Inflammatory Bowel Disease Flashcards
(23 cards)
which has a sharp cut-off?
ulcerative colitis
U | C
spread of UC
starts at rectum, continuously moves distally
no further than ileocaecal valve
which just affects mucosa and has NO granuloma?
UC - continuous and shallow
What is Chron’s associated with?
altered cell-mediated immunity
smoking increases risk
NSAIDs may exacerbate disease
features chron’s
deep fissuring ulcers (transmural granulomatous inflammation)
fibrous scarring and cobblestone
narrow lumen, thickened wall
location of Chron’s
discontinuous
anywhere from mouth to anus
esp. terminal ileum
fibrous scarring and cobblestone
narrow lumen, thickened wall
Chron’s
epidemiology
most common in western
Px usually teens + twenties
IBD aetiology
- genetic susceptibility,
- the environment
- host immune response
smoking
increases risk for CD
reduced risk for UC
host immune response
IBD results from defective mucosal immune system producing an abnormal response to luminal antigens
Clinical features CD
depend on region of involved bowel
ileocaecal is the most common
abd pain, weight loss, diarrhoea, fever etc.
Clinical features UC
diarrhoea, often bloody and mucus
blood tests
anaemia is common
Acute CD: raised ESR, CRP and platelets
radiology + imaging
rigid or flexible sigmoidoscopy
rectal biopsy
colonoscopy
SB imaging
Tx mild UC
5-ASA e.g.sulfasalazine
Tx moderate UC
if 4-6 motions/day but otherwise well, try prednisolone
Tx severe UC
> 6 months.
admit for NBM & IV hydration
hydrocortisone
rectal steroids
Tx for proctitis (inflammation of rectum + anus)
suppositories
surgery for UC
proctocolectomy + terminal ileostomy
Tx mild attacks in CD
prednisolone
what kind of diet for CD?
low residue diets
Tx severe attacks in CD
admit for IV steroids, NBM
hydrocortisone
? blood transfusion
