La maladie de Crohn et la rectocolite hémorragique font partie des maladies inflammatoires chroniques de l'intestin (MICI). Le principal objectif des traitements anti-inflammatoires est de favoriser la délivrance du principe actif localement, spécifiquement sur les zones enflammées et de limiter les effets indésirables. Ainsi, plusieurs systèmes à libération colonique de molécules actives ont été développés. Parmi eux, les pellets présentent de nombreux avantages par rapport aux formes solides unitaires conventionnelles. Dans un premier temps, des pellets comptant une substance anti-inflammatoire naturelle et nutritive, la rutine, ont été développés. L'intérêt de cette molécule est de réduire considérablement les effets secondaires qui constituent un véritable problème dans les traitements actuels des MICI. Les pellets ont été enrobé avec les polysaccharides naturels se dégradant avec la flore colonique. Les études in vitro ont démontré une libération minimale du principe actif au niveau de l'estomac et du petit intestin. Par contre, une libération rapide et totale a été observée lors de l'exposition des pellets dans les conditions du milieu colonique. Les résultats des tests in vivo ont démontré que la rutine a atténué considérablement l'inflammation au niveau de colon et les pellets enrobés ont été aussi efficaces que les pellets d'acide 5-aminosalicylique (5-ASA) commercialisés. L'administration orale de rutine via les pellets enrobés et préparés avec le chitosan semble être une approche prometteuse, permettant la libération du principe actif au niveau des zones enflammées, pour le traitement des MICI tout en réduisant les effets secondaires. Le deuxième but de notre travail était d'élucider l'impact du chitosan, un polymère mucoadhésif, sur l'efficacité thérapeutique. Les pellets de 5-ASA ont été préparés à partir de cellulose microcristalline avec ou sans chitosan. Un enrobage constitué d'un polymère pH dépendant,1' Eudragit® FS, a ensuite été réalisé autour du noyau. Les tests de dissolution ont montré que le principe actif n'était pas libéré du pellet après 2 h en milieu acide. En revanche,la libération était rapide dans un milieu simulant l'environnement colonique. Les tests ex vivo avec les pellets contenant le chitosan ont montré des propriétés mucoadhésives importantes qui ont été confirmées par la concentration élevée du métabolite de 5-ASA dans les tissus coloniques des rats. De plus, nous avons a démontré que les pellets permettaient d'atténuer de façon significative l'inflammation du côlon. Ainsi, les pellets bioadhésifs enrobés possèdent des propriétés bénéfiques supplémentaires pour la libération du 5-ASA au niveau du côlon par rapport à des formes multidoses commercialisées pour le traitement des MICI. / Crohn's disease and ulcerative colitis are two related but distinct chronic inflammatory disorders of gastrointestinal tract (GIT), commonly denoted as inflammatory bowel disease(IBD). The main goal of the anti-inflammatory treatment of this disorder is to achieve maximal drug concentration in inflamed area and reduce systemic adverse effects. For this purpose several colon-spécifie drug delivery systems have been investigated. In addition, the design of pellets as oral drug delivery systems may provide many advantages over single unit preparations and thus improve patient compliance. It is well known that most existing treatments of IBD are associated with significant side effects and for this reason the formulation with a " food like " composition was designed. In the first part of our study, therapeutic efficiency of rutin/chitosan pellets with coatings based on natural polysaccharides degraded by colonie microbiota compared to commercialized 5-aminosalicylic acid (5-ASA) pellets was investigated. Release profiles ofcoated pellets showed a minimal drug release in simulated stomach and small intestine following by rapid drug release upon exposure to the colonie fluid. The results from in vivo testing showed that rutin attenuated efficiently inflammation in the colon and coated pellets were as effective as 5-ASA pellets in mitigating experimental colitis. The studies demonstrated that rutin administration via chitosan core coated pellets seems to be apromising approach for colon-specific delivery since they could interact easily with the mucin layer and deliver drug especially to the inflamed colonie area to relieve symptoms of IBD omitting side effects related to conventional treatment. The second objective of this thesis was to explore the impact of additional mucoadhesive polymer chitosan in the pellets core on the therapeutic efficiency. For this purpose, 5-ASA loaded pellets were produced by extrusion/spheronisation method and subsequently coated with pH-sensitive polymer Eudragit® FS. No drug release at pH 1.2within 2 h, and release as intended in the simulated distal ileum and colon was observed. Chitosan-core pellets showed efficient mucoadhesive properties in ex vivo bioadhesion testing which were also confirmed by increased concentration of 5-ASA metabolite in the colonie tissues in rats. The pellets were tested in preexisting colitis and the results revealed significant attenuation of the colonie inflammation. We can conclude, that bioadhesive chitosan-corepellets showed additional beneficial properties for colonie 5-ASA delivery in the treatment of IBD over marketed dosage formulation.

