Chronic Bowel Disorder - Chron's disease Flashcards
1
Q
also association
what is affected in crohns disease
A
-affects whole GIT
-assoc with thickened wall, extending through all layers with deep ulceration
2
Q
complications caused by crohns disease
A
- intestinal strictures or fistulae
- anaemia and malnutrition
- colorectal and small bowel cancer
- growth failure and delayed puberty
- extra-intestinal manifestation; arthritis, joints, eyes, liver + skin abnormalities
stricture = narrowing in the intestine, makes it hard for food to pass
3
Q
acute crohns disease 1st flare-up in 12 month period tx
A
-
monotherapy with either; prednisolone, methylprednisolone/IV hydrocortisone
-aminosalicylate may be used sulfasalazine/mesalazine
-> less effective but less side effects
4
Q
tx of acute crohn’s disease if pt = distal ileal, ileocecal or right sided
A
use budesonide if normal tx x work
5
Q
acute crohns disease 2+ flare up in 12 month period tx
A
- add azathioprine or mercaptopurine
- methotrexate may added if azath/merca is CI
- if severe use monoclonal antibodies
6
Q
drugs tx and lifestyle changes + after surgery tx
crohns disease maintenance
A
- stop smoking
- monotherapy of azathioprine or mercaptopurine
- methotrexate can be used if used in induction or can not tolerate aza/merc
- after surgery
-> azathioprine + metronidazole
-> OR azathioprine alone if metronidazole x tolerated
7
Q
tx of diarrhoea in crohns
A
- loperamide
- codeine
- colestyramine
8
Q
what is fistulating crohns disease
A
- when fistula develops between intestine + perianal skin, bladder + vagina
- can be left alone if asymtomatic
9
Q
to improve symptoms
fistulating crohns disease
tx (not fully healed)
A
- metronidazole +/- ciprofloxacin
- metronidazole usually for ONE month no longer three due to perianal neuropathy
10
Q
maintenance tx of fistulating crohns disease
A
- azathioprine or mercaptopurine
- infliximab if no response
- tx must be at least ONE year
