Chronic Recurrent Course Research Articles

Pathogenetic Role and Possibilities for Correction of Gut Microbiota Disorders in Urinary Tract Infections

The article presents current data on the role of gut microbiota in the development of urinary tract infections. The main pathogenetic mechanisms contributing to the chronic recurrent course of the disease, the spread of antimicrobial resistance, as well as their connection to the disorders of gut microbiota are shown. It is known that most pathogens of urinary infections originate from the gut microbiota, where they exist for a long time, forming reservoirs. The normal composition and functions of the microbiota prevent colonization of the intestine by pathogenic bacteria and reduce the risk of developing this disease. Ways of correction through diet, probiotics, as well as fecal microbiota transplantation are considered. Modulation of gut microbiota may be a promising approach in the treatment and prevention of urinary tract infections. Meanwhile, a qualitative evidence base on the effectiveness of this strategy has not been formed. Further research in this direction is required.

THE ROLE OF ENDOGENOUS NEUROPEPTIDES IN THE PATHOGENESIS AND CLINICAL MANIFESTATIONS OF ROSACEA-TIDES IN WOMEN

Rosacea is a common skin disease with a chronic recurrent course. Numerous factors of etiology and pathogenesis of this dermatosis, which may influence the appearance of its clinical signs, have not been elucidated. The aim of the work is to determine the content of endogenous neuropeptides (substance P, leu-enkephalin) in the blood, to find out their role in the development of clinical manifestations of rosacea in women. Materials and methods - 47 women with rosacea were clinically and laboratory examined in whom the levels of substance P and leu-enkephalin in the blood were determined by enzyme-linked immunosorbent assay. Results. Quantitative assessment of the degree of manifestations of clinical signs of local redness of the skin and subsequent symptoms of rosacea (pink acne) in women indicates a complex nature of changes in the skin and reactions of the nervous and endocrine systems. The revealed imbalance in the blood of patients with endogenous neuropeptides with different mechanisms of effector and regulatory action (increase - substance P, decrease - leu-enkephalin) indicates a violation of the mutual compensatory relations of these peptide signaling molecules in different functional systems of the body, and the following symptoms of the disease, which differed in women of reproductive and older age.Conclusions. Imbalance of levels of endogenous neuropeptides with opposite effector and regulatory effects (substance P, leu-enkephalin) may be one of the key pathogenetic factors of the appearance and development of clinical manifestations of rosacea in women given the polypotent mechanisms of action of these biologically active compounds as neurotransmitters and antinociceptive mediators, regulators of emotional and behavioral reactions, pro- and anti-inflammatory factors, coordinators of the hypothalamic-pituitary-gonadal system. Misdiagnosis of such manifestations of the disease as rosacea-tides with «menopausal», «migraine-like» and other types of tides in women dictate the need for a comprehensive examination of such patients.Кey words: rosacea, substance P, ley-enkephalin, women’s.

Combination of isotretinoin and Contractubex Anti-Red in acne therapy

BACKGROUND: Acne vulgaris (acne vulgaris) is an urgent interdisciplinary problem. Analyzing modern scientific data on the development of acne vulgaris, it is necessary to focus on the role of inflammation that accompanies dermatosis at all its stages of development, sometimes preceding the formation of clinical symptoms. Prolonged chronic recurrent course, difficulties in choosing the correct therapy tactics, sometimes unreasonable medical interventions, exacerbation, improper skin care lead to the formation of a number of complications. AIMS: To optimize and improve the effectiveness of therapy in patients with moderate and severe degrees acne using isotretinoin and the combined innovative gel Contractubex Anti-Red. MATERIALS AND METHODS: The study included 60 patients aged 18 to 45 years with moderate to severe acne. Isotretinoin was prescribed in standard dosages. To study the effect of Сontraktubex Anti-Red on the dynamics of post-acne, patients with atrophic post-acne scars were divided into 3 subgroups, depending on the regimen of drug use. RESULTS: Almost complete relief of the inflammatory process, regression of elements was noted 12 months after the use of complex therapy, the value of the dermanologic index of acne (DIA) index was more than 70% noted in 62% of patients, significant improvement in 38%. The severity of post-acne scars on the SCAR-S scale changed significantly during treatment and in 53.3% this indicator was 1. The Cadi index decreased by 70% compared to the baseline. CONCLUSION: Good cosmetic effect, safety, absence of side effects, comfort and ease of use make it possible to recommend Contractubex Anti-Red together with basic acne therapy.

