Reusability and reliability of published data are fundamental requirements for translating results from animal experiments into reliable clinical biomarkers. Current success rates for biomarker discovery are poor, and we need to develop new tools to collate, integrate and analyse datasets, such as knowledge bases, that would enable more effective translation from mouse to human or across disciplines. However, concerns about the validity, reproducibility and replicability of existing data must be addressed first. Here, I interrogate the quality of methods reporting in experimental models of infection and inflammation. Despite evidence that most of the assessed parameters, such as sex and age, can influence the experimental results, the quality of methods reporting was poor. Inadequate methods reporting means that it is not always possible to confirm whether findings were due to improper experimental conditions that biased the results. Thus, such inaccuracies would have an impact on the construction of knowledge base tools that require appropriate annotation. However, I provide reusable checklists that could improve the quality of methods reporting prior to publication and can be used to verify papers post-publication to enable researchers from different fields to interrogate published data. Another reason that biomarkers may fail is that it can be difficult to determine the causative pathways that will better predict disease outcome in a chronically inflamed tissue where multiple pathways are happening simultaneously. I conducted novel research to identify and verify whether investigating animal models long before onset of colitis would identify potentially causative biomarkers for colitis in an animal model. Previous studies have shown early influx of dendritic cells are associated with resistance to Trichuris muris-induced colitis in mice, suggesting early biomarkers may be detectable that might predict disease outcome in inflammatory diseases, such as inflammatory bowel disease (IBD).In the T. muris colitis model, I identified differences in gene expression of multiple components of the receptor for advanced glycation end-products (RAGE) activation pathway between colitis-resistant and colitis-susceptible mice, occurring just 24 hours post infection; before any observable clinical symptoms were present. RAGE is a receptor that binds products of damage, such as calprotectin, and initiates pro-inflammatory cascades. However, RAGE can be cleaved from the cell membrane to form a soluble receptor (sRAGE) that cannot mediate proinflammatory signals, yet can bind to damage products, effectively rendering them harmless. During a longer infection timecourse, colitis-resistant mice produced significantly more sRAGE during infection, consistent with an increased ability to prevent inflammatory ligands from activating membrane-bound RAGE. These findings were also supported by additional experiments using T. muris infection in Il-10-/- mice. In summary, I have carried out an analysis of methods reporting quality in immunology research that can help improve the reliability of existing data relevant to the further study of IBD and beyond. I have also identified sRAGE as a potential biomarker for the onset of colitis in the T. muris infection model, with implications for diagnosis and treatment of IBD in a clinical setting.

L’homéostasie des muqueuses intestinale et cutanée dépend des interactions complexes entre le microbiote, l’épithélium et le système immunitaire de l’hôte. Des mécanismes régulateurs divers coopèrent afin de maintenir l’équilibre physiologique, et un défaut dans ces mécanismes entrainent des situations pathologiques. Le glucagon like peptide 2 (GLP-2) est un neuropeptide caractérisé par des propriétés prolifératives et anti-inflammatoires. Le potentiel thérapeutique des analogues de GLP-2 est actuellement évalué dans des essais cliniques pour des maladies digestives. Les effets du GLP-2 dans l’intestin sont médiés par son récepteur GLP-2 receptor (GLP-2R). Malgré la présence des nombreuses études évaluant l’expression cellulaire et la distribution tissulaire du GLP-2R, celles-ci restent controversées, que ca soit chez l’homme ou les rongeurs. Il est admis que l’expression du GLP-2R était confinée au tube digestif, principalement à l’intestin proximal, malgré des études évoquant une expression extra-intestinale. Une meilleure compréhension de l’expression et de la distribution de GLP-2R est nécessaire pour élucider les fonctions biologiques de GLP-2. Nous avons réalisé une cartographie de l’expression de GLP-2R dans différents