Lower GI Disorders (IBD+UC)

Question 1

Inflammatory Bowel Disease (IBD)

Answer 1

A group of Life-changing chronic illness

Question 2

2 types of IBD

Answer 2

1. Crones

2. Ulcerative Colitis

Question 3

IBD is characterized by

Answer 3

Chronic inflammation of the intestines

Exacerbation and remission

Question 4

IBD demographic

Answer 4

More common in:

• WOMEN
• Caucasians
• Jewish
• Smokers

Question 5

IBD etiology

Answer 5

Autoimmune activated by an infection

Question 6

Chron’s Disease Pathogenesis

Answer 6

Lymph structures of GI tract are blocked

Tissue becomes engorged and inflamed

Deep linear FISSURES and ULCERS develop in a ‘patchy’ pattern in bowel wall

1. Skip Lesions
2. Cobblestone Appearance

Question 7

Crone’s Disease Complications

Answer 7

Malnutrition (anemia)
Scar tissue + Obstructions
Fistulas
Cancer

Question 8

Crone’s Disease Manifestations

Answer 8

Crampy lower abdominal pain (RLQ)

Watery diarrhea

SYSTEMIC:
-Weight loss, fatigue, no appetite, fever, malabsorption of nutrients

Palpable abdominal mass (RLQ)

Mouth ulcers

S/S of fistulas

Question 9

Crone’s G.A.L.S

Answer 9

Granulomas
All Layers
Skip Lesions

Question 10

Ulcerative Colitis

Answer 10

Inflammation of the mucosa of the RECTUM + COLON

Question 11

UC is more common in what types of people?

Answer 11

Usually develops in third decade of life

• European
• Ashkenazi Jews
• Occasionally Blacks
• Rare in Asians

Question 12

UC Pathogenesis

Answer 12

Inflammation begins in rectum and extends in a CONTINUUS segment that may involve ENTIRE colon

• Inflammation leads to large ulcerations
• Necrosis of the epithelial tissue can result in abscesses CRIPT ABSCESSES

Colon and rectum try to repair damage with new granulation tissue

• Why is this a problem?
• Tissue is fragile and bleeds easily

Question 13

UC Clinical Manifestations

Answer 13

Abdominal Pain
Bloody Diarrhea

Systemic: Weight loss, fatigue, no appetite, fever

Question 14

UC Complications

Answer 14

Hemorrhage
Perforation
Cancer

Question 15

**More Complications of UC

Answer 15

Malnutrition
Anemia
Strictures
Fissures
Fistulas
Abscesses
TOXIC MEGACOLON
Colorectal Carcinoma
Liver disease (inflammation  and scarring of bile duct)
F+E + pH imbalances
DVT/VTE

Question 16

What is TOXIC MEGACOLON

Answer 16

A rapid dilation of the large intestine that can be life-threatening

Question 17

Diverticulosis

Answer 17

Development of diverticula:

-small pouches in lining of colon that bulge outward through weak spots

Question 18

Usual Location of Diverticula

Answer 18

Descending colon

Question 19

How do you get Diverticulosis?

Answer 19

May be congenital or acquired

Thought to be caused by low fiber diet with resulting chronic constipation

Question 20

What is Diverticulitis vs Diverticulosis

Answer 20

Diverticulitis: Outpouching with infection or inflammation of diverticula (pouch)

Diverticulosis: Outpouching without inflammation or infection

Question 21

DiverticuLOSIS Clinical Manifestations

Answer 21

Usually asymptomatic

Discovered accidently or with presentation of acute diverticulitis

Question 22

DiverticuLITIS Clinical Manifestations

Answer 22

• Abdominal Pain (LLQ)
• Fever
• Inc WBC
• Constipation or Diarrhea
• Acute passage of lots of frank blood

May resolve spontaneously

Question 23

Diverticulitis etiology

Answer 23

INFLAMMATION of one or more of the pouches (diverticula)

-usually from retained fecal material

Question 24

Diverticulitis Complications

Answer 24

Perforation
Peritonitis
Obstruction