The need for a multidisciplinary approach to the diagnosis and treatment procedures of isolated lesions of the oral mucosa in herpetiform Dühring dermatitis

The defeat of the oral mucosa in herpetiform Dhring dermatitis is a rare pathology. According to the literature, it is detected in 9.6% 10% of cases. Granular deposits of immunoglobulin A in the papillae of the dermis in herpetiform Dhring dermatitis are associated with gluten enteropathy, lead to the development of inflammatory processes on the skin and oral mucosa and the appearance of polymorphic itchy rashes and chronic recurrent course of the disease. The article describes a clinical case of a patient diagnosed with herpetiform dermatitis, manifestations in the oral cavity (ICD-10 L13.0X code). The need for a multidisciplinary approach to the diagnosis, differential diagnosis, treatment and dynamic observation of isolated lesions of the oral mucosa in herpetiform Dhring dermatitis is indicated. A scheme of measures required by a dentist is developed.

REVISIÓN DE TEMA: PAPEL DE LA ACTIVIDAD FÍSICA EN EL MANEJO NO FARMACOLÓGICO DEL SÍNDROME DE INTESTINO IRRITABLE

El síndrome de intestino irritable (SII) es el diagnóstico gastroenterológico más común, con una elevada prevalencia global que oscila entre el 5% al 21%. Esta enfermedad de curso recurrente crónico se caracteriza por su traslape con otros trastornos funcionales y su afectación en la calidad de vida de los pacientes. Actualmente son pocos los tratamientos que ofrecen un alivio sintomático satisfactorio, por lo que en el manejo efectivo del SII se ha dado importancia a la consejería sobre cambios en el estilo de vida, actividad física, dieta, entre otros. Este enfoque de esfuerzo personal por parte del paciente se sustenta en la relación del estado de estrés crónico con la exacerbación de los síntomas de SII. Las interacciones cerebro-intestino pueden jugar un rol en la asociación entre la actividad física y los síntomas en el SII. La mayoría de estudios concuerdan que las intervenciones que propician el aumento de la actividad física mejoran los síntomas gastrointestinales del SII; así como diferentes aspectos de la calidad de vida, fatiga, depresión y ansiedad a largo plazo.

P761 Illness cognition of Saudi patients with Crohn’s disease

Abstract Background The prevalence of Crohn’s disease (CD) has markedly increased in Saudi Arabia over the past 3 decades.Patients’ awareness of the chronic recurrent course and potential risk of disease complications can lead to a wide range of psychological and interpersonal concerns. Patients’ cognition about the disease and treatment are important mediators as they explain the occurrence of individual differences in the individuals’ adjustment to chronic diseases. The aim of this study is to assess illness cognition of Saudi patients diagnosed with CD and to identify clinical predictors. Methods Consecutive patients with confirmed CD seen in the adult outpatient gastroenterology clinic at King Abdulaziz university hospital were recruited between January and December of 2019. Data was collected from interviews conducted with the patients and from the hospitals’ electronic medical records.The primary endpoint of the study was patients’ illness cognition according to the illness cognition questionnaire (ICQ), which can be used to assess three cognitive functions that patients attribute to disease: helplessness (6 items), acceptance (6 items), and perceived benefits (6 items). Each item is scored from 1 to 4, with 1 corresponding to ‘Not’, and 4 corresponding to ‘Totally. Descriptive statistics were used to summarise patient characteristics and linear regression analysis was used to identify predictors of the ICQ score. Results A total of 88 patients were surveyed, of which 55.8% were females, 18% were smokers and 11.5% had undergone CD-related surgery. The mean age was 26.9 ± 7.7 years and the mean duration of disease was 54.7 ± 60.5 months. Perianal disease was reported by 16.1% of the cohort. Twenty eight percent of patients reported that they ‘completely’ missed things that they like to do the most because of their illness and 35% responded by ‘not at all’ when asked if they had learned to live with their disease. Forty one percent of patients reported that the illness ‘completely’ controls their life and 30% responded by ‘not at all’ when asked if they can accept their illness. Mean ICQ score was 44.3 ( ± 6.6). On linear regression analysis, duration of the disease in months (coef = −0.04, p = 0.008) and fatigue (coef = −1.40, p = 0.04) were predictive of the ICQ score. Conclusion A considerable proportion of Saudi patients diagnosed with CD report negative perception of their disease. Duration of illness and presence of fatigue appear to be predictive of the ICQ score.

