8 - IBD Flashcards
Where is the large intestine found and what is its function?
Between caecum and anal canal
Removes fluid from indigestible portion of chyme by aldosterone activated Na channels
Acts as a storage facility for faeces prior to defaecation
What is Crohn’s disease?
Chronic inflammatory disease of the whole GI tract, in incomplete, transmural (across whole wall) pattern
What is ulcerative colitis?
Chronic inflammatory condition starting in the rectum extending in a continuous, superficial pattern up the colon.
What is the typical presentation of Crohn’s?
Multiple non-bloody loose stools/day
Weight loss
Right lower quadrant pain
15-30 year old patient
What is the typical presentation of ulcerative colitis?
Multiple bloody (sometimes mucousy) stools/day
Weight loss
Cramping abdominal pain
Young adult
Describe the gross pathology of Crohn’s
Cobblestone appearance: Mucosal oedema form red lines
Red due to inflamed blood vessels
Ulcers form pink blobs between red lines
Transmural inflammation:
Thickening of bowel wall due to fibrosis
Narrowing of lumen, fistula form between bowel/bladder/vagina/skin
What is the difference in structure between large and small intestine?
Large - External longitudinal muscle incomplete - Tenaie coli, 3 bands of muscles that when contract form sacs called haustra
What are the extra intestinal symptoms associated with IBD?
Arthritis
Psoriasis/Erythema nodosum (bruise like swellings on shins)
Bile duct blockages
Eye problems
Describe the microscopic appearance of Crohn’s
Granuloma formation (circle of cells)
How can IBD lead to malnutrition?
Crohn’s can affect proximal jejunum and duodenum, transmural damage so can’t absorb properly
Describe the gross pathology of ulcerative colitis
Continuous inflammation, white patches = inflammation
red patches = mucosa regenerating
Pseudopolyps
Loss of haustra (no sacs)
Describe the microscopic appearance of ulcerative colitis
Crypt abscess - circle with white border as intestinal crypts have been inflamed
What endoscopic changes are seen in Crohn’s disease?
Skip lesions Cobblestone appearance Linear ulcers Narrowing Fistula
What endoscopic changes are seen in ulcerative colitis?
Continuous mucosal involvement Friable mucosa (bleeds when touched)
Describe the radiological appearance of Crohn’s
Normal to thin = strictures
