ABSTRACT
The inflammatory bowel diseases ulcerative colitis and Crohnïs disease are probably syndromes rather than single entities. Neither the susceptibility genes no definite environmental factors have been found thus far. The immune concept of these disorders might not include all patients, alternative hypotheses for etiology and pathophysiology need to be studied. Consequently non immune based new approaches on alternative etiological/pathophysiological pathways may be necessary
Subject(s)
Humans , Colitis, Ulcerative/physiopathology , Crohn Disease/physiopathology , Colitis, Ulcerative/drug therapy , Colitis, Ulcerative/etiology , Crohn Disease/drug therapy , Crohn Disease/etiology , Cytochrome P-450 Enzyme System/therapeutic use , Cytokines/therapeutic use , Probiotics/therapeutic useABSTRACT
La colestasis incluye una amplia variedad de causas. Cuando se excluyen las causas extrahepáticas un número de trastornos que producen colestasis intrahepática son definidos. El mecanismo celular de la colestasis aún no esta completamente entendido. El diagnóstico puede hacerse utilizando la historia, examen clínico, algunos parámetros de laboratorio, serología y también la PCRE. El tratamiento principalmente depende de la causa de la colestasis. Las causas más importantes de colestasis intrahepática, la cirrosis biliar primaria y la pericolangitis esclerosante primaria tienen en el ácido ursodeoxicólico, en ocasiones asociadas a terapia inmunosupresora, al tratamiento de elección. El trasplante hepático se mantiene como una importante opción terapéutica. Todos los demás tratamientos deben evaluarse, comparándose a estas medidas estándar.
Subject(s)
Cholangitis, Sclerosing , Cholestasis , Liver Cirrhosis, Biliary , Ursodeoxycholic AcidABSTRACT
Cholestasis includes a wide variety of causes. When extrahepatic causes are excluded a number of disorders causing intrahepatic cholestasis are defined at this time. The cellular mechanisms of cholestasis have as yet to be completely understood. Diagnosis can be made using history, physical examination, a few laboratory parameters, serology and also ERCP. Treatment depends largely on the cause of the cholestasis. Regarding the leading disorders such as PBC and PSB, ursodesoxycholic acid and in some instances in addition immunosuppressants are thus far established. Liver transplantation remains an important treatment option. All other treatments need to be evaluated against these standard measures.