organes murins ainsi que dans des lignées immortalisées humaines et murines. Nous avons également évalué l’expression intestinale du GLP-2R dans 2 modèles de colites induites chez la souris et dans des biopsies intestinales des patients atteints de maladies inflammatoires chroniques de l’intestin (MICI). Nous avons démontré que GLP-2R était exprimé en dehors du tube digestif notamment dans la vessie, le système nerveux central, le mésentère, les ganglions mésentériques, la rate et le foie. Nous avons également montré que la plus forte expression de GLP-2R dans le tube digestif était détectée dans le colon proximal et le rectum. Dans les modèles murins de colites et chez les patients atteints de MICI, l’expression du GLP-2R était diminuée, notamment dans les zones inflammatoires. Ceci pose la question le rôle physiopathologique des analogues de GLP-2 dans les maladies inflammatoires digestives. En conclusion, les hypothèses précédentes considérant une expression du GLP-2R majoritaire dans le tube proximal doivent être reconsidérées. Les fonctions physiologiques extra-intestinales du GLP-2 doivent être explorés afin d’anticiper des effets indésirables extra-digestifs des analogues de GLP2. / Intestinal and skin physiologies are quite similar as far as the homeostasis in both depends on complex interactions between the microbiota, the epithelium and the host immune system. Diverse regulatory mechanisms cooperate to maintain the equilibrium, and a breakdown in these pathways may precipitate pathological conditions. Glucagon like peptide 2 (GLP-2) represents one of the hot topics in research in intestinal physiology. Its dual function as an anti-inflammatory agent and growth factor has led to its consideration in therapeutic strategies and GLP-2 analogs are currently in clinical trials for several digestive diseases. The integrative responses to GLP-2 are mediated via the GLP-2 receptor (GLP-2R). Despite extensive research, precise tissue distribution of GLP-2R expression remains controversial both in rodents and humans. It is widely believed that GLP-2R expression is restricted to the gastrointestinal tract, mainly to the proximal bowel, despite the presence of few studies reporting extra-intestinal expression. Thus, to enhance our knowledge concerning the potential functions of GLP-2 analogs, a better understanding for GLP-2R expression is considered necessary. We therefore realized a panel of GLP-2R expression in mice tissues and in several human, murine and rat cells lines. Given the therapeutic beneficial effects of GLP-2 analogs in intestinal disorders, we investigated the intestinal expression of GLP-2R in mice models of chemically-induced colitis and in inflammatory bowel disease (IBD) patients. We demonstrated that GLP-2R is more widely expressed than expected with significant expression in several mice tissues including bladder, central nervous system, mesenteric adipose tissue, mesenteric lymph nodes, spleen, and liver. We also showed that the expression of GLP-2R in the gastrointestinal tract follows an increasing gradient toward the distal gut with highest expression in the colon and rectum. Interestingly, the intestinal expression of GLP-2R is significantly decreased in experimental mice models of colitis and in IBD patients which raised the point of the physiological role of GLP-2 analogs in digestive disease patients. Overall, previous hypotheses limiting GLP-2R expression and function to proximal bowel need to be revisited, and further studies should address the extra-intestinal biological function of GLP-2.

Frying in vegetable oil is a popular cooking and food processing method worldwide; as a result, the oils used for frying are widely consumed by the general public and it is of practical importance to better understand their health impacts. To date, the effects of frying oil consumption on human health are inconclusive, making it difficult to establish dietary recommendations or guidelines. Here we show that dietary administration of frying oil, which was prepared under the conditions of good commercial practice, exaggerated dextran sodium sulfate (DSS)-induced colitis in mice. In addition, to explore the potential compounds involved in the actions of the frying oil, we isolated polar compounds from the frying oil and found that administration of the polar compounds also exacerbated DSS-induced colitis in mice. Together, our results showed that dietary administration of frying oil exaggerated development of inflammatory bowel disease (IBD) in mice, and this effect could be mediated by the polar compounds in the frying oil.

