Flashcards in IBD Deck (22):
A narrowing of the start of the transverse colon seen by barium enema is indicative of what type of IBD?
Crohn's disease: in chrohn's disease there is involvement of the whole thickness of the bowel wall, therefore stricturing can occur. Ulcerative colitis only affects the mucosa and so a narrowing of the lumen would be rare
What is the most common extra-intestinal manifestation of IBD?
Arthritis - affecting the spine, sacroiliac joint and peritheral joints
What are the most common skin disorders with IBD?
1. Erythema nodosum - inflammatory condition -> inflamed fat cells under skin -> tender red lumps (shins)
2. Pyoderma gangrenosum - skin condition -> painful ulcers (usually legs)
3. And related psoriases
In addition to arthritis and skin problems, what other extra-intestinal manifestation of IBD is seen in up to 5% of patients?
Eye-related issues e.g.
1. Episcleritis - inflammatory disease affecting the episclera
2. Scleritis - inflammatory disease of the sclera
Continuous mucosal involvement is a gross pathological change observed on colonoscopies of which type of IBD?
Ulcerative colitis - not all the mucosa is ulcerated but the ulcerated portions are linked together into a continuous pattern of mucosal ulceration
Skip lesions are a gross pathological change observed on colonoscopies of which type of IBD?
Crohn's disease - where obvious gaps of normal mucosa are seen in between the disease involved areas
Fistula are a gross pathological change observed on colonoscopies of which type of IBD?
Crohn's disease - due to the involvement of the full thickness of the bowel wall
Cobblestone appearance is a gross pathological change observed on colonoscopies of which type of IBD?
Crohn's disease - in severe Crohn's where islands of mucosa are separated with longitudinal and horizontal ulceration
What parts of the GI tract are commonly involved in ulcerative colitis?
The majority of patients with UC have disease in the rectum, often continuous with disease in the colon which can extend back to the caecum.
In some cases 'backwash ileitis' can occur with the terminal ileum being inflamed
What parts of the GI tract are commonly involved in Crohn's disease
Often spares the rectum
Which parts of the gastrointestinal wall are affected in ulcerative colitis?
Chronic inflammation of the mucosa
Which parts of the gastrointestinal tract are principally affected in ulcerative colitis?
Rectum and sigmoid colon
Which parts of the gastrointestinal wall are affected in Crohn's disease?
Chronic inflammation which extends through the whole bowel wall
Which parts of the gastrointestinal tract are principally affected in Crohn's disease?
Can occur anywhere in the gastrointestinal tract but most commonly affects the terminal ileum and the more proximal colon
What characterises the first, often most serious event, of ulcerative colitis?
Urgent diarrhoea with mucus and often bloody stools
After the first event of ulcerative colitis, what type of path does the disease take?
A relentless remitting relapsing course which has a major effect on the patient's quality of life
How is ulcerative colitis managed?
Management concentrates on reducing the inflammation, usually with steroids.
Long-term patients are maintained on amino-salicylates, such as Sulphasalazine
Which is more prevalent of the two IBDs: ulcerative colitis and Crohn's disease?
Why does the presentation of Crohn's disease vary?
Depends on what part of the bowel is affected:
How does Crohn's disease present if the ileum is affected?
Pain, often associated with diarrhoea. Commonly malabsorption -> weightloss and if terminal ileum is affected there may be anaemia due to poor absorption of B12. Effects of inflammation may be severe and may present with intestinal obstruction requiring urgent medical intervention
How does Crohn's disease present if the colon is affected?
Similar to UC - bloody diarrhoea, passage of mucus and symptoms such as malaise, anorexia and weight loss.
Many patients have involvement of both the ileum and colon and so present with symptoms of both