Edudorm Facebook

Inflammatory bowel disease (IBD)

 

                                                                        Introduction

            As far as this ailment is concerned, inflammatory bowel disease (IBD) is some of the commonly known systemic inflammatory ailment in patients.  Clinical research suggests that IBD is basically the collection of Crohn’s disease and ulcerative colitis that develops as a result of the various factors, particularly genetic and environmental ones. From that perspective, Crohn’s disease is also known to be associated with persistent intestinal inflammations with other gastrointestinal signs such as pus and bloody stool, weight loss, fever, abdominal pain, and diarrhea. From the earlier assessments that have been conducted on patients suffering from Crohn’s disease, the disease have been found to show some characteristics of fibrosis, transmural inflammations and mainly exists as patchy cuts or wounds all over the human gastrointestinal tract.

            On the other hand, due to the fact that inflammatory bowel disease (IBD) is linked with various venous vascular problems, for instance, intense venous thrombosis, the level of risks they pose, especially coronary artery disease, to patients is not yet accounted for. Although such patients have a high risk of developing venous thromnoembolism as compared to the general population, such risks are always higher during the severe disease flares. The reason for that is because of the tilting of the active inflammations between the balance that occurs between anticoagulants and pro-coagulants hence resulting to characteristic hypofibrinolysis observed in IBD.

            As stated above, to date physicians have to yet found the main cause of Crohn’s disease. Despite that, the only thing they have proved from their researches is that the long-term inflammations that induce Crohn’s disease have the potential of making a person to have clogged blood vessels, especially arteries. It is this clots that have the ability of filling the inner walls of the arteries with small deposits of fats termed as plague. In case one piece grows bigger to block the normal flow of blood, or loosens and breaks off, a person will have high chances of having a heart attack or stroke. This is a condition termed as atherosclerosis. The manner in which this ailment increases the chances of a person developing such a condition is mainly based on his or her autoimmune conditions, for instance, rheumatoid and lupus arthritis. This implies that they all depend on what an individual’s body generates during long-term inflammation.                   

                                                            Literature review     

            According to the current medical research, cardiovascular disease (CVD) has the potential of emanating from inflammatory bowel disease (IBD) and chronic inflammation as one of the ailments that end up increasing heart failure considerably. Basically, the common incident of inflammatory bowel disease, that refers to either Crohn’s disease or ulcerative colitis, have increased extensively in various nations hence considered to be one of the main factors for CVD (Hankey & Eikelboom, 1999). Due to the fact that inflammatory bowel disease (IBD) has the ability of promoting the development of venous thromboembolism, the truth is that the influence it has in arterial hardening, ischemic heart disease, atherosclerosis, and myocardial infarctions are some of the factors that are under debate. Regardless of that, these kinds of research indicate that the assessments that were initially done on patients have revealed the connection of inflammatory bowel disease (IBD) with increasing heart failure or syndrome (Oussalah et al., 2011).

.           Despite that, it has been demonstrated that IBD has a wider association with heart disease. The reason for that is because the systemic inflammation that has been observed in patients suffering from IBD is the one that results into oxidative stress as well as high levels of inflammatory cytokines. Taking into account the negative impacts of these factors, clinical research suggests that because of the compromised lipopolysaccharides, endotoxins, and intestinal mucosal barrier that are generated by intestinal microflora, the products generated later on have the ability of entering blood circulation. In so doing they activate or stimulates inflammatory responses in the body. It is these responses that later results into the development of atherosclerosis in a person (Wu et al., 2016).

            Besides that, it has been suggested that heart failure and other associated diseases are the main cause of morbidity and mortality globally, despite the outstanding medical advancements in both the evaluation as well as the management of the ailment. Conversely, cardiovascular disease (CVD) has been proven to have the potential of arising from genetic, dietary, environmental, and other lifestyle factors. Furthermore, the available evidence indicates that inflammation is a significant player or factor in atherosclerosis, atherogenesis, and the pathogenesis of heart ailment. Medically, it has been proved that a large percentage of patients suffering from rheumatologic ailments could have the likelihood of suffering from coronary heart diseases (Wu et al., 2016). Therefore, it is important for them to seek medical attention, particularly the monitoring of CVD as one of the regular evaluation of the progress of their condition.

                                                            Meta-analysis

A graph of Weighted mean difference (WMD) against the number of patients with hyperhomocysteinemia in IBD (inflammatory bowel disease)

 

 

 

                        100

                        90

Number   of   80

Patients   in    70

            %        60

                        50

                        40

                        30

                        20

                         10             Weighted mean difference (WMD)

-3         -2         -1         0          1          2          3          4          5          6          7          8          9

 

            According to the meta-analysis conducted, it was discovered that there exist an elevated risk of ischemic vascular ailment in several patients suffering from IBD and not the events they experience as a result of minor arterial thromboembolic. It was also recognized that although patients analyzed did not show signs of elevated incidences of developing obesity, experiencing hypertension, or dyslipidemia, they still show a higher risk of developing coronary artery disease (Oussalah et al., 2011). Despite the fact that for a prolonged period of time systemic inflammations has the potential of causing platelet aggregation as well as endothelial dysfunction, the truth is that there is an outstanding probability that is these events that have the ability of increasing the development of CVD and atherosclerosis. With hyperhomocysteinemia in IBD (inflammatory bowel disease), it was noted that the increase in C-reactive protein and inflammatory cytokines are some of the factors are the main mediators of eventual atherosclerosis and endothelial dysfunction in the patients under assessment (Singh et al., 2014).

