tailieunhanh - Inflammatory bowel disease: A global perspective

Document presentation of content: Global incidence and East–West differences, differences in presenting features of IBD between East and West, diagnosis of IBD in adult patients, cascade IBD diagnosis, evaluation, management of IBD. | World Gastroenterology Organisation Global Guidelines Inflammatory bowel disease a global perspective June 2009 Review team Dr. Charles N. Bernstein chairman Canada Prof. Michael Fried Switzerland Drs. . Krabshuis France Prof. Henry Cohen Uruguay Prof. R. Eliakim Israel Prof. Suleiman Fedail Sudan Dr. Richard Gearry New Zealand Prof. . Goh Malaysia Prof. Saheed Hamid Pakistan Dr. Aamir Ghafor Khan Pakistan Drs. A. W. LeMair The Netherlands Prof. P Malfertheiner Germany Prof. Qin Ouyang China Prof. Rey France Dr. Ajit Sood India Prof. Flavio Steinwurz Brazil Dr. Ole 0. Thomsen Denmark Dr. Alan Thomson Canada Dr. Gillian Watermeyer South Africa Contents 1 Introduction 2 Diagnosis of IBD in adult patients 3 Evaluation 4 Management of IBD WGO Global Guideline IBD2 1 Introduction Inflammatory bowel disease IBD represents a group of idiopathic chronic inflammatory intestinal conditions. The two main disease categories the term covers are Crohn s disease CD and ulcerative colitis UC with both overlapping and distinct clinical and pathological features. The pathogenesis of IBD is incompletely understood. Genetic and environmental factors such as altered luminal bacteria and enhanced intestinal permeability play a role in the dysregulation of intestinal immunity leading to gastrointestinal injury. Global incidence and East-West differences UC incidence Has been increasing in Western countries since the Second World War beginning to level off Has been increasing in previously low-incidence areas in eastern Europe Asia and developing countries CD incidence 1 per 100 000 but probably increasing in Asia and South America 1-3 per 100 000 in southern Europe South Africa 16 per 100 000 in New Zealand and Australia 14 per 100 000 in Canada 7 per 100 000 in the USA based on data only from Olmsted County Minnesota The prevalence of CD appears to be higher in urban areas than in rural areas and in higher socio-economic classes. Most studies show that when the incidence .