Assessment of attitudes and habits about oral health in patients with inflammatory bowel disease

Cilj: Crohnova bolest i ulcerozni kolitis su najčešći oblici upalnih bolesti crijeva. Oba stanja karakterizirana su kroničnom upalom gatrointestinalne sluznice, uz koju se u nekim slučajevima javljaju i izvancrijevne manifestacije. Oralne manifestacije Crohnove bolesti su: orofacijalni edemi, krpičaste promjene sluznice, kaldrmast izgled sluznice, hiperplastični gingivitis i aftozni stomatitis, a kod ulceroznog kolitisa najčešće se viđaju aftozni stomatitis i pyostomatitis vegetans. Cilj ovog istraživanja bio je ispitati stavove i navike o oralnom zdravlju u bolesnikas upalnim bolestima crijeva. Metode i materijali: U ovom presječnom anketnom istraživanju sudjelovao je 76 ispitanika od čega je 42 ispitanika bilo s Crohnovom bolesti, te 34 ispitanika s ulceroznim kolitisom. Istraživanje se provodilo na Zavodu za gastroenterologiju i hepatologiju KBC-a Split, te Katedri za patofiziologiju tijekom razdoblja od prosinca 2017. do svibnja 2018. godine. Ispitanici su ispunjavali specijalizirani upitnik koji se sastojao od ukupno 17 pitanja, podijeljenih u 3 glavne skupine koje su obuhvaćale opće podatke i navike pacijenata, značajke i subjektivni dojam bolesti, te navike o oralnom zdravlju. Rezultati:Najveći broj ispitanika (38,2% za ulcerozni kolitis te 40,5% za Crohnovu bolest) doktora dentalne medicine posjećuju tek prema potrebi, najčešće jer ne vide razlog za češće posjete. Više od polovine ispitanika (67,1%) pere zube dva do tri puta dnevno, i to uglavnom u trajanju od 1-3 minute (73,7%). Najčešći tipovi četkice koji pacijenti koriste su srednje tvrda (44,7%) i mekana (36,8%), dok ih većinom mijenjaju svaka 3 mjeseca (44,7%). U slučaju problema sa oralnim zdravljem 27 ispitanika sa ulceroznim kolitisom (79,4%) te 38 sa Crohnovom bolesti (90,5%) konzultira doktora dentalne medicine. Zaključci: Pacijenti s upalnom bolesti crijeva većinom nisu išli na preventivne preglede u doktora dentalne medicine, te je izrazito važno dodatne napore uložiti u podizanje svijesti o ovom važnom aspektu bolesti.Objectives: Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease. Both conditions are characterized by chronic inflammation of the gatrointestinal mucosa, in which in some cases extraintestinal manifestations also occur. Oral manifestations of Crohn's disease are: orofacial edema, patchy mucous membranes, cobblestone appearance of the mucosa, hyperplastic gingivitis and aphthous stomatitis, with aphthous stomatitis and pyostomatitis vegetans most commonly seen in ulcerative colitis. The aim of this study was to examine the attitudes and habits regarding oral health in patients with inflammatory bowel disease. Subjects and methods:A total of 76 participants participated in this cross-sectional survey, of which 42 had Crohn's disease and 34 had ulcerative colitis. The study was conducted at the Department of Gastroenterology and Hepatology, University Hospital of Split, and the Department of Pathophysiology during periods from December 2017 to May 2018. Subjects completed a specialized questionnaire consisting of 17 questions divided into 3 main groups, covering general data and patient habits, characteristics and subjective impression of the disease, and oral health habits. Results: The majority of patients (38.2% ulcerative colitis and 40.5% Crohn's disease) visit doctors of dental medicine only when needed, most often because they do not see a reason for more frequent visits. More than half of patients (67,1%) brush their teeth two to three times a day, mostly for 1-3 minutes.The most common types of brush used by patients are medium hard (44.7%) and soft (36.8%), while most are changed every 3 months (44.7%). In the case of oral health problems, 27 subjects with ulcerative colitis (79.4%) and 38 with Crohn's disease (90.5%) consult a dentist. Conclusions:Patients with inflammatory bowel disease mostly did not go to preventive examinations with a doctor of dental medicine, and it is extremely important that additional efforts be made to raise awareness of this important aspect of the diseas

