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Inflammatory Bowel Disease Specimens

by | Nov 27, 2022 | News Releases | 0 comments

Bay Biosciences provides fresh frozen (-80°) high quality, clinical grade human serum (sera), plasma and peripheral blood mononuclear cells (PBMC) samples processed from patients diagnosed with inflammatory bowel disease (IBD), Ulcerative Colitis (UC) and Crohn’s disease.

Inflammatory Bowel Disease (IBD) Overview

Inflammatory bowel disease (IBD) is a term that describes disorders involving long-standing (chronic) inflammation of tissues in your digestive tract. Types of (IBD) include:

  • Ulcerative Colitis: This condition involves inflammation and sores (ulcers) along the lining of your large intestine (colon) and rectum.
  • Crohn’s disease: This type of IBD is characterized by inflammation of the lining of your digestive tract, which often can involve the deeper layers of the digestive tract. Crohn’s disease most commonly affects the small intestine. However, it can also affect the large intestine and uncommonly, the upper gastrointestinal tract.

Both ulcerative colitis and Crohn’s disease usually are characterized by diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss.

For some patients, IBD is only a mild illness. For others, it’s a debilitating condition that can lead to life-threatening complications.


Signs and Symptoms of Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease symptoms vary, depending on the severity of inflammation and where it occurs. Symptoms may range from mild to severe. IBD patients are likely to have periods of active illness followed by periods of remission.

Signs and symptoms that are common to both Crohn’s disease and ulcerative colitis include:

 

Causes of Inflammatory Bowel Disease (IBD)

The exact cause of inflammatory bowel disease remains unknown. Previously, diet and stress were suspected, but now doctors know that these factors may aggravate but aren’t the cause of IBD.

One possible cause is an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an atypical immune response causes the immune system to attack the cells in the digestive tract, too.

Several gene mutations have been associated with IBD. Heredity also seems to play a role in that IBD is more common in patients who have family members with the disease. However, most patients with IBD don’t have this family history.

Risk Factors of Inflammatory Bowel Disease (IBD)

  • Age: Most patients who develop IBD are diagnosed before they’re 30 years old. But some patients don’t develop the disease until their 50s or 60s.
  • Cigarette Smoking: Cigarette smoking is the most important controllable risk factor for developing Crohn’s disease.
  • Family history: Individuals are at higher risk if they have a close relative, such as a parent, sibling or child with the disease.
  • Race or Ethnicity: Although IBD is more common in white people, it can occur in any race. Cases are also increasing in other races and ethnicities. Smoking is harmful to overall health and quitting smoking can improve the general health of your digestive tract, as well as provide many other health benefits.
  • Nonsteroidal anti-inflammatory medications: These include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve), diclofenac sodium and others. These medications may increase the risk of developing IBD or worsen the disease in patients who have IBD.


Complications of Inflammatory Bowel Disease (IBD)

Crohn’s disease and ulcerative colitis have some complications in common and others that are specific to each condition. Complications found in both conditions may include the following:

  • Colon cancer: Having ulcerative colitis or Crohn’s disease that affects most of your colon can increase your risk of colon cancer. Screening for cancer with a colonoscopy at regular intervals begins usually about 8 to 10 years after the diagnosis is made.
  • Skin, eye and joint inflammation: Certain disorders, including arthritis, skin lesions and eye inflammation (uveitis), may occur during IBD flare-ups.
  • Medication side effects: Certain medications for IBD are associated with a risk of infections. Some carry a small risk of developing certain cancers. Corticosteroids can be associated with a risk of osteoporosis, high blood pressure (hypertension) and other conditions.
  • Primary sclerosing cholangitis: In this rather uncommon condition seen in patients with IBD, inflammation causes scarring within the bile ducts. This scarring eventually narrows the ducts, restricting bile flow. This can eventually cause liver damage.
  • Blood clots: IBD increases the risk of blood clots in veins and arteries.
  • Severe dehydration: Excessive diarrhea can result in dehydration.


Complications of Crohn’s disease may include the following:

  • Bowel Obstruction: Crohn’s disease affects the full thickness of the intestinal wall. Over time, parts of the bowel can thicken and narrow, which may block the flow of digestive contents. Patients may require surgery to remove the diseased portion of their bowel.
  • Malnutrition: Diarrhea, abdominal pain and cramping may make it difficult for the patient to eat or for the intestine to absorb enough nutrients to keep them nourished. It’s also common to develop anemia due to low iron or vitamin B-12 caused by the disease.
  • Fistulas: Sometimes inflammation can extend completely through the intestinal wall, creating a fistula, an atypical connection between different body parts. Fistulas near or around the anal area (perianal) are the most common kind. But they can also occur internally or toward the wall of the abdominal area. In some cases, a fistula may become infected and form an infected pocket of pus known as an abscess.
  • Anal Fissure: This is a small tear in the tissue that lines the anus or in the skin around the anus where infections can occur. It’s often associated with painful bowel movements and may lead to a perianal fistula.


Complications of ulcerative colitis may include:

  • Toxic Megacolon: Ulcerative colitis may cause the colon to rapidly widen and swell, a serious condition known as toxic megacolon.
  • A hole in the colon (perforated colon): A perforated colon most commonly is caused by toxic megacolon, but it may also occur on its own.

Diagnosis of Inflammatory Bowel Disease (IBD)

To help confirm a diagnosis of IBD, you will need a combination of tests and procedures:

Lab Tests

  • Tests for Anemia or Infection: Your provider may suggest blood tests to check for anemia, a condition in which there aren’t enough red blood cells to carry adequate oxygen to your tissues or to check for signs of infection from bacteria or viruses.
  • Stool Studies: You may need to provide a stool sample so that your provider can test for hidden (occult) blood or organisms, such as parasites, in your stool.


