{"id":38605,"date":"2022-05-12T18:45:53","date_gmt":"2022-05-12T22:45:53","guid":{"rendered":"https:\/\/vivesanobrasil.org\/?p=38605"},"modified":"2022-05-25T15:34:16","modified_gmt":"2022-05-25T19:34:16","slug":"que-es-la-colitis-ulcerosa","status":"publish","type":"post","link":"https:\/\/vivesanobrasil.org\/pb\/que-es-la-colitis-ulcerosa\/","title":{"rendered":"\u00bfQu\u00e9 es la Colitis Ulcerosa?"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"38605\" class=\"elementor elementor-38605\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-837ef56 elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"837ef56\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-699d39d\" data-id=\"699d39d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e83bc76 elementor-widget elementor-widget-image\" data-id=\"e83bc76\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/i0.wp.com\/vivesanobrasil.org\/wp-content\/uploads\/2022\/05\/Post-1-imagen-1.png?fit=1800%2C500&#038;ssl=1\" title=\"Post 1 &#8211; imagen 1\" alt=\"Post 1 - imagen 1\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4415a10 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4415a10\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d953421\" data-id=\"d953421\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-64c0046 elementor-widget elementor-widget-heading\" data-id=\"64c0046\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">\u00bfQu\u00e9 es la Colitis Ulcerosa?<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4ebb75 elementor-widget elementor-widget-text-editor\" data-id=\"d4ebb75\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">La colitis ulcerosa (CU) es una enfermedad inflamatoria intestinal (EII), un trastorno cr\u00f3nico que afecta el tracto gastrointestinal y que se limita al colon. Presenta inflamaci\u00f3n de la mucosa superficial que se extiende proximalmente de manera contigua hasta el recto, y puede llegar a provocar ulceraciones, sangrado intenso, megacolon t\u00f3xico y colitis fulminante.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Arial; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Fisiopatolog\u00eda de la Colitis Ulcerosa<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Hasta el momento no se ha esclarecido la causa y hace falta una comprensi\u00f3n integral de los mecanismos fisiopatol\u00f3gicos subyacentes que dan lugar a las manifestaciones cl\u00ednicas de la CU.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Las c\u00e9lulas epiteliales del colon (colonocitos) y los defectos de la barrera epitelial y de la mucosa est\u00e1n fuertemente implicados en la patogenia de la colitis ulcerosa. Al parecer hay individuos gen\u00e9ticamente susceptibles, los cuales presentan una respuesta inmune desregulada en la mucosa y\u00a0 microbiota intestinal.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Una de las teor\u00edas m\u00e1s aceptadas es que la inflamaci\u00f3n es producida por una respuesta anormal de linfocitos T contra la microbiota intestinal.<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">La expresi\u00f3n del receptor gamma activado por el proliferador de peroxisomas (PPAR-\u03b3), un regulador negativo de la inflamaci\u00f3n dependiente de NF-\u03baB, se reduce en los colonocitos de pacientes con colitis ulcerosa, lo que sugiere un v\u00ednculo causal.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Se han informado defectos asociados con los colonocitos dentro de XBP1 , un componente clave de la v\u00eda de respuesta al estr\u00e9s del ret\u00edculo endopl\u00e1smico, en la colitis ulcerosa.<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">La colitis ulcerosa se asocia con da\u00f1o a la barrera mucosa, lo que permite que la microflora luminal desencadene una respuesta inflamatoria sostenida y desinhibida.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Entre las c\u00e9lulas inflamatorias, las c\u00e9lulas TH9 perpet\u00faan la apoptosis de los enterocitos e inhiben la cicatrizaci\u00f3n de la mucosa. La IL-13, producida por las c\u00e9lulas Natural Killer, tambi\u00e9n contribuye a la lesi\u00f3n epitelial.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Adem\u00e1s, las c\u00e9lulas linfoides innatas, homeost\u00e1ticas en estado estacionario, contribuyen a la producci\u00f3n de citoquinas, perpetuando la inflamaci\u00f3n. La lesi\u00f3n y el da\u00f1o de la mucosa se asocian con disbiosis, lo que tal vez contribuya a la cascada inflamatoria.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Arial; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Manifestaciones Cl\u00ednicas y S\u00edntomas<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Los s\u00edntomas de la EII son diversos y var\u00edan seg\u00fan la localizaci\u00f3n de la enfermedad, la duraci\u00f3n de la misma y las complicaciones anat\u00f3micas de la enfermedad. De acuerdo a la localizaci\u00f3n se ha clasificado diferentes tipos de CU, signos y s\u00edntomas:\u00a0<\/span><\/p><ul><li dir=\"ltr\" style=\"line-height: 1.38;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Proctitis ulcerosa<\/span><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> &#8211; la inflamaci\u00f3n se limita a la zona cercana al ano (recto), y el sangrado rectal podr\u00eda ser el \u00fanico signo de la enfermedad.