Background: Inflammatory bowel disease (IBD) includes Crohn´s disease (CD) and ulcerative colitis (UK). The diseases are chronic and have a pattern of relapses interspersed with relatively symptom-free periods. Common symptoms during relapse are diarrhea, abdominal pain and weight loss. Since you have IBD for life it is important to find ways to relate to and cope with the disease. In that process a nurse can be of great help. Aim: The purpose of this literature review was to increase the understanding of how adult patients with inflammatory bowel disease experience their daily lives.   Method: The method used was a literature review. A literature search was performed in two separate databases which resulted in eleven examined and analyzed articles on the subject.  Results: After the analyze of the articles three different themes emerged: Limitations in daily life, Self-image and self-esteem and finally Self-care and strategies. Several individuals felt limited one way or the other in their daily life. They also described how their self-esteem was affected. Some positive changes due to the disease were also described. For example some changed their exercise and food habits for the better. Discussion: The results are discussed through the perspective of Antonovsky’s (1991/2005) salutogenic view and were connected to how the SOC (Sense of Coherence) was affected. The importance of relatives’ support and self-care was also discussed.

The objectives of our study were to determine the potential of 1H MRS in detecting (1) early colonic inflammation, (2) effects of various fatty acids on normal colon and (3) their effects on IBD. Sprague dawley rat fed with 2% carrageenan was used as a model of IBD. Flaxseed oil served as ω-3, corn oil as ω-6 and beef tallow as saturated fatty acid sources. Control group animals were fed 5% corn oil, whereas, those in high-fat diet groups received an additional 7% of the respective fatty acids. After 2 weeks, 1H MRS and histology were conducted on excised colonic mucosa. Statistical classification strategy (SCS) used for analyzing 1H MRS data achieved an accuracy of 82 % in stage 1, 90-100% in stage 2 and 96-100% in stage 3. This implies that 1H MRS is a sensitive tool to diagnose early IBD and the effects of dietary fat on IBD.

Inflammatory bowel disease (IBD), comprises Crohn’s disease (CD) and ulcerative colitis (UC), and is a chronic relapsing inflammation of gastrointestinal tract without any known cause or cure. Currently, it is accepted that IBD is a result of a dysfunctional immune response to commensal bacteria in a genetically susceptible host, and that environmental factors can trigger the onset or reactivation of the disease. This thesis considers the possibility of a specific pathogenic agent as well as an imbalance in the composition of the normal microflora in the pathogenesis of IBD. Gut biopsy tissues were taken from a population-based case-control tissue bank held at the University of Manitoba. Automated ribosomal intergenic spacer analysis (ARISA) and terminal restriction fragment length polymorphisms (T-RFLP) were employed to assess the diversity of gut microbiota. The phylogenetic, virulence and biochemical characteristics of Escherichia coli isolated from IBD biopsies were examined using multi-locus sequence typing (MLST), DNA microarray technology and API 20E system. Utilizing ARISA and T-RFLP, a remarkable increase in the order of unclassified Clostridia was detected in inflamed tissues, particularly in CD patients (P < 0.05). Moreover, species richness and diversity were the highest in non-inflamed IBD biopsies. Culture-based quantification detected a significantly higher number of E. coli in IBD tissues (P < 0.05). Phylogenetic analysis revealed the tendency of E. coli isolated from IBD patients to be grouped into separate clonal clusters based on their allelic profiles (P = 0.02). A link was detected between uropathogenic E. coli (UPEC) CFT073 and strains isolated from IBD, with regards to gene distribution and virulence, using microarray technology. Amino acid substitutions N91S and S99N in FimH, the adhesive subunit of E. coli type I fimbria, were significantly associated to IBD (P < 0.05). This study demonstrated an increase in the microbial diversity of non-inflamed IBD tissues and suggested a recruitment phase of bacterial adherence and colonization, before the inflammation sets in. Furthermore, E. coli isolated from IBD tissues were distinct from commensal strains in both clonal and virulence characteristics and shared remarkable traits with extraintestinal pathogenic E. coli. Features involved in bacterial adhesion to epithelial cells may hold the key to E. coli pathogenesis in IBD.

