coeliac and ibd Flashcards
what is coeliac disease
an autoimmune disease affects children and adults it is. a reaction from luton found in certain grains
it causes inflammatory mucosa and there is no treatment just gluten free life style
coeliac disease diagnosis
small bowel biopsy
blood test
- immunoglobulin A
- ant tissue transglutaminase
- anti endomysial antibodies EMA
what is IBD inflammatory bowel disease
- chronic immune mediated inflammation of the gastrointestinal tract
- often has a progressive destructive course
- idiopathic - the disease can arise spontaneously
- relapses
the two main forms are
- ulcerative colitis
- Crohn’s disease
what are the symptoms of ulcerative colitis
- colon (small intestine) and rectum involved
- continuous involvement of inflammation
inflammation limited to mucosa - bloody diarrhoea
- colicky left sided pin
- tenesmus - constantly feeling like you need to use the toilet
symptoms of Crohn’s disease
- transmural inflammation
- skip lesions
- leds to strictures, fistulas
- may affect many part of the gi tract
abdominal pain
diarrhoea
insidious onset
other symptoms of ibd
it doesn’t just affect the gut but can also affect other oreganos and these can be just as life threatening
such as
- bones and joints, eyes, skin, pancreas liver biliary system
what is the pathophysiology - the process associated with the disease.
the dietary and bacterial antigens penetrate the mucosal lining of the gut
they activate the immune cells within the LAMINEA PROPRIA and wall of the gut
CYTOKINES AND CHEMOKINES are involved in the recruitment of inflammatory cells such as T cells
initiate inflammation and tissue destruction
inflammation is maintained through inappropriate response to luminal bacteria
role of TNF alpha
this is an example of a cytokine
it is involved in initiation the inflammation and producing structures which are involved in the destruction of the gut
drug treatment summary
anti- inflammatory
immunosuppressants
biologics
5 - ASA - anti inflammatory drug
- the first line therapy for mild to moderate cd and ur
effective for inducing remission in cd and ur
effective in maintaining remission in uc
sulfasalazine
this prevents the absorption in the stomach and the small intestine
broken down by colonic bacterial azoreductase
it is a pro drug so it works once digested
what is the mode of action for sulfapyridine
blocks lipoxygenase pathways and inhibits LT function, also inhibits pro inflammatory cytokines IL-1 and TNFalpha
free radical scavenging
