Inflammatory bowel disease. 1. Origins, presentation, and course

Effects of guided imagery with relaxation training on anxiety and quality of life among patients with inflammatory bowel disease

BACKGROUND

Inflammatory Bowel Disease (IBD) impacts quality of life (QoL). Psychological factors influence the course of the disease and should be targeted for intervention.

METHODS

Our study was a prospective, randomised control trial. Fifty-six outpatients were randomly chosen and allocated to a treatment group or a waiting-list control group. Treatment group patients attended three relaxation-training sessions and received an audio disc for home practice. Evaluations performed pre and post-treatment: state anxiety was assessed with the State-Trait Anxiety Inventory, QoL with the IBD Questionnaire. The Visual Analogue Scale assessed pain, depression, stress and mood. Patients completed a symptom monitoring diary. The control group's symptoms were monitored without study-related treatment.

RESULTS

Thirty-nine subjects completed the study and were included in the data analysis. Following the relaxation-training intervention, the treatment group's (n = 18) measured results showed a statistically significant improvement as compared to the control group (n = 21) (time by treatment interaction): anxiety levels decreased (p < 0.01), QoL and mood improved (p < 0.05), while levels of pain and stress decreased (p < 0.01).

CONCLUSIONS

Findings indicate IBD patients may benefit from relaxation training in their holistic care. New studies as well as further investigation of the subject are warranted.

Gastrointestinal illnesses and their effects on the oral cavity

Many disease processes affecting the gastrointestinal (GI) tract may cause observable changes to the oral cavity. In fact, oral cavity changes may represent the first clinical manifestation of an underlying GI condition. Recognition and appropriate referral of a possible GI condition contribute to overall health and wellness in patients. Some of the more important GI conditions that may manifest oral cavity involvement include: reflux disorders, inherited GI polyposis syndromes, and inflammatory bowel disease. This article briefly reviews the aforementioned topics.

Anomalous leukopoiesis in two patients with Crohn's disease

Crohn's disease is a major form of chronic inflammatory bowel disease in the western world. The molecular genetic basis of Crohn's disease is unknown. In this study, we present evidence for anomalous leukopoiesis-namely, the generation of a leukocyte subset characterized by aberrant expression of gammadelta T cell receptor (gammadeltaTCR) with or without CD19 on a myeloid background-in two patients with Crohn's disease. The aberrant cells of patient 1 have the surface phenotype gammadeltaTCR + CD19 - CD14 + CD64 +. The aberrant cells of patient 2 have the surface phenotype gammadeltaTCR + CD19 + CD14 - CD64 + CD16 + CD13 + CD33 +. The results presented here are significant both in light of recent speculation that a critical defect in Crohn's disease may be at the level of hematopoiesis and because the CD19 gene lies within the region on chromosome 16 that corresponds with the Crohn's disease susceptibility locus IBD1.