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Inflammatory Bowel Disease: Overview. IBD: Overview Prevalence: ~250 cases per 100,000 1 Prevalence: ~250 cases per 100,000 1 –More than 1 million cases.

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Presentation on theme: "Inflammatory Bowel Disease: Overview. IBD: Overview Prevalence: ~250 cases per 100,000 1 Prevalence: ~250 cases per 100,000 1 –More than 1 million cases."— Presentation transcript:

1 Inflammatory Bowel Disease: Overview

2 IBD: Overview Prevalence: ~250 cases per 100,000 1 Prevalence: ~250 cases per 100,000 1 –More than 1 million cases estimated in United States 1 –Ulcerative colitis (UC): 50% 1 –Crohns disease (CD): 50% 1 Incidence: 15 cases per 100,000 1 Incidence: 15 cases per 100,000 1 –Onset: 30% between 10 and 19 years of age 2 –Young children: <2% 2 –Peak age of onset: 20s & 30s, again in 60s 3 –Slightly greater risk for women and elderly 4 1 CCFA Library: Basic Facts. Available at: 2 Grand RJ, et al. Clin Invest Med. 1996;19: Hanauer SB. Cecil Textbook of Medicine. 20th ed. Philadelphia, Pa: WB Saunders Co; 1996: Lashner BA. In: Stein SH, Rood RP, eds. Inflammatory Bowel Disease: A Guide for Patients and Their Families. 2nd ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1999:23-29.

3 IBD: Overview (contd) Scope of disorder (United States) Scope of disorder (United States) –700,000 physician visits per year –100,000 hospitalizations per year –CD accounts for two thirds Long-term outlook Long-term outlook –Chronic, lifelong disease –Acute flare-ups alternating with remission –Complications and increased mortality –Surgery for 50% to 80% of CD patients Calkins BM. Digestive Diseases in the United States: Epidemiology and Impact. Bethesda, Md: National Institutes of Health; 1994.

4 <4.0 < Risk for Developing CD Empiric Risk for Developing Crohn's Disease (%) Offspr Both Parents MZ Twin Sib Ashk Jew Parent Offspr Ashk Jew DZ Twin Sib Non-Jew Homozygote NOD2 Heterozygote NOD2 General Population

5 Eye inflammation* Liver and bile duct inflammation Skin lesions Arthritis and joint pains Kidney stones Growth failure in children Lower bone density* Subfertility* IBD: Systemic Complications *Higher incidence in women. Gallstones Ovaries Uterus

6 Influence of Gender on Illness-Related Concerns in IBD Study of 343 men and women Study of 343 men and women –Women report higher levels of symptom severity (P=.04) –Higher levels of rating of IBD patient concerns (P<.001) Maunder R, et al. Can J Gastroenterol. 1999;13: Maunder R, et al. Can J Gastroenterol. 1999;13:

7 Patients Concerns in IBD Greater in Women Than in Men Greater in Women Than in Men –Feelings about body –Attractiveness –Feeling alone –Having children –Intimacy (CD) –Sexual performance (CD) Independent of Gender Independent of Gender –Energy level –Medication effects –Uncertain nature of IBD –Having surgery –Having ostomy bag –Reaching full potential –Being a burden Maunder R, et al. Can J Gastroenterol. 1999;13: Maunder R, et al. Can J Gastroenterol. 1999;13:

8 Gender-Related Considerations in IBD WomenMen Reproductive issues fertility after IPAA or proctocolectomy fertility after IPAA or proctocolectomy risk of relapse if disease active at time of conception risk of relapse if disease active at time of conception fertility with sulfasalazine fertility with sulfasalazine Sperm count with methotrexate Sperm count with methotrexate Disease-related concerns concern re: body stigma, loss of bowel control concern re: body stigma, loss of bowel control Sexuality sexual activity because of dyspareunia, abdominal pain, etc sexual activity because of dyspareunia, abdominal pain, etc libido and sexual satisfaction after proctocolectomy libido and sexual satisfaction after proctocolectomy

9 The Effect of Smoking on Crohns Disease in Women There are now two studies that have specifically addressed the gender effect of tobacco There are now two studies that have specifically addressed the gender effect of tobacco Women smokers undergoing surgery are 5 times more likely to have a recurrence than a non-smoker, and recur more quickly 1 Women smokers undergoing surgery are 5 times more likely to have a recurrence than a non-smoker, and recur more quickly 1 Women smokers hastened onset of disease and increased the need for immunomodulators 2 Women smokers hastened onset of disease and increased the need for immunomodulators 2 1 Kane SV, Gastroenterol 2002; 124(5):A Cosnes J Clin Gastro and Hepatol 2004;2:41-48.


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