Specific features of inflammatory bowel disease iu Zadar County

Cilj istraživanja: utvrditi incidenciju i prevalenciju upalnih bolesti crijeva (Crohnova bolest i ulcerozni kolitis) u pučanstvu Zadarske županije u razdoblju od 2000 - 2010 godine, analizirati fenotipove obje bolesti, ustanoviti učestalost komlikacija, te istražiti utjecaj potencijalnih čimbenika rizika okoliša. Nacrt studije: retrospektivno – prospektivna epidemiološka studija Ispitanici i metode: u studiju je uključeno 397 pacijenata s upalnim bolestima crijeva, 243 muškarca i 154 žene, koji svi žive na području Zadarske županije. Za procjenu čimbenika rizika je formirana kontrolna skupina od 1000 zdravih dobrovoljaca koji također žive na području Zadarske županije. Za svakog oboljelog ispunjena su dva protokola, za incidenciju i prevalenciju upalnih bolesti crijeva. Fenotip Crohnove bolesti i ulceroznog kolitisa određen je prema Montrealskoj klasifikaciji upalnih bolesti crijeva. Rezultati: Pokazana je blaga predominacija ulceroznog kolitisa nad Crohnovom bolesti, te veći broj oboljelih muškaraca kod obje bolesti. Godišnja stopa incidencije za razdoblje 2000-2010 za ulcerozni kolitis iznosi 8,1/100.000 stanovnika, a za Crohnovu bolest 8,3/100.000. Prevalencija na kraju 2010 godine za ulcerozni kolitis iznosi 128,39/100.000 stanovnika, a za Crohnovu bolest 106,5/100.000 stanovnika. Bolesnici s Crohnovom bolesti su mlađi (31,9 godina) od bolesnika s ulceroznim kolitisom (42,4 godine) u trenutku postavljanja dijagnoze. Kod bolesnika s ulceroznim kolitisom najčešće je zahvaćeno cijelo debelo crijevo (fenotip E3). Bolesnici s Crohnovom bolesti su najčešće stari između 17 i 40 godina (fenotip A2), najčešće je zahvaćen terminalni ileum (L1), te imaju nekomplicirani tijek bolesti (B1). Komplikacije bolesti su češće kod Crohnove bolesti. Nađena je statistički značajna povezanost upalnih bolesti crijeva i pušenja, apendektomije i cijepljenja protiv ospica, dok te povezanosti ne postoji s tonzilektomijom, uzimanjem oralnih kontraceptiva i preboljelim ospicama. Pušenje utječe na učestalost komplikacija kod bolesnika s Crohnovom bolesti. Statistički je značajna obiteljska agregacija upalnih bolesti crijeva. Zaključak: epidemiologija upalnih bolesti crijeva se najbolje uklapa u europski „model zapad-istok“. Dobiveni su točni brojčani podatci za jednu dalmatinsku županiju, koji mogu temelj za daljnja istraživanja.Aim of study: To determine the incidence and prevalence of inflammatory bowel disease (Crohn's disease and ulcerative colitis ) in the population of Zadar County in the period 2000-2010 , to analyse phenotypes of both diseases, to determine the frequency of complication, and explore the impact of potential enviromental risk factors. Study design : retrospective – prospective epidemiological study Patients and Methods : The study included 397 patients with inflammatory bowel disease , 243 men and 154 women , who all live in Zadar County . To assess risk factors formed a control group of 1,000 healthy volunteers who also live in Zadar County. For each patient met the two protocols , the incidence and prevalence of inflammatory bowel disease. Phenotype of Crohn`s disease and ulcerative colitis is determined by the Montreal classification of inflamatory bowel disease. Results : The higher the incidence of ulcerative colitis compared to Crohn's disease. In both diseases is increasing the number of male patients.. The annual incidence rate for the period 2000-2010 for ulcerative colitis is 8.1 / 100,000 inhabitans , while Crohn's disease is 8.3 / 100,000 . Prevalence at the end of 2010 for ulcerative colitis is 128,39 / 100,000 inhabitans , while Crohn's disease is 106,5/100.000 inhabitants. Patients with Crohn's disease were younger (31.9 years) than patients with ulcerative colitis (42.4 years) at the time of diagnosis. Patients with ulcerative colitis usually affected the entire colon (phenotype E3) . Patients with Crohn's disease are usually aged between 17 and 40 (phenotype A2) , the most affected is terminal ileum (L1), and have uncomplicated disease course (B1) . Complications of the disease are more common in Crohn's disease. Discovered connection between inflammatory bowel disease and smoking, appendectomy, and vaccination against measles, while not a proven link with tonsillectomy, oral contraceptives an measles in history . Smoking affects the incidence of complications in patients with Crohn's disease. There is a statistically significant family agggregation of inflamatory bowel disease. Conclusion: The epidemiology of inflammatory bowel disease can best fit into the European " model west-east ." Obtained are accurate numerical data for one Dalmatia County, which can be the basis for further research

