INFLAMMATORY BOWEL DISEASE

Sharon Perry

Overview

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract that includes Crohn’s disease, ulcerative colitis (UC), and inflammatory bowel disease unclassified (IBD-U). The location and degree of inflammation, as well as histological findings, determine the diagnosis. The incidence of IBD is increasing in children, and up-to-date investigation, diagnosis, and management are essential (Kammermeier et al., 2015). The role of the nurse in IBD is to educate patients and their families so that they are successful in the management of their disease.

Background

Around 25% of patients are diagnosed with IBD in the first two decades of life, with the most common time between 13 and 18 years, with the incidence increasing in the early second decade of life (Ye, Pang, Chen, Ju, & Zhou, 2015). The incidence of pediatric IBD is increasing worldwide; the highest rise occurring in developing countries is thought to be because of the influence of Western culture (Ye et al., 2015). In the United States, IBD in children and adolescents accounts for 30% of all patients diagnosed; in Canada, the incidence of pediatric IBD increased from 9.5/100,000 in 1994 to 11.4/100,000 in 2005 (Ye et al., 2015).

The exact etiology of IBD is unknown. The current concept is IBD has a multifactorial etiology, consistency of an overlap between genetics, environment, dysregulation of the immune system, and the microbiome. It has been linked to several genes, including NOD2/CARD15 gene. Although the link between genetics and environment is unknown, previous research suggests that nonpathogenic intestinal bacteria trigger and perpetuate an uncontrolled inflammatory response. Microorganisms, including Mycobacterium avium paratuberculosis (MAP) and Escherichia coli adherent-invasive, have also been linked to IBD.

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