Bakgrund: Inflammatorisk tarmsjukdom (IBD) inkluderar ulcerös kolit och Crohns sjukdom. De är kroniska och uppkommer i skov då tarmslemhinnan blir inflammerad och sårig vilket ger en komplex symtombild med akuta diarréer, rektalblödning och buksmärtor. Behandlingen går ut på att minska symtom och förebygga uppkomst av skov. Då dessa sjukdomar påverkar det dagliga livet så påverkas också den individuella hälsorelaterade livskvaliteten, vilket mäter den fysiska, psykiska och sociala aspekten av ett hälsoproblem. Syfte: Syftet var att beskriva upplevelsen av hälsorelaterad livskvalitet hos personer med inflammatorisk tarmsjukdom. Metod: En litteraturöversikt har gjorts där tolv vetenskapliga artiklar har utgjort grunden till resultatet och skapat en översikt på befintlig forskning. De har lästs, sammanfattats och analyserats där likheter och skillnader har hittats och teman bildats. Resultat: Resultatets fyra huvudteman är Fysisk funktion, Psykisk funktion, Social funktion och Att återställa sin livskvalitet. Det framkom i resultatet att de fysiska symtomen och sjukdomsaktiviteten är det som i huvudsak styr såväl det psykiska välmåendet som de sociala restriktionerna. Detta visade sig även ha en negativ inverkan på den hälsorelaterade livskvaliteten. Men med tiden blev dock sjukdomen en normal del av livet och en bättre livskvalitet upplevdes. Diskussion: Metodens tillvägagångssätt samt fördelar och nackdelar diskuteras och analyseras. Vid diskussion av resultatet tas främst kunskap, utbildning och tidsperspektivet upp samt återkopplas till Orems egenvårdsteori. / Background: Inflammatory bowel disease (IBD) encompasses ulcerative colitis and Crohn's disease. They are chronic and occur in relapses when the mucosal becomes inflamed and ulcerated, causing complex symptoms such as acute diarrhoea, rectal bleeding and abdominal pain. The treatment aims to reduce symptoms and prevent the occurrence of relapses. As these diseases affect the daily life it also affects the individual health-related quality of life, which measures the physical, psychological and social aspects of a health problem. Aim: The purpose was to describe the experience of health-related quality of life in people with inflammatory bowel disease. Method: A literature review has been done where twelve original articles have formed the basis of the results, this creates an overview of existing research. They have been read, summarized and analysed where the similarities and differences were found and themes were formed. Results: The four main themes of the result is Physical function, Psychological function, Social function and Rebuilding their quality of life. It emerged in the results that physical symptoms and disease activity are those which essentially controls the psychological well-being as well as social constraints. This was shown in studies to have a negative impact on the health-related quality of life. But overtime the disease became a normal part of one's life and gave a better quality of life experience. Discussions: The method approach, benefits and weaknesses will be discussed and analysed. When discussing the results of the current study mainly knowledge, education, and time perspective will be addressed and analysed with Orem’s self-care theory.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Sammanfattning:  Bakgrund: Inflammatory Bowel Disease, IBD är ett samlingsnamn för kroniska inflammatoriska tarmsjukdomar som består av Crohns sjukdom (CD) och ulcerös kolit (UC). Sjukdomen går i skov och har symtom som frekventa diarréer, feber, rektal blödning, buksmärtor och viktnedgång.  Syfte:Syftet med studien var att beskriva personers upplevelser av att leva med IBD samt att presentera vilken undersökningsgrupp som beskrivits i de inkluderade artiklarna. Metod: Studien var en litteraturstudie med deskriptiv design baserad på 10 artiklar med kvalitativ ansats. Artiklarna söktes i databaser CINAHL och PubMed.  