Application of Fecal Calprotectin in Inflammatory Bowel Disease

Abstract In the practice, a distinction between organic and functional bowel disease and assessment for endoscopic examination is required daily for gastrointestinal symptoms. In modern gastroenterology, the evaluation of disease activity, prognosis and control of therapy in patients with chronic Inflammatory Bowel Disease (IBD) are a challenge. The search for non-invasive laboratory markers for monitoring of their chronic-recurrent course and management of treatment is an important part of ensuring a good quality of life for patients. In recent years, faecal calprotectin has become a useful non-invasive biomarker. The focus of this review is on current guidelines for the use of calprotectin, with particular emphasis on faecal calprotectin, as a tool in the treatment and diagnostic management of IBD. Publications and expert clinical guidelines from the last six years on the use of calprotectin were reviewed. We have summarized the critical evaluations in the application, also the advantages and disadvantages of using faecal calprotectin (FC) in gastroenterological practice. Conclusion: FC is a non-invasive diagnostic tool that enables physicians to more accurately, timely diagnose and predict the course and course of patients with IBD. Keywords Calprotectin; Faeces; Inflammatory bowel disease

Clinical Case of Isolated Lesion of Oral Mucosa by Dermatitis Herpetiformis

Dermatitis herpetiformis (Duhring’s disease) is an inflammatory skin disease associated with celiac enteropathy and characterized by polymorphic pruritic eruptions, chronic recurrent course, and granular deposition of IgA in the papillae of the dermis. The defeat of the oral mucosa with dermatitis occurs infrequently, in 9.6–10% of patients. The article describes the clinical case of a patient with a diagnosis of dermatitis herpetiformis, manifestations in the oral cavity (ICD-10 code - L13.0Х). A diagram of the basic differential diagnostic measures carried out by a dentist and criteria for monitoring the examinee’s condition during a follow-up of a patient are presented as well.

Modern approaches to external therapy of sensitive skin area in atopic dermatitis in children: focus on topical calcineurin inhibitors

Due to high prevalence in the pediatric population, chronic recurrent course and difficulties in choosing the local therapy, atopic dermatitis is an urgent problem for pediatricians, dermatologists and allergists. The review presents data on the prevalence and features of the clinical manifestations of atopic dermatitis in various age periods. The authors consider structural, functional and immunological features of the skin barrier are considered in detail under normal and under pathological conditions. They emphasize the problems of quality of life, compliance and steroidophobia of patients with atopic dermatitis. Particular attention is paid to the concept of sensitive skin, the definition of this concept and the localization of sensitive skin area on the surface of the body. The article describes approaches to the method of choosing external therapy according to the European guidelines for the treatment of atopic dermatitis in 2018. It presents a modern practical algorithm for prescribing local anti-inflammatory drugs (topical glucocorticosteroids, topical calcineurin inhibitors) taking into account the severity of the clinical manifestations of the disease and the areas of application (sensitive skin areas/other parts of the body). The authors provide evidence of the efficacy and safety of topical calcineurin inhibitors, in particular pimecrolimus, in the treatment of patients with mild to moderate severity of atopic dermatitis, especially in sensitive skin areas.

Therapy of bacterial vaginosis

Aim:evaluation of efficacy of Multi-Gyn® Actigel application in the complex therapy of bacterial vaginosis (BV) and prevention of its recurrence in pregnant women.Patients and methods:87 patients of reproductive age were examined and treated with the diagnosis of «bacterial vaginosis, chronic recurrent course». 41 of them from the main group were given Multi-Gyn® Actigel at the 1st stage of treatment, while 46 women of the comparison group were given 2% clindamycin cream In order to restore vaginal microbiocenosis, a probiotic containing Lactobacillus casei rhamnosus spp. LCR35 was used in both groups at the second stage Clinical laboratory methods were used.Results:efficacy of Multi-Gyn® Actigel application in complex therapy of BV and prevention of its recurrences in non-pregnant women was proved. As a result of Multi-Gyn® Actigel prescription there were no complaints, pH level was normalized, almost complete absence of BV-associated microorganisms was achieved and lactobacillus pool preservation even in the distant period after treatment.Conclusion:Multi-Gyn® Actigel is an effective remedy for treatment of BV and prevention of its recurrence in non-pregnant patients, especially in the chronic recurrent course of the disease. This effect is achieved not only by eliminating anaerobic microorganisms, but also due to the persistent preservation of the lactobacillus pool.

