Inflammatory Bowel Diseases Flashcards
What is Crohn’s disease?
Transmural GI inflammation (especially oral, perianal, small bowel) with “skip” lesions - normal mucosa inbetween affected areas
Which patient groups are most at risk of developing Crohn’s disease?
- Anglo-Saxon ancestry
- 15-40 and 60-80
- People with a family history
What symptoms/signs are patients with Crohn’s disease likely to present with?
- Abdominal pain
- Prolonged diarrhoea
- Perianal/oral lesions
- Obstructive bowel symptoms (bloating, constipation etc.)
- Rectal bleeding
- Uveitis/arthropathy
What investigations might help confirm a suspected case of Crohn’s disease?
- Colonoscopy
- Abdo imaging - lesion localisation
- CRP/ESR - elevated in Crohn’s
- FBE/iron - exclude anaemia
- Clostridium/Yersinia serology
What can present in a similar way to Crohn’s disease? How are they distinguished?
- Ulcerative colitis (no oral/anal signs, pain is generally L sided. Colonoscopy)
- Infectious colitis (contact with sick?)
- Psuedomembranous colitis (antibiotic use?)
- Colorectal cancer (FHx, biopsy)
- Diverticular disease (CT)
- Ectopic pregnancy (bHCG)
What are the prinicples of management of Crohn’s disease?
- Immunosuppression (oral budesonide/5-ASA + azathiprine/methotrexate if severe)
- Antibiotics if septic complication suspected
- Surgery - resection
What is ulcerative colitis?
An inflammatory bowel disease that tends to involve the rectum and extends proximally
What are some of the signs and symptoms in a patient that presents with ulcerative colitis?
- Rectal bleeding
- Diarrhoea
- Mucus in stools
- Abdominal pain
- Weight loss/fever
- Arthritis/uveitis
- Skin signs (pyoderma gangrenosum)
How is ulcerative colitis generally distinguished from Crohn’s disease?
Crohn’s
- Perianal/small bowel involvement, oral lesions. No rectal lesions
- Skip lesions
Ulcerative colitis
- Generally L sided abdominal pain
- Rectal lesions, no small bowel, perianal lesions
Distinguished on biopsy
