Flashcards in Inflammatory Bowel Disease Deck (23)
Inflammatory Bowel Disease is defined as
a group of chronic inflammatory conditions of the colon and small intestine
Two major forms of IBD
Crohn's and Ulcerative Colitis
The Hygiene hypothesis is
Incidence of immune-mediated diseases is rising in developed countries and many scientists wonder whether it may be due to relatively good modern hygiene or lack of exposure to bacteria.
The data surrounding this and IBD is conflicting
What is ulcerative colitis?
Chronic inflammatory disorder of the GI tract affecting the large bowel. Features a dilated and thin colon whith severe inflammation
Where does ulcerative colitis start?
Begins in the rectum and extends proximally
What is seen on endoscopy with ulcerative colitis?
hyperemia (redness), edema, granularity, easy bleeding, broad based ulceration, pseudopolyps,rarely perforation
Toxic megacolon is?
shutdown of neuromuscular function secondary to exposure of fecal material to muscularis mucosa and neural plexus
On microscopic pathology, ulcerative colitis is limited to what areas?
mucosal and submucosal layers. This is characteristic of ulcerative colitis
confined to rectum
In ulcerative proctitis rectal bleeding may be the only sign of the disease. May also have rectal pain, a feeling of urgency or inability to move bowels in spite of the urge to do so (tenesmus)
Involves the rectum and sigmoid. Bloody diarrhea, cramps, tenesmus
Left sided colitis
Disease extends from the rectum up the left side and through the sigmoid and descending colon. You would see bloody diarrhea, pain on left side, and wt loss
Wt loss first seen in what type of UC
Affects the entire colon.
You would see bouts of bloody diarrhea, abdominal cramps and pain, fatigue, wt loss
Uncommon, life-threatening, affects the entire colon.
Severe pain, profuse diarrhea, shock and dehydration, SIRS
Associated extensive and deep colonic injury
What does CT scan do well in regards to analysis of ulcerative colitis?
Evaluates free air and allows you to see other structures in the abdomen like mesenteric inflammation or lymphadenopathy
What does a CT scan do not do well?
Does not demonstrate mucosal detail which Barium studies can do
Crohn's disease involves what sections of the GI tract
Can involve any section though it has a propensity for distal small bowel and proximal colon. Can involve anywhere from mouth to anus. May see apthous ulcers in the mouth, esophageal ulcers, gastric disease, small bowel
Ways in which Crohn's is different than ulcerative
- rectal sparing (spares the rectum)
- Skip lesions
- Its very asymmetrical
- Deep ulcerations
- Stricture formation
Characteristics of Crohn's...
- Transmural involvement
- Noncaseating Granuloma
- Fissuring with Fistula
- Skip lesions