More than 5 million people in Europe are living with chronic inflammatory diseases. These conditions have in common a chronic inflammatory condition associated with an abnormal immune reaction directed against the body. Rheumatoid arthritis, chronic inflammatory bowel disease, such as ulcerative colitis and Crohn’s disease, psoriasis, and psoriatic arthritis, result in daily management of painful or disabling symptoms, compromise patients’ quality of life, are a risk factor for the development of comorbidities, such as cardiovascular diseases and cancer, and weigh on the lives of many families, with significant socio economic repercussions.
These diseases have been observed closely in recent years. At the same time, research has made enormous progress in understanding the mechanisms underlying acute and chronic inflammation, leading to the development of therapeutic options that can intervene in the inflammatory process.
Inflammation underlying chronic inflammatory diseases
The underlying mechanism of these diseases is inflammation, which must be evaluated by considering both the causes, including environmental ones, and the consequences on the whole organism, according to an integrated and multidisciplinary approach that privileges continuity and interrelationships among different chronic inflammatory diseases.
Among the causes of inflammation, in recent years, attention has grown to the role played by the microbiota, the diverse set of microorganisms that live in symbiosis with us in the gut and on all surfaces exposed to the external environment. A variation in the gut microbiota can result in inflammation that tends to spread from the gut to other organs.
A recent study published in the journal Science shows that in the case of ulcerative colitis, to prevent the spread of strong intestinal inflammation, the brain closes a sort of gate located in the choroid plexus, resulting in states of anxiety and depression often seen in patients with chronic inflammatory bowel disease.
Chronic Intestinal Diseases: Symptoms and Complications
In countries like Italy, more than 250,000 people are living with chronic inflammatory bowel diseases, of whom about 60 percent have ulcerative colitis and the remaining 40 percent have Crohn’s disease. These diseases, rapidly increasing in countries with advanced economies, manifest themselves mainly with diarrhea, often accompanied by traces of blood, abdominal pain, vomiting, asthenia, fever, and alternate between flare-ups and remission periods. Up to 40% of patients with Crohn’s disease may undergo bowel resection within ten years, and up to 20% of patients with ulcerative colitis may undergo colectomy within ten years. However, the impact of these diseases goes beyond the intestinal district.
The possibilities offered by surgery
Surgery is one of the tools increasingly being considered to induce remission, which is the best option for some patients with MICI.
Joint deformities and pain: Rheumatoid Arthritis
Rheumatoid arthritis is depicted by its impact on quality of life: Deformities and joint pain, if not adequately treated, can affect the patient’s ability to perform daily activities and limit work opportunities, even to the point of hindering the performance of household and family tasks. However, the introduction of new treatment options has charted a new course that seemed inescapable until a few years ago.
Psoriasis and changes in the Microbiota
Inflammatory mechanisms, along with triggers such as infections, stress, and alterations in the microbiota, are at the root of immune-mediated skin diseases such as psoriasis and psoriatic arthritis. Psoriasis is a systemic disease in which the inflammatory process affects the skin and other areas and organs. Especially at a young age, this disease is associated with an increased risk of acute cardiovascular complications, and in 20-30% of cases, patients with psoriasis may develop psoriatic arthritis. In addition, subclinical intestinal inflammation can be found in patients with psoriasis, especially in the moderate-severe form, and 3% of patients with chronic inflammatory bowel disease also have psoriasis.