The Usefulness of Aqueous Fluid Analysis for Epstein–Barr Virus in Patients with Uveitis

ABSTRACTPurpose: To determine characteristics of patients with laboratory findings indicative of intraocular Epstein–Barr-virus (EBV) infection and to establish the usefulness of the laboratory analysis in patients with uveitis.Methods: Retrospective study of patients who underwent diagnostic aqueous fluid analysis. Diverse demographic data of patients were registered.Results: EBV-PCR tested positive in 3/201 (1%) and EBV-GWC in 22/245 (9%). The prevalence of immunosuppression was similar in EBV positive (by PCR/GWC) and EBV negative patients (7/25; 28% vs. 50/272;18%, P = 0.29). Out of all 22 EBV-GWC positive patients, GWC was between 3 and 10 in 91%. In total, 14 patients had laboratory results indicating only EBV infection. Patients without an alternative explanation for uveitis (6/14; 43%) had a chronic recurrent course and good visual prognosis.Conclusion: Low EBV-GWC values combined with multiple positive GWC and/or PCR for other infectious agents. Intraocular assessment for EBV in the initial examination of uveitis patients has limited value.

IMPACT OF TUBERCULOSIS AND ANTITUBERCULOUS CHEMOTHERAPY ON LIPID COMPOSITION OF THE BLOOD PLASMA

Tuberculosis is an infectious disease caused by tuberculosis mycobacteria of human or bovine types and is characterized by multiple organs failure and chronic recurrent course. The blood plasma lipid spectrum state is one of the antituberculous chemotherapy toxic effect markers. The important role of the ratio of various fractions of general and blood phospholipids for the evaluation of the state of the organism in infectious pathology is proved. The purpose of this work is to study the features of the lipid spectrum of blood plasma in patients with pulmonary tuberculosis prior to treatment and at the end of the intensive phase of antituberculous chemotherapy. Three hundred and eight young and middle-aged patients with pulmonary tuberculosis were examined. The lipid and phospholipid spectrum of blood was determined prior to initiating the antituberculous chemotherapy and after the end of the intensive phase. The absolute content of general lipids and total phospholipids of blood plasma, as well as all their fractions, in patients with pulmonary tuberculosis were higher than in healthy volunteers. In this regard, the representation of the lipid spectrum in absolute units does not reflect all the features of lipid metabolism disruption, which is primarily manifested in the plasma lipids main classes ratio violation. It is shown that the spectrum of lipid and phospholipid composition of blood plasma in patients with pulmonary tuberculosis differs significantly from the spectrum in healthy people. Antituberculous chemotherapy with bactericidal and bacteriostatic action comes with normalization of a number of lipid metabolism indicators such as free fatty acids, triglycerides, cholesterol esters and phosphatidylserine. However, such indicators as total phospholipids, free cholesterol and lysophospholipids show negative dynamics, which is probably caused by the antituberculous drug’s effect.

IMPACT OF TUBERCULOSIS AND ANTITUBERCULOUS CHEMOTHERAPY ON LIPID COMPOSITION OF THE BLOOD PLASMA

Tuberculosis is an infectious disease caused by tuberculosis mycobacteria of human or bovine types and is characterized by multiple organs failure and chronic recurrent course. The blood plasma lipid spectrum state is one of the antituberculous chemotherapy toxic effect markers. The important role of the ratio of various fractions of general and blood phospholipids for the evaluation of the state of the organism in infectious pathology is proved. The purpose of this work is to study the features of the lipid spectrum of blood plasma in patients with pulmonary tuberculosis prior to treatment and at the end of the intensive phase of antituberculous chemotherapy. Three hundred and eight young and middle-aged patients with pulmonary tuberculosis were examined. The lipid and phospholipid spectrum of blood was determined prior to initiating the antituberculous chemotherapy and after the end of the intensive phase. The absolute content of general lipids and total phospholipids of blood plasma, as well as all their fractions, in patients with pulmonary tuberculosis were higher than in healthy volunteers. In this regard, the representation of the lipid spectrum in absolute units does not reflect all the features of lipid metabolism disruption, which is primarily manifested in the plasma lipids main classes ratio violation. It is shown that the spectrum of lipid and phospholipid composition of blood plasma in patients with pulmonary tuberculosis differs significantly from the spectrum in healthy people. Antituberculous chemotherapy with bactericidal and bacteriostatic action comes with normalization of a number of lipid metabolism indicators such as free fatty acids, triglycerides, cholesterol esters and phosphatidylserine. However, such indicators as total phospholipids, free cholesterol and lysophospholipids show negative dynamics, which is probably caused by the antituberculous drug’s effect.

