University:
Stanford University
Course:
MED 101 | Human Anatomy
Academic year:

2023
Views:

108

Pages:

2
Author:

larbi43100

‭Inflammatory intestinal disease‬ ‭ he digestive tract begins at the oral cavity and ends at the anus. It‬ T ‭successively comprises the oral cavity, the oropharynx, the esophagus, the‬ ‭stomach, the small intestine (duodenum, jejunum and ileum), the large intestine‬ ‭(ascending colon with its cecum, transverse colon, descending colon, sigmoid‬ ‭colon and rectum), then the anus. There are four walls of the digestive tract: the‬ ‭mucosa (deep), the submucosa, the muscularis and the serosa (superficial).‬ ‭Inflammatory bowel diseases are chronic inflammatory conditions, of unknown‬ ‭cause, mainly affecting the digestive tract. They include Crohn's disease (CD),‬ ‭described in 1932 by Burrill Bernard Crohn and his colleagues, and ulcerative‬ ‭colitis (UC, also called ulcerative colitis or UC). Although these two conditions‬ ‭are most often distinct after clinical, biological, radiological and endoscopic‬ ‭examinations, forms limited to the colon can up to 15% of cases not be‬ ‭precisely labeled at the beginning of the disease (5% remain unlabeled even‬ ‭after examination of a colectomy specimen): we then speak of indeterminate‬ ‭colitis.‬ ‭We will essentially describe Crohn's disease, ending with a comparative table‬ ‭with ulcerative colitis.‬ ‭Impact‬‭-The average incidence of CD in the United States‬‭is 3.1 to‬ ‭14.6/100,000 (in Europe: 0.7 to 9.8/100,000). The incidence of inflammatory‬ ‭bowel diseases (especially UC) is increasing significantly in countries that are‬ ‭traditionally less affected (Japan, South Korea).‬ ‭Prevalence‬‭-The chronicity and long course of these‬‭diseases explain why‬ ‭their prevalence is much higher than their incidence. The prevalence of CD in‬ ‭the USA varies from 26 to 199/100,000 (in Europe: 8.3 to 214/100,000).‬ ‭Age at diagnosis‬‭-CD presents two peaks of incidence:‬‭the first between 15‬ ‭and 30 years, the second (less marked) between 60 and 80 years.‬ ‭Sex ratio‬‭-It is slightly to the disadvantage of men‬‭(1.1 to 1.8 men for every‬ ‭woman).‬ ‭Ethnic factors‬‭-They are indisputable: the populations‬‭of Europe and North‬ ‭America are more exposed, as are Jews (especially Ashkenazim).‬ ‭Socio-economic factors‬‭-High socio-economic classes‬‭are more‬ ‭exposed to CD‬ ‭The‬‭etiology‬‭of‬‭CD‬‭is‬‭unknown‬‭(multifactorial?),‬‭it‬‭is‬‭nowadays‬‭considered‬‭as‬ ‭an‬ ‭inappropriate‬ ‭immune‬ ‭response‬ ‭to‬ ‭the‬ ‭intestinal‬‭flora,‬‭with‬‭or‬‭without‬‭an‬ ‭autoimmune component.‬ ‭Family or genetic factors -‬‭Several arguments argue‬‭in favor of their‬ ‭intervention: high concordance of CD in monozygotic twins (58%; 4%‬ ‭in dizygotic twins), existence‬