Huvudresultat:Personer med IBD upplever att både de själva och omgivningen saknar kunskaper om sjukdomen. De känner oro och osäkerhet över läkemedelseffekter, sjukdomens utveckling och återfall. Personer som hade levt med IBD under många år har utvecklat strategier för att klara av olika situationer. Deltagarna i de inkluderade studier är vuxna män och kvinnor i olika åldrar som kommer från olika länder.  Slutsats:Personer med IBD beskriver flertal upplevelser av att leva med sjukdomen. Det framkommer att en stor del av personernas problem uppstår på grund av brister på kunskap om sjukdomen. Det leder till att de drabbade personerna har svårt att hantera sina dagliga sysselsättningar och har oro inför framtiden. Patienterna behöver få bra information och individanpassat stöd för att höja KASAM, utveckla egna strategier och hantera sjukdomen på ett bättre sätt. / Abstract Background:Inflammatory Bowel Disease, IBD is a collective name for chronic inflammatory bowel disease consisting of Crohn's disease (CD) and ulcerative colitis (UC). The disease is in episode and has symptoms such as frequent diarrhea, fever, rectal bleeding, abdominal pain and weight loss. Aim: The purpose of the study was to describe people's experiences of living with IBD and to present which research group described in the included articles. Method: The study was a literature study with descriptive design based on 10 articles with qualitative approach. Articles were searched from databases CINAHL and PubMed.  Main Results: People with IBD experience that both themselves and the environment lack knowledge about the disease. They feel anxiety and insecurity about drug effects, disease development and relapse. People who had been living with IBD for many years have developed strategies to cope with different situations. Participants in the included studies are adult men and women of different ages from different countries. Conclusions: People with IBD describe several experiences of living with the disease. It appears that a large part of the people's problems arise due to lack of knowledge about the disease. This means that the affected people are having difficulty managing their daily life and are worried about the future. Patients need to get good information and personalized support to raise KASAM, to develop their own strategies and manage the disease in a better way.

A terapia celular utilizando células tronco-mesenquimais (MSCs) surge como alternativa para o tratamento das doenças inflamatórias intestinais (DII). Atualmente, os métodos terapêuticos consistem principalmente na utilização de fármacos que visam produzir e manter estados de remissão da colite ulcerativa e, muitas vezes, apresentam efeitos colaterais. Considerando a capacidade de modular células do sistema imune e de regenerar tecidos doentes, as MSCs podem ser consideradas uma alternativa para o tratamento de DII, como a colite ulcerativa. Além disso, muito tem se investigado a respeito do homing de MSCs exógenas infundidas por diversas vias em resposta a um insulto inflamatório e tem-se visto a capacidade de migração para tecidos afetados. A primeira etapa do trabalho consistiu na caracterização e desenvolvimento do modelo animal de colite ulcerativa aguda. Para isso, foram testados diferentes pesos moleculares e concentrações do reagente Dextran Sulfato de Sódio (DSS), a fim de verificar qual o melhor método de indução da doença. Após determinar o adequado modelo animal, que utilizou 2% DSS (36 000 – 50 000 Da), foi iniciado o experimento de terapia celular. Na tentativa de compreender como as MSCs podem influenciar a inflamação intestinal, o estudo avaliou o efeito do transplante de MSCs derivadas do tecido adiposo em duas diferentes