Endoscopy Procedure

  • Colonoscopy: This exam allows the doctor to view your entire colon using a thin, flexible, lighted tube with a camera at the end. During the procedure, small samples of tissue (biopsy) may be taken for laboratory analysis. A biopsy is the way to make the diagnosis of IBD versus other forms of inflammation.
  • Flexible Sigmoidoscopy: In this procedure a slender, flexible, lighted tube is used to examine the rectum and sigmoid, the last portion of your colon. If your colon is severely inflamed, your doctor may perform this test instead of a full colonoscopy.
  • Upper Endoscopy: In this procedure, a doctor will use a slender, flexible, lighted tube to examine the esophagus, stomach and first part of the small intestine (duodenum). While it is rare for these areas to be involved with Crohn’s disease, this test may be recommended if you are having nausea and vomiting, difficulty eating, or upper abdominal pain.
  • Capsule endoscopy: This test is used to help diagnose Crohn’s disease involving the small intestine. The patient swallows a capsule that has a camera in it. The images are transmitted to a recorder you wear on your belt, after which the capsule exits your body painlessly in your stool. You may still need an endoscopy with a biopsy to confirm a diagnosis of Crohn’s disease. Capsule endoscopy should not be performed if a bowel obstruction is suspected.
  • Balloon-Assisted Enteroscopy: For this test, a scope is used in conjunction with a device called an over tube. This enables the technician to look further into the small bowel where standard endoscopes don’t reach. This technique is useful when a capsule endoscopy shows abnormalities, but the diagnosis is still in question.


Imaging Procedures

  • X-ray: If the patient has severe symptoms, your doctor may use a standard X-ray of your abdominal area to rule out serious complications, such as megacolon or a perforated colon.
  • Computerized Tomography (CT) Scan: This is a special X-ray technique that provides more detail than a standard X-ray does. This CT scan test looks at the entire bowel as well as at tissues outside the bowel. CT enterography is a special scan that provides better images of the small bowel. This test has replaced barium X-rays in most medical centers.
  • Magnetic Resonance Imaging (MRI): An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. An MRI is particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). Unlike CT, there is no radiation exposure with MRI.


Treatment of Inflammatory Bowel Disease (IBD)

The goal of inflammatory bowel disease (IBD) treatment is to reduce the inflammation that triggers the IBD patient’s signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission and reduced risks of complications. IBD treatment usually involves either drug therapy or surgery.

Anti-inflammatory Drugs

Anti-inflammatory drugs are often the first step in the treatment of ulcerative colitis, typically for mild to moderate disease. Anti-inflammatories include aminosalicylates, such as mesalamine (Delzicol, Rowasa, others), balsalazide (Colazal) and olsalazine (Dipentum).

Time-limited courses of corticosteroids are also used to induce remission. In addition to being anti-inflammatory, steroids are immunosuppressing. Which medication you take depends on the area of your colon that’s affected.

Immune System Suppressors

These drugs work in a variety of ways to suppress the immune response that releases inflammation-inducing chemicals into the body. When released, these chemicals can damage the lining of the digestive tract.

Some examples of immunosuppressant drugs include azathioprine (Azasan, Imuran), mercaptopurine (Purinethol, Purixan) and methotrexate (Trexall).

More recently, orally delivered agents also known as “small molecules” have become available for IBD treatment. These include tofacitinib (Xeljanz), upadacitinib (Rinvoq) and ozanimod (Zeposia).

The U.S. Food and Drug Administration (FDA) recently issued a warning about tofacitinib, stating that preliminary studies show an increased risk of serious heart-related problems and cancer from taking this drug.

Surgery

If diet and lifestyle changes, drug therapy, or other treatments don’t relieve the IBD patient’s signs and symptoms, the doctor may recommend surgery.

  • Surgery for ulcerative colitis: Surgery involves removal of the entire colon and rectum and the production of an internal pouch attached to the anus that allows bowel movements without a bag. In certain cases, a pouch is not possible. Instead, surgeons create a permanent opening in your abdomen (ileal stoma) through which stool is passed for collection in an attached bag.
  • Surgery for Crohn’s disease: Up to two-thirds of patients with Crohn’s disease will require at least one surgery in their lifetime. However, surgery does not cure Crohn’s disease. During surgery, your surgeon removes a damaged portion of your digestive tract and then reconnects the healthy sections. Surgery may also be used to close fistulas and drain abscesses.The benefits of surgery for Crohn’s disease are usually temporary. The disease often recurs, frequently near the reconnected tissue. The best approach is to follow surgery with medication to minimize the risk of recurrence.


Other Medications and Supplements

In addition to controlling inflammation, some medications may help relieve your signs and symptoms, but always talk to your doctor before taking any over-the-counter medications. Depending on the severity of your IBD, your doctor may recommend one or more of the following:

  • Anti-diarrheal medications: A fiber supplement such as psyllium powder (Metamucil) or methylcellulose (Citrucel) can help relieve mild to moderate diarrhea by adding bulk to your stool. For more severe diarrhea, loperamide (Imodium A-D) can be effective.

    These medications could be ineffective or detrimental in some patients with strictures or certain infections.

  • Pain relievers: For mild pain, your healthcare provider may recommend acetaminophen (Tylenol, others). However, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and diclofenac sodium could make your symptoms worse and can make your overall disease worse as well.
  • Vitamins and supplements: If you are not absorbing enough nutrients, your doctor may recommend vitamins and nutritional supplements in addition to the medication.

 

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