Nursing care for patient with Crohn's disease in the surgical department

U radu se prikazuje vanjskotrgovinska razmjena Republike Hrvatske od 2012. do 2016. godine. Glavne komponente vanjskotrgovinske razmjene su, izvoz i uvoz, a njihov odnos iskazuje se na vanjskotrgovinskoj bilanci, u pozitivnom iznosu kao suficit, u negativnom kao deficit. Rad prikazuje kretanje izvoza i uvoza u apsolutnim iznosima i strukturu vanjskotrgovinske bilance te daje pregled vanjskotrgovinske razmjene s najvažnijim zemljama partnerima Republike Hrvatske. Činjenica je da sve zemlje teže ostvarivanju suficita, stoga se u radu naglašava važnost i mogućnosti stimuliranja izvoza u Republici Hrvatskoj. Metodom intervjua, na primjeru iz prakse jednog izvoznika, prikazani su problemi s kojima se susreće u poslovanju.This thesis discusses foreign trade in the Republic of Croatia since 2012 until 2016. Relations in the foreign trade are determined by Croatia's foreign trade policy. Key foreign trade components have been defined, as well as import and export. Their relations are shown in the foreign trade balance, in the positive amount as surplus and in the negative as deficit. This thesis shows the movement of exports and imports in absolute terms and structure of foreign trade balance and it gives an overview of foreign trade with the most important Croatia's partner countries. It is a fact that all countries seek to achieve a surplus, therefore, the importance and the possibility of export stimulation has been emphasized. This paper shows, in an interview, all the problems that a Croatian exporter has had during his business experience

Assessment of attitudes and habits about oral health in patients with inflammatory bowel disease

Cilj: Crohnova bolest i ulcerozni kolitis su najčešći oblici upalnih bolesti crijeva. Oba stanja karakterizirana su kroničnom upalom gatrointestinalne sluznice, uz koju se u nekim slučajevima javljaju i izvancrijevne manifestacije. Oralne manifestacije Crohnove bolesti su: orofacijalni edemi, krpičaste promjene sluznice, kaldrmast izgled sluznice, hiperplastični gingivitis i aftozni stomatitis, a kod ulceroznog kolitisa najčešće se viđaju aftozni stomatitis i pyostomatitis vegetans. Cilj ovog istraživanja bio je ispitati stavove i navike o oralnom zdravlju u bolesnikas upalnim bolestima crijeva. Metode i materijali: U ovom presječnom anketnom istraživanju sudjelovao je 76 ispitanika od čega je 42 ispitanika bilo s Crohnovom bolesti, te 34 ispitanika s ulceroznim kolitisom. Istraživanje se provodilo na Zavodu za gastroenterologiju i hepatologiju KBC-a Split, te Katedri za patofiziologiju tijekom razdoblja od prosinca 2017. do svibnja 2018. godine. Ispitanici su ispunjavali specijalizirani upitnik koji se sastojao od ukupno 17 pitanja, podijeljenih u 3 glavne skupine koje su obuhvaćale opće podatke i navike pacijenata, značajke i subjektivni dojam bolesti, te navike o oralnom zdravlju. Rezultati:Najveći broj ispitanika (38,2% za ulcerozni kolitis te 40,5% za Crohnovu bolest) doktora dentalne medicine posjećuju tek prema potrebi, najčešće jer ne vide razlog za češće posjete. Više od polovine ispitanika (67,1%) pere zube dva do tri puta dnevno, i to uglavnom u trajanju od 1-3 minute (73,7%). Najčešći tipovi četkice koji pacijenti koriste su srednje tvrda (44,7%) i mekana (36,8%), dok ih većinom mijenjaju svaka 3 mjeseca (44,7%). U slučaju problema sa oralnim zdravljem 27 ispitanika sa ulceroznim kolitisom (79,4%) te 38 sa Crohnovom bolesti (90,5%) konzultira doktora dentalne medicine. Zaključci: Pacijenti s upalnom bolesti crijeva većinom nisu išli na preventivne preglede u doktora dentalne medicine, te je izrazito važno dodatne napore uložiti u podizanje svijesti o ovom važnom aspektu bolesti.Objectives: Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease. Both conditions are characterized by chronic inflammation of the gatrointestinal mucosa, in which in some cases extraintestinal manifestations also occur. Oral manifestations of Crohn's disease are: orofacial edema, patchy mucous membranes, cobblestone appearance of the mucosa, hyperplastic gingivitis and aphthous stomatitis, with aphthous stomatitis and pyostomatitis vegetans most commonly seen in ulcerative colitis. The aim of this study was to examine the attitudes and habits regarding oral health in patients with inflammatory bowel disease. Subjects and methods:A total of 76 participants participated in this cross-sectional survey, of which 42 had Crohn's disease and 34 had ulcerative colitis. The study was conducted at the Department of Gastroenterology and Hepatology, University Hospital of Split, and the Department of Pathophysiology during periods from December 2017 to May 2018. Subjects completed a specialized questionnaire consisting of 17 questions divided into 3 main groups, covering general data and patient habits, characteristics and subjective impression of the disease, and oral health habits. Results: The majority of patients (38.2% ulcerative colitis and 40.5% Crohn's disease) visit doctors of dental medicine only when needed, most often because they do not see a reason for more frequent visits. More than half of patients (67,1%) brush their teeth two to three times a day, mostly for 1-3 minutes.The most common types of brush used by patients are medium hard (44.7%) and soft (36.8%), while most are changed every 3 months (44.7%). In the case of oral health problems, 27 subjects with ulcerative colitis (79.4%) and 38 with Crohn's disease (90.5%) consult a dentist. Conclusions:Patients with inflammatory bowel disease mostly did not go to preventive examinations with a doctor of dental medicine, and it is extremely important that additional efforts be made to raise awareness of this important aspect of the diseas