            On the other hand, it was noted that arterial hardening or stiffness was found to be associated with the circulatory levels of the inflammation generators in healthy individuals, and hypertensive subjects. During the analysis, it proven that for a prolonged period, the occurrence of arterial stiffening in patients with IBD was fundamentally associated with endothelial dysfunction and the duration of the disease and not to do with atherosclerosis itself. As a result of that, it was clear that the principal mechanism for systemic inflammations in inflammatory bowel disease (IBD) was essentially based on the dysfunction of an individual’s intestinal immune system as well as their normal cross-reactivity against the host epithelial tissues (Kristensen et al., 2013). Likewise, during the meta-analysis, the majority of the subjects under study were found to have spoiled intestinal mucosal layers. What was speculated to be the main cause is the mixing of the blood with some products that gets secreted by intestinal microflora.

                                                            Discussion

            Although the exact causes of this ailment is not yet known, in genetically vulnerable people, it is assumed that it is caused by the combinations of immune, environment, as well as bacterial factors.  Basically, the meta-analysis conducted proves that the disease also causes persistent inflammatory disorder, in which an individual’s immune system ends up attacking gastrointestinal tract, most likely aiming the microbial antigens (Kristensen et al., 2013). Despite that, it should be understood that although Crohn’s is ultimately an immune-related ailment, it is not perceived to be an autoimmune ailment. This is to imply that an individual’s immune system is not always prompted by the body itself (Wu et al., 2016). Nonetheless, since this is an immunodeficiency state, about 50 percent of the entire risks are associated with genetics with at least 70 percent having been proven to be involved.

            Individuals, particularly tobacco smokers have been proven to have a high chance of developing this disease as compared to nonsmokers. At times, medical research suggests that this condition often starts after gastroenteritis. Some of the diagnoses are relied on a number of available evidences, including medical imaging, bowel wall appearance, biopsy, and the description of the ailment. Other similar conditions that are used for the purpose of diagnosing this ailment are based on include things like Behcet’s disease and irritable bowel disorder. This is to imply that since this is one of the autoimmune ailments, an individual’s immune system has the tendency of mistaking tissues for threats and hits (Drzewoski et al., 2006). In return this causes inflammations. The only things that is clear from this research is that the inflammation that is caused by Crohn’s disease is what mainly end up damaging the lining of an individual’s blood vessels hence inducing heart disease.

            From the research conducted, it was a clear indication that chronic inflammations resulting from Crohn’s disease are mainly associated with increased risks for heart attack. Regardless of that, it was proven that the majority of these associations might be due to the fact that a large percentage of younger patients have the tendency of having more aggressive ailment with recurrent flares. On the other hand, more severe symptoms are a clear indication of the increased level hyperhomocysteinemia in IBD (inflammatory bowel disease) of which would greatly result into increasing risks of a person having a heart attack (Oussalah et al., 2011).

            Conversely, from such an evaluation, it is clear that individuals with Crohn’s disease have a high chance of developing hardened arteries at a younger age as compared to those who are not suffering from such a condition. However, they appear to be having low rates of diabetes, obesity, as well as other conditions that increases the chances of developing heart disease. The same risks are relatively higher in young adult females, particularly during flares when the ailment is more active and when the symptoms are extremely bothering them (Targan et al., 2010). As a result of that, medical research indicates that individuals with Crohn’s ailment have homocysteine, high sensitivity C-reactive protein (CRP) levels, and erythrocyte sedimentation rates.

                                                Current and future treatments

            Although it is not an uncommon scenario to treat this disease, it should be noted that patients who end up taking high doses of corticosteroids for a long period of time have a high risk of not managing this disease. The reason for that is because such drugs have the potential of accelerating the stiffening of the arteries, which can result into heart failure or heart disease (Targan et al., 2010). Moreover, since such medicines have the likelihood of causing fluid retention, and increasing an individual’s blood pressure, they will in return increase the chances of impairing the normal functioning of the heart (Wu et al., 2016).

            From the clinical perspective, when such medicines are taken excessively, they have been known to have the potential of increasing cardiovascular events. In some groups, the general use of platelet activation inhibitors have been found to be linked with decreased cardiovascular and reduced inflammation events. Even though some of the epidemiological researches have not yet shown any promising improvement in cardiovascular disease (CVD) outcomes, the use of drugs such as anti-TNF meds have been suggested to have the ability of decreasing it in individuals suffering from rheumatoid arthritis (Q, A. A. P. D, 2012).  Conversely, the intake of other initially accepted drugs such as anti-platelet activation agents clopidogrel, aspirin, and statins have been proven to be able to reduce the risks of CVD in individuals suffering from inflammatory bowel disease (IBD).

