Inflammatory Bowel Disease
Crohn’s and Ulcerative Colitis are recurrent relapsing disorders characterised by chronic inflammation of the intestinal mucosa. The major cause of inflammation is enhanced leukocyte infiltration into the gut. Crohn’s can affect any part of the gastrointestinal tract with ulcerative colitis restricted to the colon. Environmental and genetic factors have been implicated as causative parameters in the development of IBD along with the composition of the gut microbiota. Goblet cell autoantibodies may play a pathogenetic role in the development of ulcerative colitis.
Serological markers, C-reactive protein and erythrocyte sedimentation rate can reflect the presence of inflammation but is not specific to IBD. Calprotectin has emerged as a key identifier to elucidating damage in the intestinal tract. Generally high levels of faecal calprotectin can point to the presence of inflammation and disease. Antibodies against Saccharomyces cerevisae (ASCA) are seen to have a significantly higher serum concentration in Crohn’s disease than ulcerative colitis, which may assist with the diagnosis, generally during the early stages of disease onset. Other markers associated with IBD are lactoferrin, BPI, elastase and cathepsin G.
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