Inflammatory bowel disease

Spektar upalnih bolesti crijeva čine ulcerozni kolitis, Crohnova bolest i neklasificirana upalna bolest crijeva. Simptomi ovi bolesti snaţno utječu na tjelesno, fizičko i psihosocijalno funkcioniranje oboljelih, što često uključuje intestinalne tegobe poput mučnine, povraćanja, proljeva, svjeţu krv u stolici, bol u području abdomena, neţeljeni gubitak tjelesne mase i mnoge druge simptome. Ulcerozni kolitis karakterizira kontinuirana kronična upala sluznice rektuma i kolona. Crohnova bolest je kronična upalna bolest crijeva nepoznate etiologije koja moţe zahvatiti bilo koji dio probavne cijevi, od usne šupljine do anusa. Neklasificirana upalna bolest crijeva je termin koji opisuje bolesnike u kojih se ni nakon detaljne evaluacije ne moţe razlikovati radi li se o ulceroznom kolitisu, Crohnovoj bolesti ili nekom drugom obliku kolitisa. Klinički pristup bolesniku s upalnim bolestima crijeva uključuje nekoliko koraka: postavljanje dijagnoze, definiranje fenotipa, ocjenu proširenosti i aktivnosti bolesti, detekciju ekstraintestinalnih manifestacija te ocjenu djelotvornosti ranije korištene terapije. S obzirom na čestu hospitalizaciju bolesnika veliku ulogu u zdravstvenom timu ima medicinska sestra, koja svojim stručnim znanjem i vještinama kroz zdravstvenu njegu i edukaciju pomaţe bolesniku u rješavanju njegovih problema. Zdravstvena njega bolesnika s upalnim bolestima crijeva ovisi o fenotipu bolesti i stupnju zahvaćenosti crijeva, a prvenstveno o općem stanju bolesnika.The spectrum consisting of inflammatory bowel diseases are ulcerative colitis, Crohn's disease and unclassified inflammatory bowel disease. Symptoms of these diseases strongly affect physical and psychosocial functioning of patients, often involving intestinal complaints such as nausea, vomiting, diarrhea, fresh blood in the stool, pain in the abdomen, unwanted weight loss, and many other symptoms. Ulcerative colitis is characterized by continuous chronic inflammation of the lining of the rectum and colon. Crohn's disease is a chronic inflammatory bowel disease of unknown etiology that may affect any part of the gastrointestinal tract, from the mouth to the anus. Unclassified inflammatory bowel disease is a term that describes patients in which, following a detailed evaluation, can not be distinguish whether it is ulcerative colitis, Crohn's disease or some other form of colitis. The clinical approach to patients with inflammatory bowel disease involves several steps: diagnosis, defining phenotype, assessment of the extent and activity of disease, detection of extraintestinal manifestations and evaluation of the effectiveness of previously used therapies. Due to frequent hospitalization major role in the health team has a nurse, who with particular knowledge and skills through health care and education helps the patient in dealing with its problems. Nursing of patients with inflammatory bowel disease depends how much is intestine affected and primarily on the general condition of the patient

EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF PATIENTS WITH CROHN'S DISEASE IN ADULT POPULATION OF SPLIT-DALMATIA COUNTY

Cilj istraživanja: Analizirati pojavnost Crohnove bolesti u Splitsko-dalmatinskoj županiji tijekom devetogodišnjeg razdoblja, te analizirati kliničke i epidemiološke čimbenike i njihove promjene tijekom spomenutog razdoblja. Materijali i metode: Uzorak pacijenata obuhvaća sve pacijente s dijagnozom Crohnove bolesti starije od 18 godina, upisane u Registar za upalne bolesti crijeva Kliničkog odjela za gastroenterologiju i hepatologiju KBC Split od 2006. do 2014. godine. Provedeno istraživanje je bilo presječno retrospektivno. Za obradu podataka korišten je SPSS program. Rezultati: Analizirano je ukupno 204 pacijenata, od kojih je bilo 116 muškaraca (56,9%) i 86 žena (43,1%). Prosječna dob svih bolesnika iznosila je 42,4±15,6 godina; za muškarce 40,2±13,8 godina, a za žene 45,3±17,4 godina, što je bila statistički značajna razlika (P=0,024). Dobna razdioba ukazala je na najveći broj ispitanika u mladim dobnim skupinama. Analiza obrazovne strukture ukazala je na najveći broj ispitanika sa srednjom razinom obrazovanja 137 (67,2%), a prema mjestu stanovanja najviše bolesnika, 92 (45,1%), bilo je iz gradskih područja. Najviše pacijenata, ukupno 156 slučajeva (76,5%), imalo je tešku kliničku sliku bolesti. Dob je bila statistički značajno povezana s težinom kliničke slike (P=0,038); U trenutku dijagnoze najviše pacijenata, njih ukupno 86 (42,1 %), je imalo bolest leokolona. Prilikom dijagnosticiranja bolesti većini pacijenata je napravljena patohistološka analiza (83,8%) i totalna kolonoskopija (70,6%), a terminalna ileoskopija je urađena u 28,4%. Pacijenti su najčešće liječeni kortikosteroidima (79,9%). Kirurški je liječena otprilike trećina bolesnika (34,4%). Zaključak: Brojna istraživanja ukazuju na porast pojavnosti Crohnove bolesti. Ovo je prvo takvo istraživanje napravljeno za Splitsko- dalmatinsku županiju i razlika u učestalosti pojave bolesti kroz praćeni period nije pokazala statistički značajan trend. Analiza epidemioloških i kliničkih karakteristika pacijenata s Crohnovom bolesti je bitna i trebalo bi je nastaviti kako bismo dobili što bolji uvid u čimbenike razvoja bolesti i ovisnosti tih čimbenika o težini kliničke slike. Na taj način bismo mogli omogućiti bolji terapijski pristup u liječenju ove, za sada, neizlječive bolesti.Aims: To analyze the incidence of Crohn's disease in Split-Dalmatia County during the nine year period, and to analyze clinical and epidemiological factors and their changes in the mentioned period. Materials and methods: The sample of patients includes all patients with Crohn's disease diagnosis, that are older than 18 and registered in the inflamatory bowel disease register of Department of Gastroenterology and Hepatology of University Hospital Split from 2006 till 2014. Conducted research was retrospective. SPSS software was used for data analysis. Results: 204 patients were analyzed, from which there were 116 men (56,9%) and 86 women (43,1%). The average age of all patients was 42,4±15,6 years; the average age for men 40,2±13,8 was and for women 45,3±17,4, which was a statistically significant difference (P=0,024). Age distribution showed that most of the patients were in younger age groups. Education analysis showed most of the patients had a secondary level of education and place of residence analysis showed that most of the patients, 92 of them (45,1%), lived in urban areas. The most of the patients, a total of 156 cases (76,5%), had severe stage of the disease. Age was statistically correlated with the severity of the disease (P=0,038); At the moment of diagnosis most of the patients, 86 of them (42,1%), had ileocolonic disease. During disease diagnostics most of the patients have had pathohistological analysis (83,8%) and total colonoscopy (70,6%). Patients were mostly treated with corticosteroids (79,9%). Around one third of the patients was surgically treated. Conclusion: Many studies have shown increasment of the incidence of Crohn's disease. This is the first study of that kind made for Split-Dalmatia County and there was no statistically significant incidence of trend in observed period. Analysis of epidemiological and clinical characteristics of patients with Crohn's disease is important and should be continued in order to get a better insight into the factors of disease development and their dependence on severity of disease. That way, it would be possible to ensure better therapy approach in treatment of this, at the moment, incurable disease