            In case the disease makes a person to keep on going for long calls or short calls during bedtime, it means that the ailment is depriving him or her quality sleep. The reason for that is because medical research has proven that poor sleep is also one of the main factors that accelerate the development of heart disease. As a result of that, it is recommended for a person to seek consultations with his or her doctor so that he or she can receive proper medical attention. Some of the blood tests that can be done on a patient will ultimately assist in assessing whether he or she has clogged arteries (Drzewoski et al., 2006). Other imaging tests are also vital in checking inflammations in blood vessels and heart disease in such patients.

            Likewise, in order to be in the position of lowering the chances of heart failure or heart disease, it is important for patients to keep their disease under control as well as prevent flare-ups. This is what can boost the heart to recover from such a disease in the process of taking some of the heart disease medicines prescribed by the doctor. In the near future, significant advancement in curative modalities in treating cardiovascular disease is the one which have also been noted to have the potential of reducing CVD-related deaths (Descovich, 1990). To better understand the effects of this disease, it is important embark on investigating the connections that exist between the disease and the blood clots in human veins.

                                                            Conclusion

            Inflammatory bowel disease (IBD) has been noted to pose a high risk for the development of cardiovascular disease and heart failure. The incidences of this disease in conjunction with Crohn’s ailment have greatly increased globally to the extent of posing imminent risk factors for the development of CVD. Thus, the general implication of IBD in causing various diseases, especially atherosclerosis, ischemic heart disease, and arterial hardening or stiffening, is nowadays under investigation. Nevertheless, systemic inflammations in individuals suffering from this disease are what have been recognized to have the potential of increasing oxidative stress as well as elevating the levels of cytokines in a person. In the process of enhancing phenotypic changes, it ends up culminating the negative impacts of CVD and atherosclerosis in a person.

            Additionally, such a condition proves that patients suffering from inflammatory bowel disease (IBD) end up having deregulated or uncontrolled coagulation system and in case the atherosclerosis plaque breaks off, there is the exposure of thrombogenic core in the bloodstream. This scenario in return leads to the formation of thrombus which results into the development of acute coronary disorder.  The only thing they have proved from their researches is that the long-term inflammations that induce Crohn’s disease have the potential of making a person to have clogged blood vessels, especially in the arteries. Therefore, the general advancements in medical treatment have been recognized as being the ultimate means of diagnosing and treating this disease.

                                                           

 

 

                                                           

 

                                                            References

  1. Descovich, G. C. (1990). Atherosclerosis and cardiovascular disease. Kluwer Press
  2. Drzewoski J, Gasiorowska A, Małecka-Panas E, Bald E, Czupryniak L. (2006). Plasma total homocysteine in the active stage of ulcerative colitis. J Gastroenterol Hepatol. 2006;21:739–743. doi: 10.1111/j.1440-1746.2006.04255.x.
  3. Hankey, G. J., & Eikelboom, J. W. (1999). Homocysteine and vascular disease. Lancet, 354(9176), 407–413. https://doi.org/10.1016/S0140-6736(98)11058-9
  4. In Ananthakrishnan, A. N. (2016). Nutritional management of inflammatory bowel diseases: A comprehensive guide. Springer Press
  5. Kristensen SL, Ahlehoff O, Lindhardsen J, Erichsen R, Jensen GV, Torp-Pedersen C, Nielsen OH, Gislason GH, Hansen PR. (2013). Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death - a Danish nationwide cohort study. PLoS One. 2013;8:e56944. doi: 10.1371/journal.pone.0056944.
  6. Oussalah, A., Guéant, J.-L., & Peyrin-Biroulet, L. (2011). Meta-analysis: hyperhomocysteinaemia in inflammatory bowel diseases. Alimentary Pharmacology & Therapeutics, 34(10), 1173–1184. https://doi.org/10.1111/j.1365-2036.2011.04864.x
  7. Q, A. A. P. D. (2012). Bowel Diseases: ScholarlyBrief. Atlanta: ScholarlyMedia LLC.
  8. Singh S, Singh H, Loftus EV, Jr, Pardi DS. (2014). Risk of cerebrovascular accidents and ischemic heart disease in patients with inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014;12:382–393. doi: 10.1016/j.cgh.2013.08.023.
  9. Targan, S. R., Shanahan, F., & Karp, L. C. (2010). Inflammatory bowel disease: Translating basic science into clinical practice. Chichester, West Sussex, UK ; Hoboken, NJ : Wiley-Blackwell
  10. Wu, P., Jia, F., Zhang, B., & Zhang, P. (2016). Risk of cardiovascular disease in inflammatory bowel disease. Experimental and therapeutic medicine, 13(2), 395-400. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348671/

 

 

 

2691 Words  9 Pages
Get in Touch

If you have any questions or suggestions, please feel free to inform us and we will gladly take care of it.

Email us at support@edudorm.com Discounts

LOGIN
Busy loading action
  Working. Please Wait...