Zeitschrift für entzündliche Darmerkrankungen und -störungen

Immune system dysfunction plays a pivotal role in the pathogenesis of Inflammatory Bowel Diseases (IBD), including Crohn's disease and ulcerative colitis. This article explores the intricate mechanisms underlying the dysregulation of the immune system in IBD and its impact on gastrointestinal inflammation. The review delves into the immunological factors triggering chronic inflammation, genetic predispositions, and the interplay between the innate and adaptive immune responses. Furthermore, it examines the role of gut microbiota in influencing immune system dysfunction and its contribution to disease progression. Therapeutic strategies targeting immune dysregulation are also discussed, including immunomodulators, biologic therapies, and potential future prospects. By understanding the complexities of immune system dysfunction in IBD, new avenues for diagnosis and treatment may emerge, offering hope for improved patient outcomes.

Bowel endometriosis is a subtype of endometriosis characterized by the presence of endometrial tissue on or within the walls of the bowel. It is estimated that approximately 5-15% of women with endometriosis have bowel involvement. Bowel endometriosis can significantly impact fertility and reproductive health. This article aims to provide an overview of the relationship between bowel endometriosis and fertility, including the mechanisms by which it affects fertility, diagnostic approaches, and treatment options. Understanding this complex relationship is crucial for healthcare professionals involved in the care of women with endometriosis, as it can help optimize reproductive outcomes and guide treatment decisions.

Endometriosis is a chronic condition in which the tissue similar to the lining of the uterus, known as endometrial tissue, grows outside the uterus. While endometriosis commonly affects the reproductive organs, it can also involve other areas, including the bowel. Bowel endometriosis can cause a range of symptoms that significantly impact a person's quality of life. This article explores the various bowel symptoms associated with endometriosis and their underlying mechanisms. It also discusses the diagnostic methods, treatment options, and management strategies for bowel symptoms in endometriosis.

The benefits of current pharmacological therapy are minimal. Tricyclic antidepressants have strong clinical support, although antispasmodics and selective serotonin reuptake inhibitor antidepressants have weaker clinical evidence. Due to potential hazards, serotonin subtype targeting drugs are not frequently used. Both alosetron and tegaserod, which are not approved for usage in Canada, are linked to cardiovascular events and ischemic colitis, respectively. It is not surprising that nearly 50% of IBS patients seek out Complementary and Alternative Medicine (CAM) therapies given their low levels of satisfaction with therapy they receive. The national center for complementary and alternative medicine defines Complementary and Alternative Medicine (CAM) as medical procedures that are not currently regarded as a part of mainstream medicine. It must be noted right away that this definition is rather arbitrary and that what is and is not considered CAM will depend on a variety of circumstances, including cultural, racial, social, religious, educational, economic, and other considerations, as well as the attitude of the local medical community. As an illustration, the use of aromatherapy as a support for pharmaceutical analgesia in the post-operative patient illustrates how complementary medicines or medical practices are, by definition, administered or used in addition to traditional medicines. Alternative medications or medical procedures are utilised instead of standard medicines or procedures; an illustration of this would be the decision to treat cancer with a particular diet rather than surgery, radiation therapy, or chemotherapy. An approach to patient treatment known as integrative medicine mixes "mainstream" and Complementary and Alternative Medicine (CAM) methods and/or therapies. This approach has been shown to be safe and effective in a number of different contexts.

Background: Some biomarkers such as C-reactive protein (CRP) and Fecal Calprotectin (FC) have been reported to be related to the prognosis of the coronavirus disease 2019 (COVID-19).

Methods: This case control study included 76 IBD patients in clinical remission and COVID-19 patients from December 2021 to March 2022. A checklist including demographic and clinical parameters was filled out for each participant. Two stool samples in 2 stages (during one month) and one blood sample were collected to test for FC and CRP, respectively. Data were analyzed using Wilcoxon, Mann Whitney, Spearman, T-test, ANOVA and K2 tests and P<0.05 was considered significant.

Results: 33 COVID-19 patients and 43 remission IBD cases with a mean age of 51.53 ± 15.155 years take part in the study. In COVID-19 group, mean FC ± SE in the first samples were 184.46 ± 59.01 (µg/g) and 144.58 ± 38.68 (µg/g) in the second samples one month later. In IBD patients in clinical remission mean FC in the first and in the second samples were 170.25 ± 42.23 (µg/g) and 204, 35 ± 68.33 (µg/g). The reduction in FC was significant among patients with COVID-19 (severe and moderate) after one month. 8 and 11 cases with COVID-19 and IBD had FC1 above or equal 200 (µg/g), respectively. Among 8 COVID-19 patients with high level FC1, 5 cases died. Mean CRP was 44.30 ± 3.47 in COVID-19 and 4.93 ± 1.00 in IBD patients (P<0.05). In cases, a correlation was seen between FC1 and CRP (rs=0.353, P=0.04).

Conclusion: Our findings showed gastrointestinal inflammation in COVID-19 patients even a month after recovery. More mortality was observed in patients with FC above 200. Higher level FC is presented in older COVID-19 patients that show the patients need special attention. Further studies are needed to understand the role of Calprotectin in predicting COVID-19 mortality.