Description

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Context

Trial reveals filgotinib's potential to redefine Crohn’s disease treatment by delivering sustained remission and improved safety outcomes for patients worldwide.

Details

Traditional treatments involve corticosteroids, immunomodulators and biologics but they face challenges such as loss of efficacy and safety concerns.

Filgotinib a Janus kinase (JAK) 1 preferential inhibitor emerges as a novel therapeutic candidate offering potential benefits in induction and maintenance therapy for patients with moderate to severe Crohn’s disease.

About Crohn's disease

Features

Aspect	Details
Definition	Chronic inflammatory condition affecting the gastrointestinal (GI) tract.
Commonly Affected Areas	Terminal ileum and colon; can affect any part of the GI tract.
Nature of Inflammation	Transmural inflammation affecting all layers of the intestinal wall.
Pattern of Disease	Segmental with "skip lesions" (areas of normal tissue between inflamed regions).

Causes and Risk Factors

Cause/Risk Factor	Details
Genetic	Family history of IBD linked to mutations in the NOD2/CARD15 gene.
Immune Dysfunction	Abnormal immune response causing inflammation in the GI tract.
Environmental Factors	Smoking, urban living and diets high in refined sugars and low in fiber.
Microbial Factors	Changes in gut microbiota may trigger or worsen inflammation.

Symptoms

Category	Specific Symptoms
Digestive Symptoms	Abdominal pain, diarrhea (often with blood), nausea, vomiting, weight loss.
Systemic Symptoms	Fatigue, fever, anemia, malnutrition.
Extraintestinal Manifestations	Arthritis, skin disorders, eye inflammation.

Treatment Approaches

Medication Type	Purpose
Anti-inflammatory	Reduces inflammation in mild cases.
Corticosteroids	Controls acute flare-ups.
Immunomodulators	Suppresses overactive immune response.
Biologics	Targets specific inflammatory pathways.
Antibiotics	Treats secondary infections or fistulas.

Digestive System

Aspect	Details
Definition	The digestive system is responsible for breaking down food into nutrients, absorbing them and eliminating waste.
Major Functions	Digestion, absorption of nutrients and excretion of waste products.
Key Components	Alimentary canal and accessory organs.

Alimentary Canal

Organ	Structure	Function
Mouth	Teeth, tongue, salivary glands	Mechanical digestion (chewing), chemical digestion (saliva).
Pharynx	Muscular tube	Passage for food from the mouth to the esophagus.
Esophagus	Long muscular tube	Transports food to the stomach via peristalsis.
Stomach	J-shaped organ, gastric glands	Stores food, mixes it with gastric juices, initiates protein digestion.
Small Intestine	Duodenum, jejunum, ileum	Primary site for digestion and nutrient absorption.
Large Intestine	Cecum, colon, rectum	Absorbs water, electrolytes and forms feces.
Rectum and Anus	Terminal parts of the colon	Stores and expels feces through defecation.

Accessory Organs

Organ	Structure	Function
Salivary Glands	Parotid, submandibular, sublingual	Secretes saliva to moisten food and begin carbohydrate digestion (amylase).
Liver	Large, lobed organ	Produces bile to emulsify fats, detoxifies blood, stores vitamins and glycogen.
Gallbladder	Small sac beneath the liver	Stores and releases bile into the small intestine.
Pancreas	Elongated gland	Secretes digestive enzymes (amylase, lipase, protease) and bicarbonate to neutralize stomach acid.
Teeth and Tongue	Hard and muscular structures	Aid in mechanical breakdown and manipulation of food.

Processes of Digestion

Process	Location	Description
Ingestion	Mouth	Intake of food and beverages.
Propulsion	Esophagus, stomach, intestines	Movement of food through the digestive tract via swallowing and peristalsis.
Mechanical Digestion	Mouth, stomach	Physical breakdown of food (chewing, churning).
Chemical Digestion	Stomach, small intestine	Breakdown of food into simpler molecules using enzymes and acids.
Absorption	Small intestine, large intestine	Nutrient uptake into the blood or lymph.
Excretion	Large intestine, anus	Elimination of undigested food and waste as feces.

Enzymes and Secretions

Enzyme/Secretion	Source	Function
Salivary Amylase	Salivary glands	Breaks down starch into maltose in the mouth.
Pepsin	Stomach	Digests proteins into peptides in the stomach.
Bile	Liver (stored in gallbladder)	Emulsifies fats to aid in digestion in the small intestine.
Pancreatic Enzymes	Pancreas	Break down carbohydrates, proteins and fats in the small intestine.
Brush Border Enzymes	Small intestine	Complete the digestion of carbohydrates and proteins.

Common Disorders

Disorder	Cause	Symptoms
Acid Reflux (GERD)	Weak lower esophageal sphincter	Heartburn, regurgitation, chest discomfort.
Peptic Ulcers	H. pylori infection, NSAIDs	Abdominal pain, nausea, bleeding.
Irritable Bowel Syndrome (IBS)	Stress, diet, gut-brain axis issues	Abdominal cramps, bloating, diarrhea, or constipation.
Crohn’s Disease	Autoimmune, genetic factors	Chronic inflammation, diarrhea, abdominal pain, malnutrition.
Gallstones	Imbalance in bile composition	Severe abdominal pain, nausea, vomiting.

Sources:

NEWSMEDICAL

PRACTICE QUESTION

Q.Which of the following statements about the gastrointestinal (GI) tract is/are correct?

The GI tract begins at the esophagus and ends at the rectum.
The small intestine is responsible for nutrient absorption.
The liver is considered a part of the GI tract.

Options:
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2 and 3
D) 1 and 3 only

Answer: A)

Explanation:

Statement 1 is correct. The GI tract is a continuous hollow organ system beginning at the esophagus and ending at the rectum including the stomach, small intestine and large intestine.

Statement 2 is correct. The small intestine (comprising the duodenum, jejunum and ileum) plays a central role in absorbing nutrients and minerals.

Statement 3 is incorrect. The liver while essential for digestion through bile production is not a direct part of the GI tract. It is an accessory organ.