Crohn's disease Flashcards
What is Crohn’s disease
transmural inflammation along the gastrointestinal tract
where can the transmural inflammation be located in Crohn’s
it can be any where/ all parts of the GI tract from the mouth to the perianal area
where mostly is the inflammation found in Crohn’s disease
terminal ileal and perianal areas
difference between ulcerative colitis and Crohn’s
in ulcerative colitis, the inflammation is found everywhere along the GI tract whereas in Crohn’s there may be skip lesions
what are skip lesions
where normal bowel mucosa can be found
aetiology/ cause of Crohn’s disease
unknown aetiology however it is known that genetic and environmental factors can play a role
risk factors for developing Crohn’s disease
white ancestry, family Hx of Crohn’s
presenting symptoms
abdominal pain, prolonged diarrhoea, bowel obstruction, blood in the stool, fever, fatigue and abdominal tenderness
what leads to bowel obstruction in Crohn’s
transmural inflammation leads to fibrosis which then leads to obstruction of the bowel
what is the first line investigation for Crohn’s
bloods; FBC (may show inflammatory markers or anaemia), iron, folate, B12, CRP, ESR, stool testing, abdominal X-ray, MRI of abdomen
when do you do an erect X-ray
when there is a risk of perforation
treatment of an acute exacerbation of Crohn’s
fluid resuscitation, IV/oral corticosteroids, 5-ASA analogues, analgesia, parenteral nutrition
treatment of long-term Crohn’s disease
steroids- for acute exacerbation
5-ASA analogues,
immunosuppression and anti-TNF therapy
general conservative advice/management
stop smoking and dietary advice
