Terminal ileitis (TI) is an inflammatory condition of the terminal portion of the ileum that may occur acutely with right lower quadrant pain followed or not by diarrhea, or exhibit chronic obstructive symptoms and bleeding and normally it is associated to Crohn’s disease (CD) although it may be associated to other different conditions. This review intended to contribute to a better understanding of TI in order to help in the diagnosis, medical approach and patient care. This work was performed on a survey of articles collected in different databases and a retrospective search was carried out to identify relevant studies in the field. Pathological conditions such as ulcerative colitis, the intake of non-steroidal anti-inflammatory drugs, infectious diseases, eosinophilic enteritis, malignant diseases, spondyloarthropathies, vasculitides, ischemia, sarcoidosis, amyloidosis and others may be related to ileitis but it is commonly referred to CD. To a correct therapeutic approach, it is necessary to understand the causes of this inflammation process. The performance of a clinical, laboratory, endoscopic, and histopathological evaluation of the individuals is crucial to the correct diagnosis and treatment once the inflammation of the ileum may occur due to different pathological conditions besides CD, leading to difficulties in the diagnosis. Thus, an individual approach is necessary once the correct diagnosis is crucial for the immediate therapeutic approach and recovering of the patient.
Ulcerative colitis and Crohn's disease are two major forms of the inflammatory bowel diseases (IBDs). Vitamin A (VA) and vitamin D (VD) may be associated with reduction in inflammation in these disorders. The aim of this review was to show the current evidence that may associate VA and VD with IBDs. Data linking VA, VD, and IBDs were studied. Both VA and VD may be related to the immune system in different manners. The active form of VA, retinoic acid, may be related to the growth factor-β and release of interleukin-10 (IL-10), thus involved with the resolution of the inflammation. Its deficiency is associated with the increase of disease activity. The active form of VD is 1,25(OH)D that produces biological effects via the nuclear hormone receptor named VD receptor (VDR), which may interfere with the immune cells and macrophages leading to the suppression of the inflammatory process by decreasing the release of TNF-α, IL-1, IL-6, and IL-8, IL-12, and IL-23. VDR may also activate nucleotide-binding oligomerization domain 2 expression and stimulate the production of the defensin and cathelicidin that are important to the homeostasis of the mucosal immune barrier. The use of VA and VD could be helpful in the treatment and prevention of IBDs but more studies are necessary to establish the precise role of these compounds in the prevention or remission of these inflammatory processes.
Inflammatory Bowel Disease (IBD) and other auto-inflammatory disorders are conditions caused by chronic and persistent intestinal inflammation, which is mainly represented by Ulcerative Colitis (UC) or Crohn's Disease (CD), both of which typically arise as chronic inflammation of the gastrointestinal mucosa. Doctor's main focus for treating IBD is the decrease on inflammation processes when the disease is active and promotes the maintenance of inflammation at normal levels. However, to deal with these two parameters is not easy, because the drugs usually used are related to several side effects and they are not totally effective to reduce inflammation and to keep the remission. Authors agree that the therapy approach should include drugs, dietary intervention and use of alternative substances as probiotics. The standard treatment approach for patients with CD and UC is traditionally done with the use of anti-inflammatory agents, like corticosteroids, mesalamine, immunomodulators such as azathioprine and methotrexate, and biologic agents such as infliximab and others. Probiotics are known as viable microorganisms (or live microorganisms or live microbial dietary supplements) that may promote beneficial physiologic or therapeutic properties when used correctly. The interest in the role of these substances in improving human health is the reason of several researches. They may be used to help the immune system, to control gastro-intestinal infections and to prevent several diseases. Prebiotics, symbiotics, and probiotics may be helpful as adjuvants in the treatment of IBD. Probiotics are normally well-tolerated and are associated with few side effects which are undoubtedly important in the treatment of any
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