Inflammatory bowel disease distribution

Inflammatory bowel disease (IBD) encompasses both Crohn s disease (CD) and ulcerative colitis (UC). Both disorders are associated with inflammation of various regions within the gastrointestinal (GI) tract. Differences exist between UC and CD with regard to the regions of the GI tract that may be affected as well as in the distribution and depth of inflammation. Some... 

FIGURE 16-1. Major gastrointestinal landmarks and disease distribution in inflammatory bowel disease. 

Murch, S.H., Braegger, C.P., Walker-Smith, J.A. and MacDonald, T.T. (1995) Distribution and density of TNF immunoreactivity in chronic inflammatory bowel disease. Advances in Experimental Medicine and Biology 30, 1327-1330. 

Finland. Peltola and colleagues (108) reported on over a decade s effort to detect all severe adverse events associated with MMR vaccine distributed in Finland. There was no evidence to support the hypothesis that the vaccine could cause pervasive developmental disorders or inflammatory bowel disease. Comparing the incidence of Crohn s disease and the Finnish data for measles and measles immnnization, Pebody and coUeagnes (109) came to the same conclnsion, namely that there is no association between Crohn s disease and measles vaccine. 

Inflammatory bowel disease is divided into two major gastrointestinal disorders ulcerative colitis (UC) and Crohn s disease. Both diseases are chronic and tend to be characterized by periods of exacerbations and remissions. Major differences between UC and Crohn s disease are differentiated by anatomic location and distribution. UC occurs in the colon and rectum, whereas Crohn s disease can occur throughout the gastrointestinal tract. UC tends to be continuous, diffuse, and mucosal Crohn s appears segmental, focal, and transmural. Fissures, strictures, abdominal masses, and pain are commonly associated with Crohn s. Classical symptoms of UC include chronic diarrhea with tenesmus, rectal bleeding, and abdominal pain. 

The distribution of tachykinin receptors in the body is widespread, and their blockade can have diverse actions. No antagonists are yet used in human therapeutics, though a number of trials are in progress. Proposed applications include as analgesics (particularly for arthritic and other inflammatory hyperalgesic pain), in the treatment of neurogenic inflammation and migraine, as antiemetics, as anxiolytics, antidepressants, for intestinal colic and inflammatory bowel disease, and for bladder hypermotility. 

Both sexes are affected equally with inflammatory bowel disease, although some studies show slightly greater numbers of women with Crohn s disease and males with ulcerative colitis. Ulcerative colitis and Crohn s disease have bimodal distributions in age of initial presentation. The peak incidence occurs in the second or third decades of life, with a second peak occurring between 50 and 80 years of age. A significantly increased incidence of ulcerative colitis (four to five times normal) has been observed in Ashkenazi Jews, while blacks and Asians have a relatively low incidence of occurrence. ... 

The labeling of WBC with Tc chelates, in particular HMPAO dramatically increased the widespread availability and use of these studies in nuclear medicine. Several clinical applications of radiolabeled WBC exist (Table 8.6), but the main clinical indication of imaging WBC distribution has been the detection of inflammatory bowel disease. 

---