vias de infusão, intraperitoneal e intravenosa, em modelo murino experimental de colite aguda. Foram avaliados os seguintes parâmetros: atividade clínica da doença, aspecto macroscópico e histopatológico do cólon, dosagem de citocinas inflamatórias, taxas de apoptose e parâmetros de estresse oxidativo. Os resultados obtidos no trabalho mostraram que o transplante celular intravenoso melhorou a severidade clínica de colite, como perda de peso, diarreia e presença de sangue nas fezes. Na avaliação histológica, observou-se a diminuição da inflamação colônica através da redução de perda de criptas e de infiltração de células inflamatórias. Ainda, os fatores secretados pelas MSCs parecem poder reduzir os níveis de IL-6 e aumentar os níveis de IL-10 e IL-4 do soro. Um aumento de células apoptóticas foi observado nos animais tratados com MSCs por via intravenosa, sugerindo que as MSCs induzem morte celular em células T resistentes à apoptose. Além disso, a terapia intravenosa foi capaz de aumentar os níveis de glutationa reduzida, um importante antioxidante natural, revertendo o dano causado pelo estresse oxidativo no cólon. Em conjunto, nossos resultados demonstram que a melhor via para a terapia celular na colite ulcerativa foi a intravenosa e que o tratamento proposto foi eficaz no que se refere à redução da inflamação do cólon. / Mesenchymal stem cell (MSC) therapy is an alternative for the treatment of inflammatory bowel disease (IBD). Currently, therapeutic methods consist primarily on the use of drugs which aim to produce and maintain state of ulcerative colitis remission and often present side effects. Considering the ability to modulate the immune system cells and regenerate injuried tissues, MSCs can be considered an alternative for treating IBD, such as ulcerative colitis. Moreover, there is many research investigating the homing of exogenous MSCs infused through different routes in response to an inflammatory insult, and has demonstrated the migration capacity of these cells into the affected tissues. The first stage of this study consisted in the characterization and development of acute animal model of ulcerative. For this, different molecular weights and concentrations of Dextran Sulfate Sodium (DSS) reagent were tested in order to verify the best method for disease induction. After determining the appropriate animal model, that uses 2% DSS (36000-50000 Da), the cell therapy experiment was initiated. In an attempt to understand how MSCs can influence intestinal inflammation, the study evaluated the effect of MSCs transplantation using two different infusion routes, intraperitoneal and intravenous, in an acute colitis murine model. The following parameters were evaluated: clinical disease activity, colon macroscopic and histological analysis, serum inflammatory cytokine, determination apoptosis rates and oxidative stress parameters. Results show that MSC intravenous transplantation has improved the clinical severity of colitis, such as weight loss, diarrhea, and blood stool. Histological evaluation demonstrated a decreased colonic inflammation by reducing colonic crypt loss and infiltration of inflammatory cells. Also, MSCs secreted factors which seem to reduce levels of IL-6 and increase levels of IL-10 and IL-4 in the serum. In addition, an increase of apoptotic cells was observed in animals treated with intravenous MSCs, suggesting that MSCs induce cell death in T cells resistant to apoptosis. Furthermore, intravenous therapy was able to increase the levels of reduced glutathione, an important natural antioxidant, reversing the damage caused by oxidative stress in the colon. Taken together, our results demonstrate that the best route for cell therapy in ulcerative colitis was intravenous and the proposed treatment was effective with regards to reducing colon inflammation.