Urological complications of Chrone\u27s disease

Iznesen je općeniti pregled današnjeg saznanja o Crohnovoj bolesti. Regionalni enteritis (Crohnova bolest) može biti lokaliziran od kardije do rektuma, a veoma se često manifestira urološkim komplikacijama. Preliminarna dijagnoza je redovito karcinom, a konačna se dijagnoza postavlja histološkom analizom operativnog preparata. Prikazana su 4 slučaja regionalnog enteritisa sa urološkim komplikacijama: jedan sa slikom ileovezikalne fistule, jedan sa kolovezikalnom fistulom, jedan kao paranefritički apsces i jedan pod slikom progredirajućeg karcinoma prostate. Sva 4 slučaja potvrđuju da kod Crohnove bolesti urološka slika može dominirati kliničkim tokom, a da je preoperativna dijagnoza mahom nemoguća i konačno, da urološke komplikacije mogu biti najbizarnije vrste.The following are common aspects of today’s knowledge of Crohne’s disease. It can be extended from the cardia through the rectum, and very often there are urological complications. Often the preliminary diagnosis is carcinoma although the final diagnosis cannot be confirmed without pathohistological finding. We treated 4 cases of regional enteritis with urological complications: one patient had ileovesical fistulas, one had colovesical fistulas, one had paranephritic apscess and one had symptoms of progradiated prostatic cancer disease. In all these cases it is clear that Crohne’s disease can be dominated by urological symptoms, the preoperative diagnosis is almost difficult to give and urological complications can be very unusual

Oral manifestations of the inflammatory bowel disease

Crohnova bolest i ulcerozni kolitis su oblici upalnih bolesti crijeva. Crohnova bolest javlja se duž cijele dužine probavne cijevi, a zahvaća cijelu debljinu stijenke. Upalne promjene su diskontinuirane, izmjenjuje se zdrava i bolesna sluznica. Ulcerozni kolitis je ograničen na sluznicu debelog crijeva. Za razliku od Crohnove bolesti, upalne promjene su kontinuirane. Oba stanja karakterizirana su kroničnom upalom gatrointestinalne sluznice, uz koju se u nekim slučajevima javljaju i izvancrijevne manifestacije. Oralne manifestacije Crohnove bolesti su: orofacijalni edemi, krpičaste promjene sluznice, kaldrmast izgled sluznice, hiperplastični gingivitis i aftozni stomatitis. Najčešće se javljaju na bukalnoj sluznici, gingivi, usnama, vestibulumu i retromolarnom području. Orofacijalna granulomatoza je neuobičajeno kliničko patološko stanje koje opisuje pacijente s oralnim manifestacijama identičnima onima kod Crohnove bolesti, no bolest crijeva nije prisutna. Oralne manifestacije ulceroznog kolitisa nisu tako upečatljive kao oralne manifestacije Crohnove bolesti. Najčešće se viđaju aftozni stomatitis i pyostomatitis vegetans. Terapija oralnih manifestacija usmjerena je liječenju osnovne bolesti. Bolesnici s upalnom bolesti crijeva liječe se kortikosteroidima i imunosupresivima te je potreban oprez kod stomatološkog liječenja.Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease. Crohn's disease is present along the entire length of the gastrointestinal tract, and involves the entire thickness of the intestinal wall. Inflammatory changes are discontinuous, with alternating areas of healthy and diseased mucosa. Ulcerative colitis is confined to the mucosa of the colon. Inflammatory changes, as opposed to Crohn's disease, are continuous. Both conditions are characterised by the chronic inflammation of gatrointestinal mucosa, and in some cases extraintestinal manifestations. Oral manifestations of Crohn's disease are: orofacial oedemas, mucosal tags, cobblestoning, hyperplastic gingivitis and aphthous stomatitis. They occur mostly on buccal mucosa, gingiva, lips, vestibule and retromolar area. Orofacial granulomatosis is an uncommon condition amongst patients with oral lesions identical to those of Crohn's disease, yet the intestine is unaffected. Oral manifestations of ulcerative colitis are not as prominent as oral manifestations of Crohn's disease. Most common features are aphthous stomatitis and pyostomatitis vegetans. Treatment of oral lesions focuses on the treatment of the underlying disease. Patients with inflammatory bowel disease are treated with corticosteroids and immune suppressants. Caution is therefore required during dental treatment

