Abdominal pain: focus on inflammatory bowel diseases

Abstract

Abdominal pain is a frequent reason to see a doctor. At the same time, it is very important in the first stage of diagnosis to determine the degree of pain risk, as in some diseases such as acute ulcer, myocardial infarction, acute pancreatitis, the urgency of medical care is directly related to the survival of patients or the development of related complications. The most typical clinical manifestations of abdominal pain are pain of varying intensity, signs of peritoneal irritation and disturbance of intestinal motility. In some cases, the clinical picture may be accompanied by fever, nausea and vomiting, signs of pain or toxic shock, etc. The diagnosis of abdominal pain is based on a thorough analysis of the examination results, which includes not only laboratory examinations of blood, urine and feces, but also echography of abdominal organs, endoscopic (esophagogastroduodenoscopy, colonoscopy) and, if necessary, methods of radiation diagnostics (in particular, computer tomography, magnetic resonance imaging).The article presents the classification and mechanisms of development of abdominal pain. The main attention is paid to inflammatory intestinal diseases (Crohn's disease and ulcerative colitis) for which etiology, pathogenesis, clinical signs, diagnostics and treatment are considered, taking into account modern trends in clinical practice. The main diagnostic measures to determine inflammatory bowel diseases are given, based on the analysis of the clinical picture and the results of laboratory, radiological and endoscopic examinations. It is emphasized that the results of the study, its diagnostic accuracy and therapeutic safety largely depend on the quality of patients' preparation for diagnostic activities. The main drugs used to prepare the intestines for research are solutions based on polyethylene glycol. The choice of medication therapy depends on the degree, location and severity of the disease. The same medications may be prescribed for different diagnoses - ulcerative colitis and Crohn's disease.

Keywords

• abdominal pains
• inflammatory bowel diseases
• crohn's disease
• ulcerative colitis
• colonoscopy
• medications based on polyethylene glycol
• low volume polyethylene glycol
• 5-aminosalicylic acid
• glucocorticoids
• immunomodulators
• biological drugs
• faecal microbicota transplant
• etrolisumab
• janus kinase inhibitors
• sphingosine-1-phosphate receptor modulators