A azatioprina e a 6 mercaptopurina (6-MCP) são drogas muito utilizada no tratamento das doenças inflamatórias intestinais (DII), porém estão associadas a vários efeitos colaterais. A determinação prévia do genótipo da tiopurina metiltransferase (TPMT) pode identificar pacientes de maior risco de toxicidade a droga. Os objetivos deste estudo foram avaliar a prevalência dos polimorfismos do gene da TPMT em pacientes com DII acompanhados no Hospital Universitário Pedro Ernesto (HUPE) da UERJ, comparando com a prevalência em outras populações e correlacionar a presença desses polimorfismos com a toxicidade às drogas. Foram avaliados 146 pacientes com doença de Crohn (DC) e 73 com retocolite ulcerativa idiopática (RCUI). A pesquisa dos principais genótipos da TPMT (*2, *3, *3C) foi realizada por técnicas de PCR (alelo específico e RFLP). Os achados clínicos foram correlacionados com a genotipagem e avaliados por análises multivariadas. Dentre os pacientes que estavam em uso de azatioprina, 14 apresentaram pancreatite ou elevação de enzimas pancreáticas, 6 apresentaram hepatoxicidade e 2 evoluíram com neutropenia. Os polimorfismos do gene da TPMT foram observados em 37 dos 219 pacientes (8 foram heterozigotos para o genótipo *2, 11 heterozigotos para *3A e 18 foram heterozigotos para o polimorfismo *3C). Não foi observado nenhum homozigoto polimórfico. Uma correlação positiva foi observada entre a elevação de enzimas pancreáticas e os genótipos *2 e *3C. A prevalência dos polimorfismos neste estudo (16,89%) foi maior que a descrita para população caucasiana e em outros estudos brasileiros. Apesar do predomínio do genótipo *3C, não houve ocorrência exclusiva de um polimorfismo, conforme observado em outras populações. A população brasileira devido à sua miscigenação têm características genotípicas próprias diferentes do outros países do mundo. Dois polimorfismos da TPMT (*2 e *3C) estiveram associados à toxicidade ao uso da azatioprina em pacientes com DII no sudeste do Brasil. O teste genético pode auxiliar na escolha da melhor droga e na dose ideal para os pacientes portadores de DII antes do início do tratamento. / Although azathioprine is commonly used for treating patients with inflammatory bowel disease (IBD), there is still concern about potential severe side effects. Determining the Thiopurine-Methyl-Transferase (TPMT) genotype is expected to identify patients predisposition in respect of toxicity prior to azathioprine administration. The aim of this study was to analyze the prevalence of TPMT genotypes and association with drug toxicity in IBD patients from south-eastern Brazil, constituted by a heterogeneous population. We analyzed 146 Crohns disease (CD) and 73 ulcerative colitis (UC) patients, for the presence of the major TPMT genetic variants (TPMP*2, *3A, *3C) by means of specific allele and RFLP PCR. Clinical data were systematically recorded and correlated with the genotype results, and analyzed in multivariate models. Among the side effects recorded from patients taking azathioprine, 14 presented pancreatitis and/or elevation of pancreatic enzymes, while 6 had liver toxicity, and 2 had neutropenia. TPMT polymorphisms were detected in 37/219 patients (8 heterozygous for *2, 11 heterozygous for *3A and 18 heterozygous for *3C). No homozygotic polymorphisms were found. A positive correlation was found between the elevation of pancreatic enzymes and either TPMT*2 or TPMT*3C. The prevalence of polymorphisms in this study (16,89%) was greater than described with caucasian population or other Brazilian studies. Despite the prevalence of genotype *3C, it was not the only polymorphism shown as observed in other populations. Two genetic variants of TPMT gene (*2 and *3C) are associated with azathioprine toxicity in IBD patients from a south-eastern Brazilian population. Genetic testing may help in the selection of the most appropriate medication prior to treatment initiation.

