Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a group of chronic systemic diseases involving the inflammation of the gastrointestinal tract including ulcerative colitis (UC), which only affects the colon and Crohn’s disease (CD), which can affect the entire gastrointestinal tract. These chronic diseases of multifactorial background are considered to have the highest prevalence and incidence in western countries. It started after the second world war to show an abrupt increase in incidence in North America and European countries. Racial and ethnicity were considered in the background of the development of the disease. However, recently rising trends have been observed in countries previously known to have a low prevalence and incidence. For instance, Middle East countries were known to have the lowest numbers of incidence for developing the disease, but in the last ten to fifteen years IBD has been a great challenge in the medical field. The clinical base presentation of UC and CD are indistinguishable to some point with overlapping signs and symptoms. Physicians and researchers are now trying to find out new diagnostic methods and other biological markers in order to differentiate between the two IBD subtypes and other gastrointestinal disorders. Unfortunately, IBD has no definitive cure and most of the drugs used now are for relieving the symptoms and helping to remit the disease. Relapsing is common in IBD patients and is counted as big challenge for physicians. Using conventional agents such as 5-aminosalcylic acid derivatives, corticosteroids and immunomodulators can help in relieving the symptoms but do not offer complete cure. Despite the challenges, a promising future with biological agents has been introduced. These agents target different inflammatory pathways and reduce the inflammation effectively. Biological agents are now drugs of choice but their costs are much higher than other older and conventional agents which make them a burden for insurance companies and patients. The aim of this thesis is to show the sudden increase in incidence of these diseases in Kingdom of Saudi Arabia (KSA) and other Middle East countries based on clinical studies and data from the last decade. In this thesis we are also going to investigate the different modern and conventional methods for IBD diagnosis and providing other recent diagnostic information. Finally, we are investigating up-to-date medications which are currently in use and some new biological agents which are still not used in clinical practice but are promising to be the goal of treatment for patients with IBD.egységes, osztatlanáltalános orvosangolOrvosbiológia-farmakológi