IBS

Question 1

what are the features of Chron’s?

Answer 1

Chron’s: crows NESTS
- No blood or mucus
- Entire GI tract
- Skip lesions
- Terminal ileum most affected and Transmural (full thickness) inflammation
- Smoking is a risk factor

Question 2

apart from Chron’s NEST, what other features are linked to Chron’s?

Answer 2

Also associated with weight loss, strictures and fistulas

Question 3

how do you induce remission of chron’s?

Answer 3

first line – steroids
- Oral prednisolone or IV hydrocortisone second line - Under specialist can add immunosuppressant – azathioprine, mercaptopurine, methotrexate, infliximab, adalimumab

Question 4

what are the aims of maintain remission in chrons?

Answer 4

tailored to individual needs, side effects, nature of disease and patients preferences

Question 5

what is the first line and second line therapy for maintaining remission in Chron’s?

Answer 5

• First line: azathioprine/ mercaptopurine
  second- Or other immunosuppressants

Question 6

when would surgery be appropriate in Chron’s?

Answer 6

if it only affects distal ileum - can resect that area
to treat fistulas or strictures secondary to Chron’s

Question 7

why might Chron’s not be surgically appropriate?

Answer 7

Chron’s can occur anywhere within the whole GI tract - mouth to anus - can not resect the whole thing

Question 8

where does ulcerative colitis occur?

Answer 8

colon and rectum only

Question 9

what is the pathology of UC?

Answer 9

continuous inflammation
superficial mucosa only affected

Question 10

what are the CLOSEUP features of UC?

Answer 10

• Continuous inflammation
• Limited to colon and rectum
• Only superficial mucosa affected
• Smoking is preventative
• Excrete blood and mucus
• Use aminosalicylates
• Primary sclerosing cholangitis