Submitted by JAQUELINE RIBEIRO DE BARROS null (jack_kbca@hotmail.com) on 2016-04-18T17:10:25Z No. of bitstreams: 1 dissertação 18042016.pdf: 4767202 bytes, checksum: 13d294155fb8e9de0350cb1df1e26df9 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-04-19T16:24:20Z (GMT) No. of bitstreams: 1 barros_jr_me_bot.pdf: 4767202 bytes, checksum: 13d294155fb8e9de0350cb1df1e26df9 (MD5) / Made available in DSpace on 2016-04-19T16:24:20Z (GMT). No. of bitstreams: 1 barros_jr_me_bot.pdf: 4767202 bytes, checksum: 13d294155fb8e9de0350cb1df1e26df9 (MD5) Previous issue date: 2016-02-19 / Doença inflamatória intestinal (DII) é um termo amplo, usado para a Doença de Crohn (DC) e a Retocolite Ulcerativa (RCUI), ambas caracterizadas pela inflamação crônica do intestino. A DII pode alterar permanentemente a qualidade de vida (QV) dos pacientes, sobretudo em seu período de exacerbação. Os sintomas apresentados pelos portadores da doença podem gerar mudanças de grande impacto nas atitudes e condutas, assim como nos aspectos emocionais, sociais, físicos e sexuais. Frente à escassez de estudos científicos, achamos oportuno estudar as consequências da DII sobre a sexualidade dos pacientes e a prevalência de disfunção sexual. Os objetivos foram avaliar a prevalência de disfunção sexual nos pacientes com DII e identificar os fatores clínicos e psicológicos associados com a disfunção sexual nos pacientes. Metodologia: foi realizado um estudo observacional, de corte transversal. Foram avaliados 99 pacientes com DII atendidos no Ambulatório DII do Hospital das Clínicas da Faculdade de Medicina de Botucatu e os resultados foram comparados com dados de 118 indivíduos não cônjuges que acompanhavam os pacientes no Ambulatório de DII e no Pronto Socorro Adulto. Foi utilizado um protoloco para obtenção de dados sociodemográficos, clínicos e de estilo de vida. A atividade da doença foi classificada através do Escore de Mayo (RCUI) e do Índice de atividade da Doença de Crohn (CDAI). Os instrumentos para avaliação da QV, sintomas pscicológicos e autoestima foram: Inflammatory Bowel Disease Questionnaire (IBDQ), The Medical Outcomes Study 36 item Short-Form Health Survey (SF-36), Escala Hospitalar de Ansiedade e Depressão (HAD) e Escala de Autoestima de Rosenberg. Para avaliar a disfunção sexual feminina foi utilizado o Female Sexual Function Index (FSFI) e para a disfunção erétil o International Index of Erectile Function (IIEF). Foi adotado um nível de significância estatístico de p<0,05. Resultados: Foram avaliados 56 pacientes com DC e 43 pacientes com RCUI. A idade média foi de 38,89 anos (±10,15) e houve predomínio do sexo feminino (56,57%). O grupo controle foi composto por 118 indivíduos com idade média de 38,13 (±10,18) anos e predomínio do sexo feminino (59,32%). Na análise da QV avaliada através do questionário IBDQ, notou-se que 27,27% dos pacientes apresentavam QV excelente, 38,38% QV boa, 28,28% QV regular e apenas 6,06% QV ruim. 47% dos pacientes e 36% dos controles foram classificados como ansiosos (p=0,096). 24% dos pacientes e 17% dos controles foram classificados como depressivos (p=0,23). 28% dos pacientes e 12,5% controles apresentaram disfunção erétil (DE) (p=0,11) A presença de DE no grupo paciente foi associada com a presença de perda de peso (p=0,0593), fadiga (p=0,0277) e fraqueza (p=0,0445), além de história de cirurgia perianal nos pacientes com DC (p=0,0009), presença de doença perianal (p=0,0078) e satisfação com a vida sexual (p<0,0001). A presença de depressão (OR:1,501; IC95%:1,106-2,037; p=0,0091) (R=-0,32180; p=0,0354) e baixa autoestima (OR:0,817; IC95%:0,709–0,942;p=0,0053) (R=0,43244; p=0,0038) foram associados com risco aumentado de DE. Com relação à QV, pacientes com maiores pontuações no questionário IBDQ (OR: 0,981; IC95%:0,963–0,999; p=0,0379) e no domínio aspectos físicos (OR: 0,984; IC95%:0,968 - 1; p=0,0476) e estado geral de saúde (OR: 0,958; IC95%:0,924-0,993; p=0,0177) do questionário SF-36 apresentaram risco diminuído de DE. Com relação às mulheres, 93% das pacientes e 96% controles apresentaram disfunção sexual (p=0,69). Apesar disso, mais de 70% delas relataram ter lubrificação vaginal e mais de 80% relataram estar satisfeitas com a vida sexual em geral. A presença de disfunção sexual feminina foi associada com a presença de dispareunia (p=0,0346), alta autoestima (R:-0,32924; p=0,0132), lubrificação vaginal durante o ato sexual (p=0,0046) e satisfação com a vida sexual (OR: 0,054; IC95%:0,005-0,625; p=0,0185). Conclusões: A disfunção sexual é frequente nos pacientes com DII. Os distúrbios do humor e os aspectos sociais apresentam um maior impacto na função