Acute exacerbation of inflammatory bowel diseases in pregnancy

Upalne bolesti crijeva su idiopatske, upalne, kronične bolesti probavnog sustava nepredvidljivog tijeka. Unutar skupine upalnih bolesti crijeva spadaju Crohnova bolest i ulcerozni kolitis. Upalne bolesti crijeva često mogu zahvatiti mlade žene u reproduktivnoj dobi. Pojava upalnih bolesti crijeva u trudnoći jednaka je učestalosti pojave tih bolesti u općoj populaciji. Bolest se u trudnoći može javiti po prvi put ili kao relaps prijašnje poznate bolesti. Crohnova bolest u otprilike 50% pacijentica mlađih od 35 godina se javlja u vrijeme prve dijagnoze i 25% njih zatrudni po prvi put poslije dijagnoze. Trećina žena sa inaktivnom Crohnovom bolesti kod začeća će doživjeti relaps u trudnoći ili puerperiju. Bolest se klinički prezentira kao perforacija crijeva ili opstrukcija crijeva. Za dijagnostiku uz detaljnu anamnezu se koriste suvremene pretrage poput kolonoskopije, sigmoidoskopije i ultrazvuka. Liječenje Crohnove bolesti može biti medikamentozno ili kirurški. Od lijekova najčešće se koristi infliximab i 5-aminosalicilna kiselina. Od kirurških zahvata najčešće se radi resekcija crijeva s anastomozom ili stomom. Porod može biti elektivni vaginalni ili carski rez, te je ponekad zbog komplikacija potrebno učiniti hitni carski rez. Ulcerozni kolitis ima sličnu incidenciju pojave u trudnoći kao i Crohnova bolest. Za dijagnostiku uz detaljnu anamnezu se koristi ultrazvuk. Liječenje je najčešće kirurški, operativnim zahvatima Turnbull ''Blowhole'' i totalna abdomnalna kolektomija. Porod je uglavnom elektivan ili carski rez. Ishod trudnoće u upalnim bolestima crijeva je vrlo dobar s povremenim povećanim rizikom nedonoščadi, smanjene tjelesne težine i visine za gestacijsku dob.Inflammatory bowel diseases are idiopathic, inflammatory, crohnic diseases of gastrointestinal tract with unpredictable course. Inflammatory bowel diseases include Crohn's disease and ulcerative colitis. Inflammatory bowel diseases often affect young women of reproductive age. The appearance of inflammatory bowel disease in pregnancy is equal to the incidence of these diseases in the general population. The disease can occur in pregnancy for the first time or as a relapse of an earlier known disease. In approximately 50% of patients younger than 35 Crohn’s disease occurs at the time of first diagnosis, and 25% become pregnant for the first time after diagnosis. A third of women with inactive Crohn's disease at conception will experience a relapse during pregnancy or puerperium. The disease presents clinically as intestinal perforation or obstruction. Diagnosis includes detailed history and use of modern time diagnostics such as colonoscopy, sigmoidoscopy and ultrasound. Treatment of Crohn's disease can be medical or surgical. Most often used drugs are infliximab and 5-aminosalicylic acid. The most common surgical procedure is resection of the intestine with anastomosis or stoma. Childbirth can be an elective vaginal or Cesarean section, and sometimes because of complications emergency C-section is done. Ulcerative colitis has a similar incidence in pregnancy as Crohn's disease. Diagnosis includes detailed medical history and ultrasound. Treatment is usually surgical Turnbull '' Blowhole '' surgery and a total abdominal colectomy. Childbirth is mostly elective or Caesarean section. The outcome of pregnancy in inflammatory bowel diseases is very good with occasional increased risk of premature infants, reduced body weight and height for gestational age