Flashcards in 14) Inflammatory Bowel Disease Deck (23)
What are the 2 common types of IBD?
Crohn's and ulcerative colitis
What age groups does Crohn's disease mainly affect?
15-30 and 60+
What age group does ulcerative colitis mainly affect?
Describe how Crohn's affects the GI tract:
Affects anywhere in GI tract
Ileum involved in most cases
Transmural - full thickness of wall and may have skip lesions
Describe how UC affects the GI tract:
Begins in rectum
Can extend to involve entire colon
Continuous pattern but just mucosal inflammation
What extra-intestinal problems can IBD cause?
MSK pain (50%) - Arthritis
Skin (30%) - Erythema nodosum (red lumps on leg), pyoderma gangrenosum, psoriasis
Liver/biliary tree - Primary Sclerosing Cholangitis (PSC)
What are the probable causes of IBD?
How does Crohn's present?
Loose stools (non-bloody)
Weight loss - malabsorption
Right lower quadrant pain
Anaemic - not absorbing iron or B12
What pathological changes does Crohn's cause in the GIT?
Transmural inflamm - thickening of bowel wall and narrowing of lumen
What pathological change occur in advanced Crohn's?
Fistulae - bladder, vagina, skin
What can be seen on microscopy in Crohn's?
What investigations may be done if Crohn's is suspected?
Bloods - anaemia
CT/MRI - bowel wall thickening, obstruction
How does UC present?
Blood and mucus in stools
Mid lower abdominal pain or cramps
What pathological changes does UC cause in the GIT?
Chronic inflammatory infiltrate of lamina propria
Loss of goblet cells - less protective mucus
Loss of haustra
What investigations may be done if UC is suspected?
Bloods - anaemia, serum markers
What is the disease called if it can't be distinguished between Crohn's and UC?
What sign may be seen on radiology in Crohn's?
String sign of Kantour
What may be seen on radiology in UC?
Lead pipe colon - featureless bowel
What is the first stage of medical treatment for IBD?
Aminosalicylates e.g. sulfasalazine
For flares (symptoms active) and remission
What is the second stage of medical treatment for IBD?
Corticosteroids e.g. prednisolone
For flares only
What is the third stage of medical treatment for IBD?
Immunomodulators e.g azathioprine
For fistulas or maintaining remission if other drugs haven't worked
What surgical procedures may be used to treat Crohn's?
Not curative but may be used for strictures or fistulas
Remove as little bowel as possible