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The anti-TNF-α monoclonal antibody infliximab is a major biological therapy for inflammatory bowel disease. Biological therapy, the use of medications called biopharmaceuticals or biologics that are tailored to specifically target an immune or genetic mediator of disease, plays a major role in the treatment of inflammatory bowel disease. [1]
The association between inflammatory conditions of the eye and Crohn's disease is due to many Crohn's disease patients having genetic markers such as HLA-B07, HLA-B27 and HLA-DRB1*0103. [57] Additionally, cytokines IL-6, IL-10, and IL-17 which are produced in the bowel enter the circulatory system and travel to the eyes to trigger inflammation.
Exclusive enteral nutrition is a first-line therapy in pediatric Crohn's disease with weaker data in adults. [81]: 331 [82] Evidence supporting exclusive enteral nutrition in ulcerative colitis is lacking. [81]: 333 Nutritional deficiencies play a prominent role in IBD. Malabsorption, diarrhea, and GI blood loss are common features of IBD.
Surgery is normally reserved for complications of Crohn's disease or when disease that resists treatment with drugs is confined to one location that can be removed. [30] Surgery is often used to manage complications of Crohn's disease, including fistulae , small bowel obstruction , colon cancer , small intestine cancer and fibrostenotic ...
However, a complete colonoscopy with entry into the terminal ileum should be performed to rule out Crohn's disease, and assess extent and severity of disease. [73] Endoscopic findings in ulcerative colitis include: erythema (redness of the mucosa ), friability of the mucosa, superficial ulceration, and loss of the vascular appearance of the colon.
People with inflammatory bowel disease (ulcerative colitis and Crohn's disease) are at increased risk of colon cancer. [32] [33] The risk increases the longer a person has the disease, and the worse the severity of inflammation. [34] In these high risk groups, both prevention with aspirin and regular colonoscopies are recommended. [35]