Although no single gene has been found to be responsible for the development of CD, several susceptibility gene loci have been identified. The recently discovered association of NOD2 gene mutations with CD represents a major advancement in this regard. The Nod2 proteins encoded by NOD2 gene bind to bacterial lipopolysaccharides (LPS) as well as activate NF-kB, a key inflammatory cytokine. Deletion of the LPS binding domain has, however, been associated with activation of NF-kB, further propagating inflammatory cascade. The prevalence of these NOD2 variants is < 20% of the patients with CD. More importantly, mutations in NOD2 have been associated with ileal CD, fibrostenotic disease behavior, and possibly early age at onset and, perhaps, non-perianal fistulizing disease (Brant et al, 2003; Abreu et al, 2002; Cuthbert et al, 2002). In fact, the risks of ileal disease and fibrostenotic disease are about 10-fold and 7-fold, respectively, for CD patients with 2 NOD2 mutations compared to those without any mutation. Whether patients with SB CD may be stratified by their genotypes and managed accordingly (eg, more aggressive medical therapy and earlier surgery if mutations are identified) will need to be further examined.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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