Le malattie infiammatorie croniche intestinali

The inflammatory bowel diseases (IBD), namely Crohn's disease and ulcerative colitis, are uncommon diseases characterized by a relapsing and remitting course. The highest incidence is observed in the Caucasian population living in developed countries. The pathogenesis is still unknown, although the literature suggests that many factors are involved, including infectious, genetic (NOD 2/CARD 15 mutations), immunological and environmental factors. The most common clinical symptoms are diarrhea with ematochezia, abdominal pain anemia and fever. Complications of IBD may be intestinal (toxic megacolon, perforation, strictures and fistulas) and/or extraintestinal (arthritis, dermatological lesions and ocular inflammations). The diagnosis is made by endoscopic and histological evaluation; radiological imaging and ultrasonography also provide significant information for disease management and diagnosis of complications. Treatment is based on 5-ASA products for maintaining remission and corticosteroids for management of relapse., Immunosuppressant agents (AZA; MTX) may be used in the event of steroid dependence/resistance. The new and developing approach is the use of biological drugs, like Infliximab and other anti-TNF-(alpha) drugs. Other new therapies like leucocyte apheresis or autologous stem cell transplantation need to be validated in large population studies.