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Flashcards in Inflammatory Bowel Diseases and IBS Deck (34):

Name the two inflammatory bowel diseases

Crohn's and ulcerative colitis


What is the major difference between Crohn's and ulcerative colitis?

ulcerative colitis involves mucosal ulceration in the colon whereas Crohn's involves transmural inflammation (ileitis, ileocolitis, and colitis)


Ethinic group with increased incidence of inflammatory bowel disease



Age group most commonly affected by inflammatory bowel disease

2nd and 3rd decades


Defect in the function of the intestinal lumen. Breakdown of the defense barrier of the gut. Exposure of mucosa to microorganisms or their products. Results in chronic inflammatory process mediated by T cells

pathophysiology of inflammatory bowel disease


Systemic complications include: apthous stomatitis, episcleritis and uveitis, arthritis, vascular complications, E. nodosum, P. gangrenosum

inflammatory bowel disease


complications of inflammatory bowel disease related to small bowel pathophysiology

gallstones, malabsorption, renal stones


Involves the mucosal surface of colon with the formation of crypt abscesses. Always includes the rectum, spreads proximally

ulcerative colitis


Clinical course is marked by flare-ups and remissions. More common in nonsmokers. Higher risk for development of cancer

ulcerative colitis


Hallmark of ulcerative colitis

bloody diarrhea


Symptoms include: rectal bleeding, LLQ cramps, severe diarrhea, fever, anemia, hypoalbuminemia, and hypovolemia

severe ulcerative colitis


disease of bile ducts that causes inflammation and obstruction, 80% have UC, liver transplant

sclerosing cholangitis


Systemic associations include: peripheral and central arthritis, uveitis, sclerosing cholangitis

ulcerative colitis


What is needed for the diagnosis of ulcerative colitis?

sigmoidoscopic demonstration of inflammation and the exclusion of bacterial and parasitic infection.


What are dietary recommendations for treatment of ulcerative colitis?

reduce dietary fiber during exacerbation, folic acid supplements w/sulfasalazine.


What are pharmacological options for ulcerative colitis?

oral Fe w/rectal bleeding or anemia. Loperamide for troublesome diarrhea. Prednisone for inflammation.


What do the following have in common in relation to ulcerative colitis: exsanguinating hemorrhage, toxicity/perforation, suspected cancer, dysplasia, systemic complications, growth retardation, and intractibility

indications for surgery


Transmural involvement with formation of fistulas, narrowing of lumen, obstruction. Can involve any segment of the G.I. tract, but usually rectal sparing.

Crohn's Disease


Name of predominant segment of GI tract when it's involved with Crohn's disease

ileocolitis (45%)


strongly associated with the development of Crohn’s Disease, resistance to medical therapy and early disease relapse

cigarettes (not e-cigs though)


Insidious onset. Intermittent bouts of low-grade fever, diarrhea and RLQ pain. Postprandial pain common. RLQ mass. Perianal disease (abscess, fistula)

Crohn's disease


Often nocturnal B.M.’s, night sweats, weight loss.
Skin lesions, primarily erythema nodosum, may precede intestinal symptoms.

Crohn's disease


Common presentation of physical exam includes: abdominal distention, abnormal bowel sounds, tenderness in area of involvement.

Crohn's disease


Associated with abscesses, fistulas, skin tags in the perianal region as well as anal strictures.

Crohn's disease


Serum test that can be used for Crohn's disease that is highly specific, but has low sensitivity

ASCA (anti-saccharomyces cerevisiae antibody)


Radiography that is better for finding complications of Crohn's disease including strictures and fistulas

Barium contrast studies


“cobble stoning”, “skip lesions”, pseudodiverticula, dilated bowel, fistulas communicating to adjacent bowel/mesentery/bladder/vagina

Crohn's Disease


Serum test that can be used for detection of ulcerative colitis but is not useful as the sole diagnostic test due to low sensitivity.

Perinuclear antineutrophil cytoplasmic antibodies (pANCA)


Common radiologic finding of Crohn's disease due to narrowing and stricturing of terminal ileum

String sign


A functional gastrointestinal disorder that is a variable combination of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities

irritable bowel syndrome


How long must a patient have abdominal pain or discomfort, pain relieved by defecation, and pain with a change in frequency or form of stools to be classified as having irritable bowel syndrome?

3 months


Associated symptoms in order of prevalence includes: fatigue, back ache, early satiety, nausea, HA, irritable bladder, functional dyspepsia

irritable bowel syndrome


How do we make a positive diagnosis of irritable bowel syndrome without costing the patient tons of money

Rome and Manning Guidelines


positive diagnosis is usually made from h/o that includes onset during late teens/early twenties, intermittent, crampy pain that doesn't occur at night

irritable bowel syndrome