<\/span><\/li><li dir=\"ltr\" style=\"line-height: 1.38;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Proctosigmoiditis<\/span><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> &#8211; la inflamaci\u00f3n afecta al recto y al colon sigmoides (extremo inferior del colon). Entre los signos y s\u00edntomas, se incluyen diarrea con sangre, dolor y c\u00f3licos abdominales e imposibilidad de defecar a pesar del deseo de hacerlo (tenesmo).<\/span><\/li><li dir=\"ltr\" style=\"line-height: 1.38;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Colitis del lado izquierdo<\/span><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> &#8211; la inflamaci\u00f3n se prolonga desde el recto hasta el colon sigmoides y el descendente. Entre los signos y s\u00edntomas, se incluyen diarrea con sangre, dolor y c\u00f3licos abdominales del lado izquierdo y necesidad imperiosa de defecar.<\/span><\/li><li dir=\"ltr\" style=\"line-height: 1.38;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Pancolitis<\/span><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> &#8211; este tipo suele afectar al colon en su totalidad y provocar episodios de diarrea con sangre que puede ser intensos, dolor y c\u00f3licos abdominales, fatiga y una p\u00e9rdida importante de peso.<\/span><\/li><\/ul><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">En el momento del diagn\u00f3stico, entre un 14 y un 37% de los pacientes presentan pancolitis, entre un 36 y un 41% muestran enfermedad de extensi\u00f3n m\u00e1s all\u00e1 del recto y entre un 44 y un 49% presentan proctosigmoiditis.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-497a582 elementor-widget elementor-widget-image\" data-id=\"497a582\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/i0.wp.com\/vivesanobrasil.org\/wp-content\/uploads\/2022\/05\/Plantilla-Banner-Blog-20-1.png?fit=1600%2C800&#038;ssl=1\" title=\"Colitis ulcerosa\" alt=\"Colitis ulcerosa\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-efa9911 elementor-widget elementor-widget-text-editor\" data-id=\"efa9911\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\">\u00a0<\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Arial; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Diagn\u00f3stico<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">El diagn\u00f3stico de colitis ulcerosa se basa en una combinaci\u00f3n de s\u00edntomas, hallazgos endosc\u00f3picos, histolog\u00eda y ausencia de diagn\u00f3sticos alternativos. La endoscopia con biopsias es la \u00fanica forma de establecer el diagn\u00f3stico de colitis ulcerosa.<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Tambi\u00e9n son de utilidad pero de manera espec\u00edfica los marcadores inflamatorios como la VSG y la prote\u00edna C reactiva, los cu\u00e1les pueden estar elevados (colitis ulcerosa grave) o normales (enfermedad leve a moderada), as\u00ed como biomarcadores de heces no invasivos como la calprotectina fecal.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Arial; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Colitis Ulcerosa y Estado Nutricional<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">La desnutrici\u00f3n tiene una prevalencia del 25 al 80% en los pacientes con EII, esta es debida a factores etiol\u00f3gicos que contribuyen al desarrollo de malnutrici\u00f3n energ\u00e9tico-proteica (MEP) en la EII:<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">D\u00e9ficit de ingesta<\/span><\/p><ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\"><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Anorexia relacionada con la inflamaci\u00f3n<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Dietas restritivas<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Ayunos terap\u00e9uticos<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Intolerancia digestiva a medicamentos (sulfasalazina, 5-ASA, metronidazol)<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Incremento del metabolismo<\/span><\/p><ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\"><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Inflamaci\u00f3n<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Complicaciones infecciosas<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Tratamiento esteroideo<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">P\u00e9rdidas proteicas intestinales<\/span><\/p><ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\"><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Inflamaci\u00f3n\/ulceraci\u00f3n de la mucosa<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Adem\u00e1s, en el 40% de los pacientes se presenta sarcopenia,\u00a0 como resultado de la inflamaci\u00f3n cr\u00f3nica, la desnutrici\u00f3n y la inactividad f\u00edsica. Sin embargo, aunque hay una creciente prevalencia de la obesidad entre los pacientes con EII, \u00e9sta generalmente coexiste con una masa muscular baja (Obesidad sarcop\u00e9nica).\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Tambi\u00e9n puede existir deficiencia de vitaminas y minerales, debido a<\/span><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">:\u00a0<\/span><\/p><ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\"><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Vitamina D y K &#8211; por deficiencia en las sales biliares.