BACKGROUND: Early identification of pediatric patients with Inflammatory Bowel Disease (IBD), including ulcerative colitis and Crohn disease, is important to help clinicians design optimal treatment regimens. Existing endoscopic techniques are effective in identifying disease activity. However, these methods are invasive, expensive, and less amenable to serial measurement. Recent studies have identified potential serologic and fecal biomarkers that may have the potential to provide clinicians with a more objective evaluation of disease activity. In the case of ulcerative colitis (UC), in which disease is confined to the large intestine, the information provided by fecal biomarkers is likely to be more specific than that provided by serologic biomarkers. Fecal lactoferrin (FLA) is one such biomarker that has shown to be useful not only in identifying levels of colonic inflammation, but also for use as a predictor of disease relapse and treatment efficacy. Measurement of fecal lactoferrin, in conjunction with information provided by other diagnostic modalities could expedite patient assessment and treatment. Additionally, it has been suggested that fecal lactoferrin levels may also provide prognostic information about response to treatment and disease outcome in pediatric patients with UC. The goal of this study is to explore the relationship between changes in FLA levels and response to medical therapy in hospitalized pediatric patients with UC. METHODS: Serial stool samples were collected daily from 10 patients admitted for management of severe active UC. Of these 10 patients, 3 responded favorably to standard treatment with intravenous corticosteroid therapy and were discharged to complete a course of oral steroids. 7 were unresponsive to steroid therapy and went on to require rescue (more intensive) medical therapy. Changes in FLA were correlated with steroid response and medical disposition at the time of discharge. RESULTS: A t-test was performed to determine the significance of the differences in percent change in FLA levels between patients discharged on steroids and patients discharged on rescue therapy. Patients discharged on steroids demonstrated a net decrease in FLA levels over the course of the first three days of steroid treatment while patients ultimately requiring rescue medical therapy demonstrated a net increase in FLA levels (mean values = -64.4% and +203.8%, respectively). A difference was found between the averages; however, this value did not reach statistical significance when analyzed with a t-test (p = 0.18). CONCLUSIONS: This study suggests that quantitative FLA levels may prove useful in predicting clinical course and discharge outcome in pediatric patients with ulcerative colitis. Future research in this field should seek larger sample sizes, increased longitudinal sample collection, and the potential for a composite assessment that will yield additional objective measures of disease activity.

INTRODUCTION: Inflammatory bowel disease (IBD) is a growing public health concern with a pressing need for new diagnostic and disease activity biomarkers. Recently, studies have linked IBD disease factors to an imbalance in the gut’s reductive-oxidative (redox) defensive mechanisms and the resulting oxidative stress due to reactive oxygen species. With this new paradigm, direct measurement of redox status in the body could be utilized as a novel biomarker of disease activity for patients with IBD. OBJECTIVES: The goal of this study is to determine how gastrointestinal oxidative state relates to IBD disease activity. Additionally, this study aims to establish a reproducible and accurate measurement protocol for measuring redox status in the human body. METHODS: Patients with and without IBD admitted to Boston Children’s Hospital (Boston, MA) were enrolled in the study from October 2020 to February 2021. Stool and urine samples were collected from these patients and the oxidative status in these biosamples was measured via three redox measuring systems. RESULTS: Data suggests that relative stool oxidative state is more positive in patients with active disease states compared to controls. Also, a finalized protocol for the measurement of relative redox status in stool and urine was established in this study. CONCLUSION: With a reliable and accurate method of measurement established, the potential for relative redox status in the human body to serve as a predictive biomarker for IBD state is promising. Moving forward this study will focus on expanding the study’s size and types of samples to make more significant conclusions in the future. The usefulness of oxidative state in the body as a disease biomarker is just beginning to be realized.

