http://www.medicinaeinformazione.com/ / medicinaeinformazione Chronic inflammatory bowel diseases, the so-called IBD, so we are talking about Crohn's disease and Ulcerative Colitis, have some points in common and some differences especially in the location of the disease in the intestine, but both have an autoimmune origin and a chronicity that can be in the most severe forms strongly disabling and debilitating also creating social problems, but if well controlled with drugs - drugs that today combine cortisone with the latest generation immunosuppressants with biological drugs - leads to long periods of remission - we talk about all this with Prof. Antonio Gasbarrini, Director of the Internal Medicine and Gastroenterology Unit of the Agostino Gemelli Polyclinic in Rome who explained to us that to be in the presence of IBD you must first of all exclude infectious causes that can give similar symptoms and then you must have had manifestations of the disease for at least six months. Manifestation that in the mildest forms of Ulcerative Colitis can only cause occasional diarrhea, perhaps with mucus, but in severe forms can even reach 15 discharges a day, while Crohn's disease has more subtle manifestations affecting absorption (sometimes the onset can be for example gallstones) but also disorders such as constipation, abdominal pain or meteorism. Without forgetting that chronic inflammatory intestinal diseases can also cause manifestations in organs that are not the intestine, such as the liver, and that can be found in combination with other autoimmune diseases such as ankylosing spondylitis, psoriasis or some forms of arthritis. The investigations to arrive at a definitive diagnosis, in addition of course to a careful anamnesis also considering the presence of familiarity, are the search for some new biomarkers of the stool, the latest generation abdominal ultrasound, magnetic resonance or enterotac with oral contrast medium, use of the video capsule and of course gastroscopy and colonoscopy which also offer the possibility of taking biopsy samples for histological examination that can confirm the presence of the disease. Naturally the complexity of the disease makes a multidisciplinary approach necessary to be able to address every aspect of the disease, not least the psychological one. And coming to the therapy, Prof. Gasbarrini talks to us about the therapies considered gold standard, therefore immunosuppressants to lower the immune response, the best of which always remains cortisone, also used in massive doses in the acute phases of the disease, some antibiotics and biological drugs, which are able to determine mucosal healing. Without forgetting that in cases where it is necessary, it is possible to resort to operative endoscopy (for example in the case of not too extensive stenosis, or to surgery with a clear improvement in the patient's quality of life. An important chapter is that of pregnancies in patients with IBD because since they often affect young subjects, thinking about planning a pregnancy is really fundamental and the Professor explains to us how it is possible today. And in conclusion we also talk about the role of the intestinal microbiota, stress and how it acts on the immune system - and why psychological support can also be useful in particular moments of life (a bereavement, a separation can sometimes reactivate the disease) and nutrition that must always be monitored with great attention, sometimes temporarily suspended in the attack phases of the disease to give the intestine a rest.