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Hierro por baja ingesta &#8211; malabsorci\u00f3n y p\u00e9rdida cr\u00f3nica de sangre.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Folato &#8211; por malabsorci\u00f3n y el uso de medicamentos.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Vitamina C &#8211; por un bajo consumo de vegetales y frutas.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Vitamina B12 &#8211; tras cirug\u00eda ileal y sobrecrecimiento en el intestino delgado.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Calcio &#8211; por el uso de corticoides, diarrea cr\u00f3nica, malabsorci\u00f3n y el bajo consumo de productos l\u00e1cteos.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Magnesio y zinc &#8211; por malabsorci\u00f3n, diarrea cr\u00f3nica y s\u00edndrome del intestino corto.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type: disc; font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre;\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" role=\"presentation\"><span style=\"font-size: 11pt; font-family: Arial; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Sodio y potasio &#8211; por el bajo consumo de productos l\u00e1cteos, v\u00f3mitos persistentes y diarrea cr\u00f3nica.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">En el caso de CU los pacientes tienden a presentar un deterioro r\u00e1pido del estado nutricional durante un brote agudo.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Arial; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Terapia Nutricional<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">El objetivo de la intervenci\u00f3n diet\u00e9tica debe centrarse en prevenir la malnutrici\u00f3n o recuperar el estado nutricional, disminuir y reemplazar la p\u00e9rdida de nutrientes asociada al proceso inflamatorio, corregir las deficiencias y evitar el agravamiento de los s\u00edntomas y\/o su aparici\u00f3n. En CU la dietoterapia no tiene el objetivo de inducir el estado de remisi\u00f3n.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Durante los brotes agudos de la enfermedad se extiende el uso de dietas reducidas en fibra o en residuos, aunque en los casos m\u00e1s severos la intervenci\u00f3n puede incluir nutrici\u00f3n enteral e incluso parenteral.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Durante el estado de remisi\u00f3n, la terapia diet\u00e9tica se centra sobre todo en promover una dieta saludable, variada y equilibrada en la mayor medida de los posible y evitar exclusiones de alimentos y grupos de alimentos llevados a cabo por el paciente.<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Por fin, para profundizar el manejo nutricional se sugiere consultar la gu\u00eda pr\u00e1ctica ESPEN: Nutrici\u00f3n Cl\u00ednica en la enfermedad inflamatoria intestinal, d\u00f3nde se encuentran 40 recomendaciones en las que se abordan aspectos generales de la atenci\u00f3n en pacientes con EII y aspectos espec\u00edficos durante la enfermedad activa y en remisi\u00f3n.<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 14pt; margin-bottom: 14pt;\"><span style=\"font-size: 12pt; font-family: 'Times New Roman'; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Autora: PhD. <\/span><span style=\"font-size: 11pt; font-family: Arial; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Ang\u00e9lica Quintero<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 14pt; margin-bottom: 14pt;\"><span style=\"font-size: 12pt; font-family: 'Times New Roman'; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Contenido extra\u00eddo de la clase <\/span><span style=\"font-size: 12pt; font-family: 'Times New Roman'; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Enfermedades inflamatorias intestinales: colitis ulcerosa<\/span><span style=\"font-size: 12pt; font-family: 'Times New Roman'; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">, de nuestra <\/span><a style=\"text-decoration-line: none;\" href=\"https:\/\/vivesanobrasil.org\/certificacion-internacional-en-gastroenterologia-actualizacion-en-salud-digestiva-cohorte-2\/\"><span style=\"font-size: 12pt; font-family: 'Times New Roman'; color: #1155cc; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; text-decoration-line: underline; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;\">Certificaci\u00f3n Internacional Gastroenterolog\u00eda<\/span><\/a><span style=\"font-size: 12pt; font-family: 'Times New Roman'; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">.<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 14pt; margin-bottom: 14pt;\"><span style=\"font-size: 12pt; font-family: 'Times New Roman'; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">In\u00edcio: 21\/06\/2022<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0e6ebe8 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"0e6ebe8\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/vivesanobrasil.org\/certificacion-internacional-en-gastroenterologia-actualizacion-en-salud-digestiva-cohorte-2\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Inscr\u00edbete aqu\u00ed<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-66b1aa3 elementor-widget elementor-widget-text-editor\" data-id=\"66b1aa3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><b>Referencias<\/b><\/p><p><span style=\"font-weight: 400;\">Yamamoto-Furusho JK, Bosques-Padilla FJ, Char\u00faa-Guindic L, et al. Inflammatory bowel disease in Mexico: Epidemiology, burden of disease, and treatment trends. Rev Gastroenterol Mex (Engl Ed). 