sexual dos pacientes em detrimento aos fatores relacionados à doença. Os temas relacionados ao relacionamento interpessoal, intimidade sexual e emocional, auto-imagem e atividade sexual devem ser abordados com todos os pacientes. / Inflammatory bowel disease (IBD) is an ample term used for Crohn's disease (CD) and Ulcerative Colitis (UC), both characterized by chronic inflammation of the gastrointestinal tract. Inflammatory Bowel Disease can permanently change the quality of life (QOL) of these patients, especially during periods of exacerbation. The symptoms presented by patients with the disease can have strong effects of changes in attitudes and behaviors, as well as the emotional, social, physical and sexual. Faced by the shortage of scientific studies, we thought that was interesting to study the impact of IBD on sexuality of patients and the prevalence of sexual dysfunction. The aims were to assess the prevalence of sexual dysfunction in patients with IBD and to identify the clinical and psychological factors associated with sexual dysfunction in patients. Methodology: It was an observational study, of transversal cut, where 99 patients with IBD were evaluated and seen in the Inflamatory Bowel Diseases Ambulatory of the Medicine School’s Clinic Hospital of Botucatu and 118 controls paired by gender and age. A protocol was used to obtain demographic data, clinical and lifestyle Disease activity was classified by the score of Mayo (RCUI) and the DC Activity Index (CDAI). The instruments for evaluation of psychological symptoms and quality of life (QOL) were: Hospital Scale Anxiety and Depression (HAD), Inflammatory Bowel Disease Questionnaire (IBDQ) and The Medical Outcomes Study 36 Item Short-Form Health Survey (SF-36). To assess female sexual dysfunction we used the Female Sexual Function Index (FSFI) and erectile dysfunction the International Index of Erectile Function (IIEF). A level of statistical significance of p <0,05 was adopted. Results: We evaluated 56 patients with CD and 43 patients with UC. The average age was 38.89 years (±10.15) and there was a predominance of females (56.57%). The control group consisted of 118 individuals with an average age of 38.13 (±10.18) years and predominance of females (59.32%). In the analysis of QOL assessed by IBDQ questionnaire, it was noted that 27.27% of patients had excellent QOL, 38.38% good QOL, 28.28% regular QOL and only 6.06% poor QOL. 47% of patients and 36% of controls were classified as anxious (p=0.096). 24% of patients and 17% of controls were classified as depressed (p=0.23). 28% of patients and 12.5% had ED controls (p=0.11) The presence of ED in the group of patients was associated with the presence of weight loss (p=0.0593), fatigue (p=0.0277) and weakness (p=0.0445), and history of perianal surgery in CD patients (p=0.0009), presence of perianal disease (p=0.0078) and satisfaction with sex life (p<0.0001). The presence of depression (OR:1.501; 95% CI:1.106 to 2.037; p=0.0091) (R=-0.32180; p=0.0354) and low self-esteem (OR:0.817; 95% CI:0.709 to 0.942; p=0.0053) (R=0.43244; p=0.0038) were associated with increased risk of erectile dysfunction (ED). Regarding QOL, patients with higher scores on questionnaires IBDQ (OR:0.981; 95% CI:0.963 to 0.999; p=0.0379) and in the areas physical (OR:0.984; 95% CI:0.968 to 1; p=0.0476) and general health (OR:0.958; 95% CI:0.924 to 0.993; p=0.0177) of the SF-36 questionnaire showed decreased risk of ED. With regard to women, 93% of patients and 96% of controls reported sexual dysfunction (p=0.69). Nevertheless, over 70% of them reported having vaginal lubrication and over 80% reported being satisfied with their sex life in general. The presence of female sexual dysfunction has been associated with the presence of dyspareunia (p=0.0346), high self-esteem (R:-0.32924, p=0.0132), vaginal lubrication during sex (p=0.0046) and satisfaction with sex life (OR:0.054; 95% CI:0.005 to 0.625; p=0.0185). Conclusions: Sexual dysfunction is common in patients with IBD. Disorders of mood and social aspects have a greater impact on sexual function of patients over the factors related to the disease. Issues related to interpersonal relationships, sexual and emotional intimacy, self-image and sexual activity should be addressed with all patients.