The ability to sense and respond to external environmental signals is closely regulated by a plurality of cell signaling pathways, thereby maintaining homeostasis. In particular, the inflammatory signaling cascade contributes to cellular homeostasis and regulates responses prompted by external stimuli. Such responses are diverse and range from a variety of processes, including tissue repair, cell fate decisions, and even immune-cell signaling. As with any signaling cascade, strict regulation is required for proper functioning, as abnormalities within the pathway are often associated with pathologic outcomes. A hyperactive inflammatory response within the gastrointestinal tract, for example, contributes to inflammatory bowel disease (IBD), presenting as Crohn’s disease or ulcerative colitis. Furthermore, as a chronic condition, IBD is associated with an increased risk for the development of colitis-associated cancer. In order to resolve inflammation and thus restore homeostasis, negative regulation may be utilized to mediate the activity of inflammatory molecules. The mechanistic action of a specific negative regulator of interest, interleukin receptor associated kinase M (IRAK- M), is explored in detail within the present dissertation. Investigation of IRAK-M in mouse models of colitis, which mimics human IBD, and in mouse models of inflammation-driven tumorigenesis, which models colitis associated cancer, demonstrated that loss of this molecule contributes to host protection. Therefore, IRAK- M may be a suitable target for inhibition in order to advance therapeutic options for human patients afflicted with a GI-related inflammatory disease, such as IBD and colitis associated cancer. Furthermore, an ex vivo method that models the interaction of intestinal epithelial cells with microbes present in the GI tract was optimized and is described in the present dissertation. This method takes advantage of primary intestinal derived organoids, also termed “mini-guts”, which display similar features corresponding to intestinal tissue in vivo. For this reason, the use of “mini-guts” has several advantages, particularly for the enhancement of personalized medicine. The method discussed herein aims to normalize experimental conditions in order to enhance reproducibility, which can further be used to uncover microbial-epithelial interactions that contribute to a pathological state, such as IBD. Finally, this method of intestinal epithelial cell culture was utilized to evaluate the role of a protein, termed NF-κB inducing kinase (NIK), in intestinal epithelial cell growth and proliferation. Ultimately, ex vivo organoid culture can serve as an important model system to study the contribution of NIK in intestinal stem cell renewal, cancer progression, as well as in maintenance of the integrity of the gastrointestinal barrier. / Ph. D. / Inflammation is a tightly regulated physiologic process that is employed by body systems such as the gastrointestinal (GI) tract to handle pathogenic insult, aid in wound healing, and help prevent infections. When abnormal inflammatory responses occur, this can lead to the progression of severe diseases such as ulcerative colitis and Crohn's disease. When inflammation persists in the GI tract, such as in inflammatory bowel disease, this can predispose patients to the development of inflammation- associated colorectal cancer. In order to improve the treatment options for patients afflicted with these maladies, this dissertation is aimed at studying the signaling pathways of the innate immune system that regulate such inflammatory responses. Furthermore, this body of work encompasses a detailed method for isolating and culturing intestinal stem cells, which can be applied in personalized medicine for patients with intestinal diseases. This method was utilized in this dissertation to study genetically modified intestinal stem cells, and can further be used to investigate the interactions of intestinal epithelial cells with pyogenic bacteria that contribute to inflammatory maladies in the GI tract.