2020;85(3):246-256.<\/span><\/p><p><span style=\"font-weight: 400;\">\u00a0<\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32143974\/\"><span style=\"font-weight: 400;\">https:\/\/pubmed.ncbi.nlm.nih.gov\/32143974\/<\/span><\/a><\/p><p>\u00a0<\/p><p><span style=\"font-weight: 400;\">Chang, CT. Pathophysiology of Inflammatory Bowel Diseases. N Engl J Med 2020;383:2652-64. DOI: 10.1056\/NEJMra2002697 Disponible en:<\/span><\/p><p><span style=\"font-weight: 400;\">\u00a0<\/span><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMra2002697\"><span style=\"font-weight: 400;\">https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMra2002697<\/span><\/a><\/p><p>\u00a0<\/p><p><span style=\"font-weight: 400;\">Ungaro R,\u00a0 Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel J-F. Ulcerative colitis<\/span><\/p><p><span style=\"font-weight: 400;\">Lancet. 2017;389(10080):1756-1770. Disponible en: <\/span><a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(16)32126-2\"><span style=\"font-weight: 400;\">https:\/\/doi.org\/10.1016\/S0140-6736(16)32126-2<\/span><\/a><span style=\"font-weight: 400;\">\u00a0<\/span><\/p><p>\u00a0<\/p><p><span style=\"font-weight: 400;\">Chiu, E.; Oleynick, C.; Raman, M.; Bielawska, B. Optimizing Inpatient Nutrition Care of Adult Patients with Inflammatory Bowel Disease in the 21st Century. Nutrients 2021, 13, 1581. <a href=\"https:\/\/doi.org\/\" rel=\"nofollow\">https:\/\/doi.org\/<\/a> 10.3390\/nu13051581 Disponible en: <\/span><a href=\"https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1581\/htm\"><span style=\"font-weight: 400;\">https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1581\/htm<\/span><\/a><span style=\"font-weight: 400;\">\u00a0<\/span><\/p><p>\u00a0<\/p><p><span style=\"font-weight: 400;\">Cabr\u00e9 Gelada E.. Nutrici\u00f3n y enfermedad inflamatoria intestinal. Nutr. Hosp.\u00a0 [Internet]. 2007\u00a0 Mayo [citado\u00a0 2022\u00a0 Abr\u00a0 26] ;\u00a0 22( Suppl 2 ): 65-73. Disponible en: <\/span><a href=\"http:\/\/scielo.isciii.es\/scielo.php?script=sci_arttext&amp;pid=S0212-16112007000500009&amp;lng=es\"><span style=\"font-weight: 400;\">http:\/\/scielo.isciii.es\/scielo.php?script=sci_arttext&amp;pid=S0212-16112007000500009&amp;lng=es<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p><p>\u00a0<\/p><p><span style=\"font-weight: 400;\">Bischoff SC, Escher J, H\u00e9buterne X, et al. ESPEN practical guideline: Clinical Nutrition in inflammatory bowel disease. Clin Nutr. 2020;39(3):632-653. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32029281\/\"><span style=\"font-weight: 400;\">https:\/\/pubmed.ncbi.nlm.nih.gov\/32029281\/<\/span><\/a><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t<div class='cb-post-url-qr-code'><br><img src='https:\/\/api.qrserver.com\/v1\/create-qr-code\/?size=185x185&ecc=L&qzone=1&data=https%3A%2F%2Fvivesanobrasil.org%2Fpb%2Fque-es-la-colitis-ulcerosa%2F' alt='\u00bfQu\u00e9 es la Colitis Ulcerosa?'\/><\/div>","protected":false},"excerpt":{"rendered":"<p>\u00bfQu\u00e9 es la Colitis Ulcerosa? La colitis ulcerosa (CU) es una enfermedad inflamatoria intestinal (EII), un trastorno cr\u00f3nico que afecta el tracto gastrointestinal y que se limita al colon. Presenta inflamaci\u00f3n de la mucosa superficial que se extiende proximalmente de manera contigua hasta el recto, y puede llegar a provocar ulceraciones, sangrado intenso, megacolon t\u00f3xico [&hellip;]<\/p>\n","protected":false},"author":135836161,"featured_media":38606,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_crdt_document":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[675839595,675839547],"tags":[],"class_list":["post-38605","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articulos","category-publicaciones"],"acf":[],"aioseo_notices":[],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/vivesanobrasil.org\/wp-content\/uploads\/2022\/05\/Post-1-portada.png?fit=1080%2C1350&ssl=1","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p9Ia6I-a2F","_links":{"self":[{"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/posts\/38605","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/users\/135836161"}],"replies":[{"embeddable":true,"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/comments?post=38605"}],"version-history":[{"count":0,"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/posts\/38605\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/media\/38606"}],"wp:attachment":[{"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/media?parent=38605"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/categories?post=38605"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vivesanobrasil.org\/pb\/wp-json\/wp\/v2\/tags?post=38605"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}