Chrohn's Disease and Management

Paper Summary:

The paper explores Crohn's disease's pathogenesis, clinical staging and prognosis. The paper looks at current management trends and discusses the most promising medical therapy, which is the use of tumor necrosis factor (TNF) antagonists as an immunomodulator. The paper then examines Natalizumab, a monoclonal antibody against a cellular adhesion molecule, anti-interleukin 12 (anti-IL 12) medications, corticosteroids and their role in Crohn's disease, as well as current discoveries about their short and long-term consequences. The paper looks at the association of diet to the prognosis, progression or alleviation of Crohn's disease and concludes by presenting the best management for adult and child patients with this debilitating disease.

Outline:
Introduction
Discussion
Conclusion

From the Paper:

"Crohn's disease is a chronic relapsing inflammatory bowel disease (IBD) that affects any part of the gastrointestinal tract from the mouth to the anus. More often, Crohn's disease is seen in the terminal ileum and colon (Caprilli and Clemente, 2008). As many as 7 newly diagnosed cases per 100,000 people are diagnosed every year, with a prevalence rate of 162 cases per 100,000 people every year (National Institute of Diabetes and Digestive and Kidney Disease [NIDDK], 2005). Along with the other major form of IBD, ulcerative colitis and Crohn's disease caused 825 deaths in 2002. Of 169,000 patients confined in the hospital, 62% were due to Crohn's disease. People with Crohn's disease suffer from severe diarrhea and abdominal pain, which results from the inflammation of the digestive tract."

Sample of Sources Used:

• Akonberg, A. K., Richmond, K., Miller, V., and Thomas, A. G. (2007). "Effect of exclusive enteral nutritional treatment on plasma antioxidant concentrations in childhood Crohn's disease." Clinical Nutrition, 26: 51-56.
• American Gastroenterological Association Institute. (2006). "American Gastroenterological Association Institute Technical Review on Corticosteroids, immunomodulators, and infliximab in inflammatory bowel disease." Gastroenterology, 130: 940-987.
• Armuzzi, A., De Pascalis, B., De Vicentis, F., and Gasbarrini, A. (2008). "Infliximab in Crohn's disease: early and long-term treatment." Digestive and Liver Disease, 40S: S271-S279.
• Baumgart, D. C. and Sandborn, W. J. (2007). "Inflammatory bowel disease: clinical aspects and established and evolving therapies." Lancet, 369: 1641-1657.
• Borrelli, O., Cordischi, L., Cirulli, M., Paganelli, M., et al. (2006). "Polymeric diet alone versus corticosteroids in the treatment of active pediatric Crohn's disease: a randomized controlled open-label trial." Clinical Gastroenterology and Hepatology, 4: 744-753.

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