Bakgrund:Inflammatoriska tarmsjukdomar (IBD) är ett samlingsnamn för både Ulcerös kolit och Crohns sjukdom. Dessa sjukdomar är kroniska och kommer i skov, vilket innebär en tillfällig försämring i sjukdomsförloppet. Sjuksköterskans roll i omvårdnaden av kroniska sjukdomar är att lyssna, se patienten och inte sjukdomen samt att försöka uppnå och främja hälsa hos patienten. Syfte: Att belysa unga vuxnas upplevelser av att leva med en inflammatorisk tarmsjukdom. Metod:Uppsatsen är baserad på en kvalitativ metod där data har samlats in via bloggar. 14 bloggar har utgjort källan för den kvalitativa innehållsanalysen.  Resultat:Presenteras via kategorier och subkategorier.Redogör för ungas upplevelser av att drabbas av en kronisk tarmsjukdom. De beskrev svårigheter med att få rätt diagnos och att det bidrog till försämrad livskvalité. Sjukdomarna medförde sociala begränsningar på grund symtomen som uppstod. Konklusion:Med ökad kunskap hos sjuksköterskor och omgivning kan det bidra till en förbättrad livskvalité och kan leda till att dessa individer vågar öppna upp sig och känna sig mindre ensamma i deras sjukdom. Sjuksköterskor har ett stort ansvar att stödja patienter i deras hälsoprocess. I samförstånd med patient och närstående ska sjuksköterskor tillhandahålla vård utifrån dennes behov. Genom att individernas upplevelser uppmärksammas får sjuksköterskor en bättre inblick och förståelse för hur det är att leva med IBD. / Background: Inflammatory Bowel Diseases (IBD) are a term for both Ulcerative colitis and Crohn's disease. These diseases are chronic and come in flares, which means a temporary deterioration in the course of the disease. The nurse's role in nursing people with chronic diseases is to listen, see the patient and not the disease, and to try to achieve and promote health. Aim: To illuminate young adult people's experiences of living with an inflammatory bowel disease. Method: The thesis is a qualitative method where data have been collected via blogs. 14 blogs have been the source of the narrative analysis. Result: Presented via categories and subcategories. Describes young people's experiences of suffering from a chronic bowel disease. They described difficulties in getting the right diagnosis which contributed to a deterioration in quality of life. The diseases caused social constraints due to the symptoms that arose. Conclusion: With increased knowledge from nurses and the society, it can contribute to improved quality of life and make these individuals dare to open and feel less lonely in their illness. Nurses have a responsibility to support patients in their health process. In consultation with the patient and the relative, nurses should perform care based on their needs. By paying attention to their experiences, nurses will get a better insight and understanding into how it is to live with IBD.

Syfte: Syftet med studien var att beskriva unga människors upplevelser av att leva med en inflammatorisk tarmsjukdom (IBD), samt att beskriva hur sjukdomen påverkar livskvaliteten. Vidare var syftet att beskriva artiklarnas kvalitet utifrån den metodologiska aspekten urval.Metod: Beskrivande litteraturstudie baserad på 14 vetenskapliga artiklar, som söktes i databaserna Cinahl och PubMed via Högskolan i Gävle. Sökorden som användes var: Inflammatory bowel disease, Quality of life, Chronic disease, Experience och Adolescents. Sökningarna var begränsade inom publiceringsåren 2009 - 2013.Huvudresultat: De unga människorna upplevde många olika besvärande symtom som sågs som ett hinder till ett ”normalt” liv, och symtomen visade sig ha ett samband med ungdomarnas sömnkvalitet samt ångest och depression. Sjukdomen påverkade ungdomarnas skolgång och deras fritidsaktiviteter på så vis att de ibland var tvungna att avstå. Detta kunde vara känsligt då ungdomarna ville vara som alla andra, och inte behöva sticka ut på grund av sin sjukdom. Ju mer symtom och sjukdomsaktivitet ungdomarna hade desto lägre var den hälsorelaterade livskvaliteten. Ungdomarna uppskattade den omsorg och stöd som familjen gav, speciellt stödet av föräldrarna. En relation till en högre makt/stöd av Gud, böner, meditation och avkoppling kunde även användas för att bidra till deras välmående.Slutsats: Unga människor med IBD har inte bara en kronisk tarmsjukdom, de befinner sig också i en kritisk utvecklingsperiod i livet. Upplevelserna av sjukdomen och påverkan på livskvaliteten var individuell och uppfattades på olika sätt. Fysiska, psykosociala och andliga upplevelser identifierades som kunde ge upphov till påverkan på det vardagliga livet. Avslutningsvis menar författarna till föreliggande litteraturstudie att sjuksköterskan kan ha stor nytta att känna till hur unga människor upplever sin sjukdom, och hur sjukdomen påverkar deras livskvalitet, för att på bästa sett kunna erbjuda dem god omvård. / Aim: The aim of the study was to describe young people's experiences of living with an inflammatory bowel disease (IBD), and to describe how the disease affects quality of life. A further aim was to describe the