17-7 -- IBS/IBD Flashcards
IBS
Irritable Bowel Syndrome
Symptoms of IBS?
Relapsing abdominal pain, bloating and changes in bowel habits
Relapsing abdominal pain, bloating and changes in bowel habits
IBS
Microscopic evaluations of IBS?
NORMAL
Most common people affected by IBS/IBD
Females 20-40 in high income countries
Ashkenazi Jews
For IBS, there is interplay between stressors, diet, abnormal GI motility and increased enteric sensory responses. What are 2 possible etiologies for IBS?
Excessive bile acid = IBS-D
Defective brain-gut signaling axis
For IBS, there is interplay between stressors, diet, abnormal GI motility and increased enteric sensory responses. What are 2 possible etiologies for IBS?
Excessive bile acid = IBS-D
Defective brain-gut signaling axis
2 types of IBD?
Ulcerative Colitis
Crohn Disease
Inappropriate immune activation against intestinal microbiota is seen with?
IBD
What 2 food changes are thought to increase IBD?
Increased food hygiene and preservatives
Crohn Disease - location
Ileum and Colon
= skip lesions
Ulcerative Colitis - location
Rectum and continuous colon involvement
Crohn Disease is patchy and often termed ___ lesions
Skip lesions
- ileum and colon
Crohn Disease has ____ inflammation
Transmural
Ulcerative Colitis has _____ inflammation
Mucosal
Something unique to Crohn Disease?
Creeping fat
= fat extends over serosa
Something unique to Ulcerative Colitis?
Pseudopolyps
= bulging mucosa
Ulcers may present with both types of IBD. Describe the differences in them.
Crohn - DEEP ulcers
Ulcerative Colitis - SUPERFICIAL
Marked Fibrosis and Serositis with possible fistulas occurs with what IBD type?
Crohn Disease
Crohn Disease bowel anatomical changes?
THICK walls with possible strictures present
What does the Mucosa look like in Ulcerative Colitis?
Red, granular with broad ulcers
If the Pseudopolyp tips fuse with Ulcerative Colitis, what does that create?
Mucosal bridges
What polymorphism may be present in some cases of Crohn Disease?
NOD2
What is the earliest lesion with Crohn Disease?
Aphthous ulcers
The earliest lesion with Crohn Disease progresses how?
Aphthous ulcers coalesce to form an elongated, serpentine ulcer running along the axis of the bowel
Crohn Disease often has a _____ appearance
Cobblestone
Crohn Disease and ulcerative Colitis - mucosal changes
Crohn - edema and loss of mucosal folds
Ulcerative Colitis - Mucosal atrophy
Iron deficient anemia, along with malabsorption and hypoalbuminemia can present with?
Crohn Disease
Severe initial attack is seen with which IBD?
Ulcerative colitis
Both IBD have intermittent diarrhea, abdominal pain, RLQ pain. What is more severe and seen with Ulcerative Colitis?
Bloody diarrhea attacks with stringy mucoid material
Cramps relieved by defection
2 other causes of Chronic Colitis?
Diversion Colitis
Microscopic Colitis
2 other causes of Chronic Colitis?
Diversion Colitis
Microscopic Colitis
Describe how Diversion Colitis arises
Some GI disorders require a creation of an ostomy (blind distal segment of colon) from which fecal flow is diverted
– Colitis can develop in diverted segment
Describe how Diversion Colitis arises?
Some GI disorders require a creation of an ostomy (blind distal segment of colon) from which fecal flow is diverted
– Colitis can develop in diverted segment
Main sign of Diversion Colitis?
Numerous Mucosal Lymphoid Follicles
Numerous mucosal lymphoid follicles could indicate?
Diversion Colitis
2 types of Microscopic Colitis?
Collagenous Colitis
Lymphocytic Colitis
Collagenous Colitis
Watery diarrhea without weight loss in middle aged women
Water diarrhea without weight loss in middle aged women
Collagenous Colitis
Type of Microscopic Colitis
Lymphocytic Colitis
Watery diarrhea without weight loss in autoimmune/celiac disease
Watery diarrhea without weight loss in autoimmune/celiac disease
Lymphocytic Colitis
Type of Microscopic Colitis
Graft Vs. Host Disease occurs following?
HSC transplant
What are destroyed with Graft Vs. Host Disease?
Crypts
Symptoms of Graft vs. Host Disease?
Water to bloody diarrhea
What is Sigmoid Diverticular Disease?
Acquired pseudodiverticular outpouchings of the colonic mucosa and submucosa
Acquired pseudodiverticular outpouchings of the colonic mucosa and submucosa
Sigmoid Diverticular Disease
US common site of Diverticular Disease?
Left colon
Africa/Asia common site of Diverticular Disease?
Right colon
Pathogenesis of Sigmoid Diverticular Disease?
Unique structure of mucularis propria + increased intraluminal pressure
Increased intraluminal pressure can lead to?
Sigmoid Diverticular Disease
Symptoms of Sigmoid Diverticular Disease?
Asymptomatic
Cramping and abdominal discomfort with intermittent constipation/diarrhea
- Sensation of never fully emptying the rectum
Symptoms of Sigmoid Diverticular Disease
Asymptomatic
Cramping and abdominal discomfort with intermittent constipation/diarrhea
- Sensation of never fully emptying the rectum
Sensation of never fully emptying the rectum can be seen with?
Sigmoid Diverticular Disease
