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Flashcards in IBD & IBS Deck (57)
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1

Main Diseases of IBD

Crohn's Disease
Ulcerative Colitis

2

Difference between Ulcerative Colitis & Crohn's Disease

UC: mucosal colitis, recurring episodes
Crohn's: transmural inflammation, skip lesions

3

Epidemiology of IBD

Males = females
Infrequent in countries with poor sanitation

4

Etiology Theories of IBD

Infectious
Immunologic
Genetic
Dietary
Environmental
Vascular
Neuromotor
Allergic
Psychogenic
Autoimmune

5

Pathophysiology of IBD

Defect in function of intestinal lumen
Breakdown defense barrier
Results in chronic inflammatory process

6

Systemic Complications of IBD

Aphthous stomatitis
Episcleritis & uveitis
Arthritis
Vascular complications
E. Nodosum
P. Gangrenosum
Gallstones
Malabsorption
Renal stone, fistulae, hydronephrosis, amyloidosis

7

Define Ulcerative Colitis

Involves mucosal surface of colon with the formation of crypt abscess

8

Where is the initial point of ulcerative colitis?

Rectum

9

Clinical Course of Ulcerative Colitis

Flare-ups
Remission

10

What can cause a flare-up in ulcerative colitis?

Stress
Lack of sleep
Illness

11

What is protective in the case of ulcerative colitis?

Smoking

12

Signs/Symptoms of Mild to Moderate Ulcerative Colitis

Bloody diarrhea
Lower abdominal cramps- relieved with defecation
Fecal urgency

13

Signs/Symptoms of Severe Ulcerative Colitis

Rectal bleeding
LLQ cramps
Severe diarrhea
Low-grade fever
Anemia
Hypoalbuminemia
Hypovolemia

14

Systemic Associations of Ulcerative Colitis

Peripheral arthritis
Central arthritis
Erythema nudism
Uveitis
Sclerosing cholangitis

15

Labs for Ulcerative Colitis

CBC: anemia, leukocytosis
ESR & CRP: elevated
CMP: electrolyte disturbances, decreased albumin, prolonged clotting time
pANCA: Perinuclear antineutrophil cytoplasmic antibodies

16

Mild Ulcerative Colitis

Stools:

17

Moderate Ulcerative Colitis

Stools: 4-6/day
Pulse: 90-100
Hematocrit: 30-40
Weight loss: 1-10%
Temp: 99-100
ESR: 20-30
Albumin: 3-3.5

18

Severe Ulcerative Colitis

Stools: >6/day (bloody)
Pulse: >100
Hematocrit: 10%
Temp: >100
ESR: >30
Albumin:

19

Diagnostics of Ulcerative Colitis

Bloody diarrhea
Plain abdominal X-rays
Sigmoidoscopy or colonoscopy
CT

20

Differential Diagnosis of Ulcerative Colitis

Infectious colitis
CMV colitis
Rectal CA
Crohn's
GI bleed
Mesenteric ischemia
Diverticulitis

21

Intestinal Complications of Ulcerative Colitis

Bleeding
Toxic megacolon
Perforation
Benign stricture
Malgnant stricture
Colorectal CA

22

Treatment of Ulcerative Colitis

Reduce fiber during exacerbation
Folic acid supplements with sulfasalazine
Oral iron with bleeding
Frequent follow-up
Short course loperamide
Yearly colonoscopy

23

Treatment of Mild to Moderate Ulcerative Colitis

Sulfasalazine
Olsalazine
Mesalamine
+/- prednisone

24

Treatment of Moderate to Severe Ulcerative Colitis

Sulfasalazine
Olsalazine
+/- prednisone

25

Sulfasalazine

Mild anti-inflammatory compared to steroids
Azospermia
Severe depression in males

26

Types of Sulfasalazine

Oral
Topical
Hydrocortisone (enema, suppositories, foam)

27

Indications for Surgery in Ulcerative Colitis

Exsanguinating hemorrhage
Toxicity/perforation
Suspected CA
Significant dysplasia
Growth retardation
Systemic complications
Intractability

28

Define Crohn's Disease

Transmural involvement with formation of fistulas, narrowing of lumen, obstruction

29

Main Areas where Crohn's is Located

Ileocolitis
Ileitis
Colitis
Gastroduodenitis
Jejunoileitis

30

What is smoking strongly associated with?

Development of Crohn's
Resistance to medical therapy
Early disease relapse