Periocular and Intravitreal Steroid Use in Treatment of Behcet’s Disease-Related Uveitis

Behcet’s disease has an intractable chronic recurrent course and ocular involvement is one of the most important morbidity reasons. Systemic steroids and immunosuppressive constitute the basis of the treatment in ocular involvement. However, both the side effects and the necessity of high dosages for ocular penetration of the medications favors the local treatment options. Periocular injections (orbital floor and subtenon) in this manner are found to be effective as an adjuvant in the treatment of intractable disease, reducing the systemic dosage and preventing the recurrences. In the intravitreal route, the most commonly used is triamcinolone acetonide (IVTA) injection. With this route, local depot effect, rapid impact on the posterior segment, and retinal vasculitis, better outcomes in vitreous haze and macular edema can be achieved. However, complications like cataract and intraocular pressure (IOP) rise are commonly seen. Other options in the intravitreal route are Fluocinolone acetonide (Retisert®) and dexamethasone (Ozurdex®) implants. Ozurdex® becomes a suitable treatment option with its long-lasting effect and low side effect profile compared to IVTA. Although Retisert® seems effective with its action that might extend to 3 years, the necessity of surgery for implantation, and the high rate of cataract and glaucoma complications, it is not preferred frequently.

Microscopic Colitis

Microscopic colitis (MC) is still an underestimated cause of chronic, non-bloody watery diarrhea. It is typically manifested in elderly patients with a female predominance. The incidence of microscopic colitis has been increasing. The aetiology and pathophysiology remain unclear. Conditions associated with it include autoimmune diseases. There may be a genetic predisposition, as familial cases have been described. As implicated by the name microscopic colitis, the diagnosis is found by histological examination. There are mainly two subtypes, the lymphocytic colitis (LC) and the collagenous colitis (CC). Even if the condition's long-term course is benign, a chronic recurrent course of the symptoms is frequent. Due to the symptoms, there is an impairment of patient's health-related quality of life. A correct diagnosis and therapy is therefore mandatory. The aim of this paper is to create awareness for microscopic colitis.

BIOFILMS OF PATHOGENIC BURKHOLDERIA AND THEIR ROLE IN RESISTANCE TO ANTIBIOTICS

The review contains the current knowledge on the main issues of Burkholderia pseudomallei and Burkholderia mallei biofilm formation. The role ofknown structural elements of Burkholderia cells (flagella, type IV pili, LPS), as well as autotransporter adhesin proteins in the attachment of bacteria to surfaces, the formation of microcolonies and biofilm is described. The review also includes information of genetic regulatory mechanisms (QS-systems, RpoE-sigma factor, c-di-GMP, two-component signal transduction system), differentially expressed genes related to the formation of B. pseudomallei biofilm, role ofbiofilms in the virulence and resistance to antibiotics of pathogenic Burkholderia and their significance for the chronic processes and recurrent course of melioidosis and glanders.

Symptomatic and Functional Recovery From Major Depressive Disorder in the Ibadan Study of Ageing

Very little is known about the association between symptomatic and functional recovery from late-life major depressive disorder (MDD) in sub-Saharan Africa. We investigated factors associated with sustained symptomatic remission (SR) from MDD and the 5-year trajectory of post-MDD physical functioning. 5-year prospective study with three follow-up waves in 2007, 2008, and 2009. Household multistage probability sample of 2,149 Nigerians who were aged 65 years or older. Activities of Daily Living (ADL) and MDD were assessed using the Kadz index and Composite International Diagnostic Interview, respectively. We studied those with current MDD (prevalent in 2003-2004 or incident in 2007), and who achieved SR in subsequent waves compared with a chronic/recurrent course (CR). Baseline demographic characteristics, health, and lifestyle factors were not associated with SR in logistic regression analyses. In mixed-effect linear regression models adjusting for age, sex, and socioeconomic status, ADL worsened in SR (β = 1.0, 95% CI: 0.2, 1.8), but more so in CR (β = 2.3, 95% CI: 1.6, 3.0). Poorer ADL at follow-up was predicted by age (β = 2.9, 95% CI: 1.8, 4.0) and economic status (β = 1.4, 95% CI: 0.3, 2.4). There was a deteriorating course of disability despite symptomatic recovery from late-life MDD in this sample. This finding has implications for policy and guidelines for the management of late-life depression and disability.

