Inflammatory Bowel Disease
The term inflammatory bowel disease refers to two chronic in-flammatory GI disorders: regional enteritis (ie, Crohn’s disease or granulomatous colitis) and ulcerative colitis. Both disorders have striking similarities but also several differences. Table 38-4 com-pares regional enteritis and ulcerative colitis.
The incidence of IBD in the United States has increased in the past century; 10,000 to 15,000 new cases occur annually (Yamada et al., 1999). In the past, a higher rate was observed among Caucasians in general and the Jewish population in par-ticular. Data now indicate a higher risk for African Americans and a lower risk for Jewish people, and women appear to be at higher risk than before. People between the ages of 10 and 30 are at greatest risk.
Despite vast amounts of research, the cause of IBD is still un-known. Researchers think it is triggered by environmental agents such as pesticides, food additives, tobacco, and radiation (Kirsner
Shorter, 2000). Nonsteroidal anti-inflammatory drugs have been found to exacerbate IBD. Allergies and immune disorders have also been suggested as causes. Abnormal response to dietary or bacterial antigens has been studied extensively, and genetic fac-tors also are being studied. There is a high prevalence of coexis-tent IBS, which complicates the overall symptom presentation.
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