Características e diagnóstico diferencial das doenças inflamatórias intestinais / Characteristics and differential diagnosis of inflammatory bowel diseases

As doenças inflamatórias intestinais (DIIs) compreendem, principalmente, a doença de Crohn (DC) e a retocolite ulcerativa (RU), ambas idiopáticas, porém relacionadas a uma resposta imunológica anormal à microbiota bacteriana da luz intestinal. Na RU a inflamação é difusa, restrita à mucosa e inespecífica, com comprometimento contínuo da parede, principalmente do reto, enquanto na DC as lesões são descontínuas, podem comprometer todas as camadas da parede e afetar qualquer parte do trato gastrointestinal. O quadro clínico é comum e compreende diarreia, febre e dores abdominais, podendo cursar também com manifestações extraintestinais. O diagnóstico é feito através dos dados clínicos, achados radiológicos e histológicos, sem haver, no entanto, nenhuma característica que isoladamente feche o diagnóstico de DII específica.

Inflammatory bowel diseases (IBDs) comprise mainly Crohn?s disease (CD) and ulcerative colitis (UC), both are idiopathic but believed to be related to an abnormal immune response to bacterial microbiota in the intestinal lumen. In RU diffuse inflammation is restricted to the mucosa and is nonspecific, with continued commitment that stars at rectum?s wall. In DC, the injuries are discontinuous, involve all layers of the intestinal wall and can affect any part of the gastrointestinal tract. The clinical picture of both is diarrhea, fever, abdominal pain, and may present with extraintestinal manifestations. The diagnosis is made by the junction of clinical, radiological and histological findings, without having, however, a feature alone that leads to a diagnosis of a specific IBD.

Enfemedad inflamatoria intestinal: segunda parte / Inflammatory bowel disease: second part

En los últimos años gracias a la aparición de nuevas alternativas terapéuticas han permitido darle a ésta enfermedad, un enfoque más integral e individualizado. Se considera que la desnutrición tiene una amplia gama de consecuencias de carácter general. Actualmente existen dos teorías para explicar el retraso en el crecimiento en estos pacientes. La disminución de la densidad mineral ósea es una grave complicación de la EII. Existen tres modalidades específicas de tratamiento: farmacológico, quirúrgico y nutricional.

In recent years, thanks to the emergence of new therapeutic options have led its to this disease, a more comprehensive and individualized. It is considered that malnutrition has a wide range of general consequences. Currently there are two theories to explain the growth retardation in these patients. The decrease in bone mineral density is a serious complication of IBD. There are three specific forms of treatment: pharmacological, surgical and nutrition.

Development of a Rating System for Digestive System Impairments: Korean Academy of Medical Sciences Guideline

A systematic and effective welfare system for people with digestive system impairments is required. In Korea, an objective and scientific rating guideline does not exist to judge the digestive system impairments. Whether the impairments exist or not and the degree of it need to be examined. Thus, with these considerations we need a scientific rating guideline for digestive system impairments to fit our cultural and social background. In 2007, a research team, for the development of rating impairment guidelines, was organized under the supervision of Korean Academy of Medical Sciences. The rating guidelines for digestive system impairments was classified into upper and lower gastrointestinal tracts impairments and liver impairment. We developed objective rating guidelines for the upper gastrointestinal tract, the impairment generated after surgery for the stomach, duodenum, esophagus, and for the lower gastrointestinal tract, the impairment generated after construction and surgery for colon, rectum, anus, and intestinal stomas. We tried to make the rating impairment guidelines to include science, objectivity, convenience, rationality, and actuality. We especially emphasized objectivity as the most important value. We worked to make it easy and convenient to use for both the subjects who received the impairment ratings and the doctors who will give the ratings.

Tratamiento actual de las enfermedades inflamatorias intestinales / Current treatment of inflammatory bowel diseases

En el curso de las últimas décadas y debido a los progresos terapéuticos logrados, las Enfermedades Inflamatorias Intestinales que antes eran afecciones crónicas, progresivas e irreversibles, de alta mortalidad y de tratamiento quirúrgico, se han transformado en cuadros susceptibles de alcanzar remisiones clínicas completas y mantenidas, compatibles con una calidad de vida prácticamente normal. Progresos y avances igualmente significativos se han alcanzado prácticamente en todos los campos de la Medicina Interna en la segunda mitad del presente siglo