Flashcards in Inflammatory bowel disease- clinical Deck (17)
What do UC and Crohn's differ in?
Crohn's: abdominal pain and peri-anal disease
UC: diarrhoea and bleeding
What three factors contribute to the pathogenesis of IBD?
Mucosal immune system
Which gene has been recognised has a IBD susceptibility gene?
Where is it found?
What does this gene encode?
It is found on chromosome 16q12
It encodes a protein involved in bacterial recognition
a) Which immune cell mediates Crohn's disease?
b) Which immune cells mediate UC?
b) Mixed Th1/Th2 and NKTC
Is there reduced or increased antimicrobial activity compared to normal in a) Crohn's and b) UC?
b) Increased- body produces its own "antibiotics" in the cells lining the intestine
How does smoking affect a) Crohn's disease and b) UC?
b) Protects against
What is the effect of NSAIDs on IBD?
They can aggravate it as they break down the mucous lining
How is severe ulcerative colitis identified?
If there are at least 6 bloody stools per day as well as one or more of:
Anaemia (Hb < 10.6 g/ld)
Elevated ESR (> 30mm/hr)
How wide is a toxic colon in a) the transverse colon and b) the caecum?
a) >5.5 cm
What is a longterm complication of ulcerative colitis?
What is this determined by?
Increased risk of colorectal cancer.
Risk determined by:
Severity of inflammation
Duration of disease
What is primary sclerosing cholangitis (in IBD)?
The pipes which drain bile out of the liver are inflamed in tandem with the gut. Causes cirrhosis of the liver very rapidly and people require a liver transplant.
What perianal disease can be present in Crohn's disease?
Recurrent abscess formation
Can lead to fistula formation with persistent leakage
What percentage of Crohn's patients require surgery in 8-10 years?
50% of these patients require a second operation
What are the symptoms of UC?
Diarrhoea + bleeding
Increased bowel frequency (HOW OFTEN?)
Lower abdo pain (esp. LIF)
(proctitis can cause constipation)
What determines the symptoms in Crohn's?
The site of the disease
What are symptoms of Crohn's disease?
Abdominal cramps (peri-umbilical)
Diarrhoea, weight loss
Abdominal cramps (lower abdomen)
Diarrhoea with blood
Painful ulcers, swollen lips, angular chielitis
peri-anal pain, abscess