quality of the articles based on the methodological aspect selection.Methods: Descriptive literature review based on 14 scientific articles, which were searched in the databases Cinahl and PubMed via the University of Gävle. Keywords used were: Inflammatory bowel disease, Quality of life, Chronic Disease, Experience and Adolescents. The searches were limited within the publication period 2009 - 2013.Main results: The young people experienced many troubling symptoms that were seen as an obstacle to a "normal" life, and the symptoms were shown to be associated with young people's sleep quality, anxiety and depression. The disease affected young people's education and their leisure activities such that they sometimes had to abstain. This could be sensitive when young people wanted to be like everyone else, and not have to stand out because of their illness. The more symptoms and disease activity young people had, the lower was the health-related quality of life. The young people appreciated the care and support that the family gave, especially the support of the parents. A relationship to a higher power / support of God, prayers, meditation and relaxation could also be used to contribute to their well-being.Conclusion: Young people with IBD have not only a chronic bowel disease, they are also in a critical period of development in life. The experiences of the disease and the impact on quality of life were individual and perceived in different ways. Physical, psychosocial and spiritual experiences were identified that could give rise to the impact on everyday life. Finally, the authors of this literature wants to emphasize that nurses can greatly benefit from knowing how young people feel about their disease, and how the disease affects their quality of life, to provide them with good nursing.

Bakgrund: Inflammatorisk tarmsjukdom räknas som en folksjukdom i Sverige. Tillstånden drabbar oftast personer i ett tidigt skede av livet och symtomen kommer i skov. Patientens vardagliga liv kan påverkas markant efter insjuknande och behandling går ut på att minska risken för nya skov och förhindra en försämring av patientens livskvalitet. Stödjande faktorer är viktigt för patienterna samt att skapa strategier för att hantera sjukdomens påverkan på dagligt liv. Syfte: Syftet med litteraturstudien var att beskriva kvinnors upplevelser av att leva med IBD. Metod: En litteraturstudie med en kvalitativ design baserad på 12 vetenskapliga artiklar utfördes. Litteratursökningen gjordes i databaserna CINAHL, PubMed och Psycinfo. De utvalda studierna kvalitetsgranskades och analyserades med innehållsanalys. Resultat: Smärta och fatigue var de två fysiologiska konsekvenser av inflammatorisk tarmsjukdom som framförallt beskrevs påverka dagligt liv. Kvinnorna kände sig ofta begränsade av sina symtom och i sin kost vilket påverkade både aktivitetsnivån, arbetslivet och socialt samliv. Begränsningarna orsakade emotionella konsekvenser och support och stöd var viktigt. Kvinnorna beskrev att de var i större behov av information gällande sin sjukdom men att det behovet inte alltid kunde tillgodoses av vårdpersonal. Konklusion: Med den ökad förståelse för sjukdomens yttrande i vardagligt liv kan sjuksköterskan genom ett helhetsperspektiv tillämpa en personcentrerad vård utifrån patientens behov och vara uppmärksam på outtalade behov som kan behövas lyftas fram i vården av patienten. / Background: Inflammatory bowel disease is considered an endemic disease in Sweden. The conditions usually affect people at an early stage of life and the symptoms come inflare-ups. The patient's daily life can be significantly affected by their illness and treatment aims to reduce the risk of new relapses and prevent a deterioration in the patient's quality of life. Supporting factors are important for patients and to create strategies for managing the impact the disease has on daily life. Aim: The aim of the literature study was to describe women's experiences of living with IBD. Method: A literature study with a qualitative design based on 12 scientific articles was conducted. The literature search was performed in the databases CINAHL, PubMed and Psycinfo. The chosen studies were quality reviewed and a content analysis was conducted. Results: Pain and fatigue were the two physiological consequences of inflammatory bowel disease that were primarily described to affect daily life. The women often felt limited by their symptoms and in their diet, which affected both the level of activity, working life and social cohabitation. The limitations caused emotional consequences and support was important. The women emphasized that they were in greater need of information regarding their illness, but that this need could not always be met by healthcare staff. Conclusion: With the increased understanding of the disease's manifestation in everyday life, the nurse can, through a holistic perspective, apply a person-centered care based on the patient's needs and be aware of unspoken needs that may need to be highlighted inthe care of the patient.

