Inflammatory bowel disease
In inflammatory bowel disease (IBD; engl. Inflammatory bowel disease, IBD) refers to recurrent (recurrent ) or continuous inflammatory diseases of the intestine. The two most common of which are the ulcerative colitis and Crohn's disease. Less common are the collagenous and lymphocytic colitis, which can only be diagnosed histologically, and are therefore collectively referred to as microscopic colitis.
Typical symptoms and differential diagnosis
Fistulas abscesses toxic megacolon
Rarely often often rarely
Often rarely occasionally occasionally
Infestation Colon ( infestation) terminal ileum small intestine
Discontinuous often stiff, closely often infested
Continuous always far normal
- Macroscopic morphology mesenteric lymph nodes fistulas - Histology Depth of infestation granulomas crypt abscesses malignancies
Cobblestone pattern ( discontinuous, Engl " skip lesions " ) Ulceration ( in the form of so-called "snail tracks", engl. " Snail trails " ) edematous often transmural (all layers ) often rarely rare ( small intestine)
Fibrosis, pseudopolyps Bicycle tube phenomenon not affected rarely Mucosa and submucosa rarely often occasionally (large intestine)
2009, scientists discovered by Christoph Klein, former head of the Department of Pediatrics at the Medical University of Hannover, and Bodo Grimbacher from the Royal Free Hospital in London the first human genetic defect that causes chronic inflammatory bowel disease. A mutation in the two genes of the IL10 receptor ( IL10RA and IL10RB ) the immune cells can no longer receive the modulating signals of the messenger interleukin -10. This leads to severe inflammatory changes in the intestinal wall with fistula formation and accumulation of pus. By allogeneic stem cell genetic defect that can be corrected permanently.
It is believed that in the chronic inflammatory bowel diseases psychosocial stress also to a dysregulation of the immune response and - leads to disease activation - with the appropriate disposition. This stress can lead to the occurrence in patients renewed inflammation. In the Holy Seven Franz Alexander describes chronic inflammatory bowel disease as a psychosomatic disease.