14) Inflammatory Bowel Disease Flashcards Preview

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Flashcards in 14) Inflammatory Bowel Disease Deck (23)
1

What are the 2 common types of IBD?

Crohn's and ulcerative colitis

2

What age groups does Crohn's disease mainly affect?

15-30 and 60+

3

What age group does ulcerative colitis mainly affect?

Young adults

4

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

5

Describe how UC affects the GI tract:

Begins in rectum
Can extend to involve entire colon
Continuous pattern but just mucosal inflammation

6

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)
Eye problems

7

What are the probable causes of IBD?

Genetic
Gut organisms
Immune response

8

How does Crohn's present?

Loose stools (non-bloody)
Weight loss - malabsorption
Right lower quadrant pain
Anaemic - not absorbing iron or B12
Fever
Tiredness

9

What pathological changes does Crohn's cause in the GIT?

Mucosal oedema
Deep ulcers
Transmural inflamm - thickening of bowel wall and narrowing of lumen

10

What pathological change occur in advanced Crohn's?

Cobblestone appearance
Fistulae - bladder, vagina, skin

11

What can be seen on microscopy in Crohn's?

Granuloma formation

12

What investigations may be done if Crohn's is suspected?

Bloods - anaemia
CT/MRI - bowel wall thickening, obstruction
Barium enema
Colonoscopy

13

How does UC present?

Blood and mucus in stools
Diarrhoea
Weight loss
Mid lower abdominal pain or cramps

14

What pathological changes does UC cause in the GIT?

Chronic inflammatory infiltrate of lamina propria
Loss of goblet cells - less protective mucus
Pseudopolyps
Loss of haustra

15

What investigations may be done if UC is suspected?

Bloods - anaemia, serum markers
Stool cultures
Abdominal XR
Colonoscopy

16

What is the disease called if it can't be distinguished between Crohn's and UC?

Indeterminate colitis

17

What sign may be seen on radiology in Crohn's?

String sign of Kantour

18

What may be seen on radiology in UC?

Lead pipe colon - featureless bowel
Continuous ulceration

19

What is the first stage of medical treatment for IBD?

Aminosalicylates e.g. sulfasalazine
For flares (symptoms active) and remission

20

What is the second stage of medical treatment for IBD?

Corticosteroids e.g. prednisolone
For flares only

21

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

22

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

23

What surgical procedures may be used to treat UC?

Colectomy is a cure