Aetiology and pathogenesis

Notwithstanding the genetic and environmental predisposing factors, the aetiology of both Crohn's disease and ulcerative colitis remains unknown. It is still debated whether Crohn's disease and ulcerative colitis are separate diseases or whether they represent a continuous spectrum of inflammatory bowel disease.

There is continuing speculation that Crohn's disease may be related in some way to mycobacterial infection, although immunological and therapeutic studies do not show evidence of mycobacterial infection in the majority of cases.

The pathogenesis of the disease is also unclear. The major hypothesis of the pathogenesis of inflammatory bowel disease relates to abnormal immune responses and dysfunctional immune-regulation within the bowel wall. Psychosocial factors related to IBD are addressed in Chapter 13.

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