory bowel diseases (IBD), belong to the group of immune-mediated diseases and characterized by a chronic relapsing and chronically continuous course, which leads to serious exacerbations and consequences. Patients may undergo radical surgery, often for drug-resistant disease, and the costs associated with IBD are significant and rising. Over the past two decades, there has been a paradigm shift in the treatment of IBD. The therapeutic goal has shifted from eliminating symptoms alone to achieving combined (symptomatic and endoscopic) remission, which is associated with better outcomes, including a lower risk of relapse, need for corticosteroids, hospitalization, colectomy, and colorectal neoplasia. Despite all the successes, the trend of non-response to ongoing conservative therapy continues. Most studies monitor through endoscopic evaluation and a small number of laboratory tests. There is an important need to understand how noninvasive biomarkers can serve as accurate and reliable indicators for assessing inflammation and predictors of lack of response to therapy. The purpose of this publication is to provide evidence on the use of biomarkers to assess disease activity and predictors of non-response to therapy in patients with IBD.
Part of the book: Miscellaneous Considerations in Inflammatory Bowel Disease
The Role of Eosinophilic Inflammation in Inflammatory Bowel Diseases: Conductor or “First” Violin?
Eosinophils, one of the subgroups of leukocytes, are present in the gastrointestinal tract, with the exception of the esophagus (their presence in quantities of 15 or more is considered eosinophilic esophagitis). Much of the research on eosinophils has focused on their responses against helminths and type II immune system disorders. However, information on the role of eosinophils in the development and maintenance of inflammatory processes, as well as in the formation and progression of fibrotic changes in patients with inflammatory bowel diseases is limited. With increasing interest in innate immunity and the fact that eosinophil granules contain certain inflammatory mediators, eosinophils are becoming one of the current objects of study in inflammatory bowel diseases. In this paper, the authors presented already known data on the functions of eosinophils in inflammatory bowel diseases and some other chronic inflammatory conditions, and also presented the results of their own research on the role and influence of eosinophils on the course of inflammatory bowel diseases.
Part of the book: Eosinophils and Their Role in Human Health and Disease [Working title]