PHARMACOECONOMIC EVLUATION OF 5-ASA APPLICATION IN LIGHT AND MEDIUM GRAVE DISSEMINATED (RECURRING) ULCERATIVE COLITIS

Inflammatory bowel diseases are chronic relapsing immune-mediated diseases affecting the gastrointestinal tract. The goal of therapy of ulcerative colitis (one of the IBD variants) is the achievement and maintenance of steroid-free remission, prevention of UC complications, prevention of surgeries and the timely use of surgical treatment when the process progresses and lifethreatening complications develop. It Is predominantly diagnosed in young people and leads to a significant reduction of quality of life. The peculiarity of the UC is its chronic recurrent course. Work on the choice of the most rational schemes of therapy continues goes on. New data from clinical studies on the efficacy and safety of modern methods of pharmacotherapy in addition to data on pharmacoepidemiology and pharmacoeconomics should help the medical community to develop the most optimal treatment strategies based on clinical and socio-economic factors. The standard therapy in the first phase is 5-ASA preparations, such as sulfasalazine and mesalazine. Given the efficacy and safety of each of these preparations it is possible to predict the frequency of transition of patients to more difficult treatment options systemic corticosteroids and biological agents arising in connection with this the possible side effects and additional economic load on the healing process. The article presents economic assessment of the use of two alternative first-line drugs for therapy - mesalazine and sulfasalazine; it shows a possible burden on the budget and subsequent benefit when switching to the most optimal treatment option.

DTI and Myelin Plasticity in Bipolar Disorder: Integrating Neuroimaging and Neuropathological Findings.

Bipolar disorder (BD) is a major psychiatric illness with a chronic recurrent course, ranked among the worldwide leading disabling diseases. Its pathophysiology is still not completely understood and findings are still inconclusive, though a great interest on the topic has been constantly raised by magnetic resonance imaging, genetic and neuropathological studies. In recent years, diffusion tensor imaging (DTI) investigations have prompted interest in the key role of white matter (WM) abnormalities in BD. In this report, we summarize and comment recent findings from DTI studies in BD, reporting fractional anisotropy as putative measure of WM integrity, as well as recent data from neuropathological studies focusing on oligodendrocyte involvement in WM alterations in BD. DTI research indicates that BD is most commonly associated with a WM disruption within the fronto-limbic network, which may be accompanied by other WM changes spread throughout temporal and parietal regions. Neuropathological studies, mainly focused on the fronto-limbic network, have repeatedly shown a loss in cortical and subcortical oligodendrocyte cell count, although an increased subcortical oligodendrocyte density has been also documented suggesting a putative role in remyelination processes for oligodendrocytes in BD. According to our review, a greater integration between DTI and morphological findings is needed in order to elucidate processes affecting WM, either glial loss or myelin plasticity, on the basis of a more targeted research in BD.

Intestinal Behçet's Disease: A True Inflammatory Bowel Disease or Merely an Intestinal Complication of Systemic Vasculitis?

Behçet's disease (BD) is a multi-systemic inflammatory disorder of an unknown etiology and shows a chronic recurrent clinical course. When the disease involves the alimentary tract, it is called intestinal BD because of its clinical importance. Intestinal BD is more frequently reported in East Asian countries than in Western or Middle Eastern countries. While any part of the gastrointestinal tract can be involved, the most common location of intestinal BD is the ileocecal area. A few, large, deep ulcerations with discrete border are characteristic endoscopic findings of intestinal BD. Currently, there is no single gold standard test or pathognomonic finding of intestinal BD. However, recently developed novel diagnostic criteria and a disease activity index have helped in assessing intestinal BD. As intestinal BD shares a lot of characteristics with inflammatory bowel disease, including genetic background, clinical manifestations, and therapeutic strategies, distinguishing between the two diseases in clinical practice is quite difficult. However, biologic agents such as anti-tumor necrosis factor α antibody shows a considerable efficacy similar to inflammatory bowel disease cases. It is important to distinguish and treat those two disease entities separately from the standpoint of precise medicine. Clinicians should require comprehensive knowledge regarding the similarities and differences between intestinal BD and inflammatory bowel disease for making an accurate clinical decision.