5: IBD clinical signs and symptoms Flashcards
Normally, the gut acts as a ___ organ for the ___ immune system.
surveillance
mucosal
What are the two types of inflammatory bowel disease?
Crohn’s disease
Ulcerative colitis
What symptoms tend to be seen in Crohn’s disease?
Abdominal pain
Perianal disease
Watery diarrhoea
What symptoms tend to be seen in ulcerative colitis?
Bloody diarrhoea
What three factors are involved in the pathogenesis of IBD?
Genetics
Mucosal immune system
Environmental triggers
Which gene predisposes you to develop IBD?
NOD2
What does the NOD2 gene code for?
Proteins involved in bacterial recognition
Smoking (aggravates / protects against) Crohn’s disease.
aggravates
Smoking (aggravates / protects against) ulcerative colitis.
protects against
Which class of drug aggravates colitis?
NSAIDs (ibuprofen, naproxen, diclofenac)
Which part of the GI tract does ulcerative colitis start in?
Where does it go after that?
Rectum
Proximally
If an acute flareup of UC doesn’t clear up with drugs (e.g steroids), what is performed?
Colectomy
What are the main symptoms of ulcerative colitis?
Diarrhoea with blood
Increased bowel frequency
Lower abdominal pain in the left iliac fossa is characteristic of which disease?
Ulcerative colitis
What aspect of the past medical history is important in UC?
Antibiotics / NSAID use
Skin, eye, joint problems
What is the criteria for diagnosing severe UC?
>6 bloody stools within 24 hours
+ 1 or more of:
Fever
Tachycardia
Anaemia
What may be seen on the AXR of someone with UC?
Absence of stools
Mucosal oedema - thumb print sign
Toxic megacolon
What would be seen upon endoscopy of someone with UC?
Continous inflammation
Granular mucosa
Pseudopolyps
Absence of goblet cells
Crypt abscesses
Does UC affect the whole thickness of the gut?
No - mucosa only
What does ulcerative colitis increase your risk of?
Colorectal cancer
What are some extra-intestinal symptoms of UC?
Skin - rashes
Joint problems
Eye problems
Mouth ulcers
Oxalate renal stones
What gallbladder condition is associated with ulcerative colitis?
Primary sclerosing cholangitis
inflammation due to stricture in cystic duct
Which areas of the GI tract are affected by Crohn’s disease?
Mouth to anus
What kind of lesions are seen in Crohn’s disease?
How does this differ from UC?
Skip lesions
UC is continous, Crohn’s skips bits of the GI tract
What kind of inflammation is seen in Crohn’s disease?
Transmural
penetrates the whole gut wall
What is perianal disease associated with?
Crohn’s disease
Give an example of a perianal disease associated with Crohn’s.
Rectal abscesses
What is a complication of rectal abscesses seen in Crohn’s disease?
Fistula formation
Why may someone with Crohn’s disease become incontinent?
Damage to anal sphincters caused by abscesses
What pathology, causing bowel obstruction, is seen in Crohn’s disease?
Strictures
What kind of mucosa is seen in Crohn’s disease patients?
“Cobblestoning”
What causes cobblestone mucosa in Crohn’s disease?
Omentum wraps round bowel and tries to seal off the injury
