IBD Flashcards
what are the two major forms of IBD ?
crohn’s disease
Ulcerative colitis
what are the areas of affection for each disease ?
CD - anywhere in the GI tract , but has a tendency to affect the terminal ileum and ascending colon
UC - only the large bowel is affected
what gene increases the susceptibility of IBD ?
HLA-B27
what are the pathological features associated with CD ?
transmural
skip lesions
cobblestone appearance
backwash ileitis is specific to which type of IBD ?
Ulcerative colitis
what is an early feature seen on endoscopy of Crohn’s disease ?
aphthoid ulcerationn
what is a late feature seen in CD ?
llarger, deeper ulcers appear in patchy distribution
what are the pathological features associated with UC ?
inflammatory polyps
superficial affection
pseudo polyps and friability
what are thee microscopic changes seen in CD vs UC ?
CD - since its transmural - lymphoid hyperplasia and granulomas are present ( langhan cells )
UC- superficial inflammation , crypt abscess and goblet cell depletion
what are the extra gastrointestinal manifestations of IBD ?
joint affection ( type 1 and 2 polyarthropathy)
eyes (uveitis )
pyoderma gangrenosum and erythema nodosum
primary sclerosing cholangitis
what does fulimant colitis refer to ?
intense form of UC
what are the clinical features of CD ?
diarrhea, abdominal pain and weight loss
diarrhea usually contains blood
constitutiional symptoms
if the small bowel is affected in CD what is the C/P of that ?
steatorrhea
what often precedes small intestine symptoms in CD ?
anal and perianal diseases as well as enteric fistula
what type of anemia is seen in CD ?
normocytic normochromic anemia
what is seen on blood test of CD ?
normocytic normochromic anemia
iron and folate deficiency
raised ESR and CRP
hypoalbuminemia
what are the serological tests performed in CD ?
Anti-ASCA is usually positive
P-ANCA is negative
when should colonoscopy be performed ?
if colonic involvement is suspected except in acute severe disease
what appears on colonoscopy before cobblestone appearance in CD ?
aphthoid ulcers
what investigation is required for patients suspected to have CD ?
small bowel imagine whether CT oral contrast or MRI enteroclysis
what imaging modalities can be used to asses the thickness of the bowel wall and abscesses ?
High resolution US
Spiral CT scanning
what can be used as a non invasive marker of disease activity in IBD ?
faecal calprotectin
what marker can be used to predict response and failure to treatment ?
faecal calprotectin
what is the management for CD patients with mild symptoms ?
cigarette smoking should be stopped
diarrhea - use loperamide, codeine phosphate, co-phenotrope
correct anemia according to cause
