ABSTRACT
We examined data from two large colorectal chemoprevention trials for possible associations of hyperplastic polyps and adenomas with subsequent development of these lesions. Hyperplastic polyps do not predict metachronous adenomas.
Subject(s)
Adenoma/epidemiology , Adenomatous Polyps/epidemiology , Colonic Polyps/epidemiology , Colorectal Neoplasms/epidemiology , Neoplasm Recurrence, Local , Adenomatous Polyps/drug therapy , Colonic Polyps/drug therapy , Colorectal Neoplasms/drug therapy , Female , Follow-Up Studies , Humans , Hyperplasia , Male , RiskSubject(s)
Esophagitis , Acute Disease , Adult , Aged , Endoscopy, Digestive System , Esophagitis/epidemiology , Esophagitis/etiology , Esophagitis/pathology , Esophagus/pathology , Humans , Male , NecrosisABSTRACT
The exact cause of inflammatory bowel disease remains undiscovered, but its destructive nature is clearly recognized. In this article, the authors summarize what is known about the pathogenesis and epidemiology of ulcerative colitis and Crohn's disease and how to distinguish between the two, both clinically and pathologically. They also describe disorders that may mimic inflammatory bowel disease. In part 2 of this article, beginning on page 86, the authors discuss some of the therapeutic options that are the commonly used as well as some that are investigational but show promise for patients with this chronic and relapsing disease.
Subject(s)
Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/etiology , Crohn Disease/diagnosis , Crohn Disease/etiology , Colitis, Ulcerative/immunology , Crohn Disease/immunology , Diagnosis, Differential , Humans , Risk Factors , Severity of Illness IndexABSTRACT
The exact source of interference with the normal protective immune response in patients with inflammatory bowel disease remains unclear. Infectious causes have been proposed, and the increased incidence among family members indicates genetic predisposition. No matter what the pathogenesis may be, the disease is chronic, recurrent, and destructive in many cases. Conventional therapy with 5-ASAs, corticosteroids, immunomodulating agents, methotrexate, and antibiotics often offers relief. However, adverse effects accompany long-term use of many of these agents, so follow-up is important. Much investigation of alternative methods is under way, and anecdotal as well as published experience suggests benefits in at least some patients. Because of the chronic nature of their condition, patients with inflammatory bowel disease often become quite sophisticated in their understanding of treatment methods. Therefore, they should be told of updates regarding new options for disease control. We recommend that patients be seen periodically by a gastroenterologist who has expertise in inflammatory bowel disease, even when the disease is quiescent. Our experience in observing these patients over time strongly supports use of some of the agents discussed in this article for prophylaxis against flares and chronic inflammation.
