INFLAMMATORY BOWEL DISEASE - PART 9

Tỷ lệ mắc bệnh Crohn (CD) ở phụ nữ đã được tăng lên trong vài thập kỷ qua. Nó không phải là rõ ràng cho dù đây là một kết quả của kỹ thuật chẩn đoán được cải thiện, sự gia tăng thói quen hút thuốc của phụ nữ trẻ (những bệnh nhân với CD có xu hướng hút thuốc so với những người mà không cần đĩa CD) | 15 Gender-Specific Issues in Inflammatory Bowel Disease Sunanda V Kane MD Contents Introduction Self-Image Issues The Menstrual Cycle Fertility Contraception Effect of IBD on Pregnancy Effect of Pregnancy on IBD Treatment of IBD During Pregnancy Surgery and Pregnancy Surgical Outcomes Menopause Summary References INTRODUCTION The incidence of Crohn s disease CD in women has been increasing over the past few decades. It is not clear whether this is a result of improved diagnostic techniques an increase in smoking habits by young women patients with cd tend to be smokers compared to people without cd or other factors not yet identified. However the consequence of this trend is a growing population of patients with gender-specific needs and concerns related to their medical care. Every component of the reproductive cycle can potentially effect disease course or symptomatology. Because the diagnosis of cd or ulcerative colitis UC is From Clinical Gastroenterology Inflammatory Bowel Disease Diagnosis and Therapeutics Edited by R. D. Cohen Humana Press Inc. Totowa NJ 295 296 Kane often made in the childbearing years fertility and pregnancy are important issues that previously have been handled exclusively by gynecologists. Gastroenterologists caring for women with inflammatory bowel disease IBD should be aware of these issues and their appropriate management. SELF-IMAGE ISSUES Maunder et al. reported consistently higher levels of symptom severity and rating of IBD patient concerns in women than men 1 . Patient concerns that differed by gender included attractiveness intimacy and sexual performance. Women also had stronger concerns about selfimage feeling alone and fearful of having children. Active disease can lead to fatigue and loss of libido in addition to the embarrassment of fecal incontinence. Corticosteroids to treat active disease leads to Cushingoid features along with weight gain and mood swings. Perineal involvement in CD can be physically deforming as well as

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