Bakgrund: Inflammatorisk tarmsjukdom (IBD) är en term som innefattarsjukdomarna Ulcerös kolit och Crohns sjukdom samt ospecificerad kolit. För attkunna få en större förståelse av sjukdomen och dess påverkan på individer, är detviktigt att djupare undersöka personers upplevelser av att leva med IBD. Dennaförståelse ska användas för att kunna ge en bättre vård av drabbade personer.Syfte: Syftet med denna litteraturstudie är att beskriva personers upplevelser av attleva med IBD.Metod: Metoden som har använts är litteraturstudie och innefattar n=10 artiklardär urvalet fokuserar på personer med IBD över 18 år och som alla berättar omupplevelser om att leva med IBD. Analysen gjordes genom syntetisering avresultat vilket resulterade i tre huvudteman och sju subteman, dessa teman varMiljö, Mat och Social påverkan. Resultat: Temat Miljö speglar kampen förpersonen att anpassa sig till den nya miljön där sjukdomen och symtomen styr.Temat Mat speglar verkligheten att behöva ändra sin diet kring sjukdomen för attundvika onödigt obehag. Sociala påverkan speglar personens egen syn på sig självmen även vänner och familjens stöd och påverkan på personens självkänsla.Resultatet visar också hur personer med IBD har upplevt hanteringen avsjukdomens symtom och på vilket sätt de har valt att hantera de olika hindernasom sjukdomen har skapat. Slutsats: Upplevelserna som personer med IBD ställsinför är olika och i många fall obehagliga. Eftersom IBD är en kronisk sjukdom såär det viktigt för sjuksköterskor inom vården att få en inblick i hur personer medIBD upplever sin sjukdom och hur dem hanterar den när sjukdomen är som värstför att kunna ge bättre stöd och information kring sjukdomen. / Background: Inflammatory bowel disease (IBD) is a term that includes thediseases Ulcerative colitis and Crohn's disease as well as unspecified colitis. Inorder to gain a greater understanding of the disease and its impact on individuals,it is important to more deeply examine people's experiences of living with IBD.This understanding should be used to be able to provide better care for affectedpeople.Aim: The aim of this literature review is to describe people's experiences of livingwith IBD.Method: The method that has been used is a literature review and includes n=10articles where the focus of the sample is on people over the age of 18 and who alltell about experiences of living with IBD. The analysis was made usingsynthesizing results which resulted in three main themes and seven sub-themes,these themes were Environment, Food and Social impact.Results: The theme Environment reflects the struggle for the person to adapt tothe new environment where the disease and symptoms rule. The theme Foodreflects the reality of having to change your diet around the disease to avoidunnecessary discomfort. Social impact reflects the person's own view of himselfbut also friends and family's support and influence on the person's self-esteem.The results also show how people with IBD have experienced the management ofthe disease's symptoms and in what way they have chosen to deal with the variousobstacles that the disease has created.Conclusion: The experiences that people with IBD are faced with are differentand in many cases unpleasant. Since IBD is a chronic disease, it is important forhealthcare professionals to get an insight into how people with IBD experiencetheir disease and how they handle it when the disease is at its worst in order toprovide better support and information about the disease.