Coeliac Disease + Inflammatory Bowel Disease (L11) Flashcards
What is coeliac disease?
Auto-immune disease of the small intestine which is triggered by the ingestion of gluten.
What is the consequence of coeliac disease?
Malabsorption
What is gluten?
A protein found in wheat, rye and barley
What can lead to a cessation of the symptoms of coeliac disease?
Gluten-free diet
What are the microscopic features of coeliac disease?
- Villous atrophy
- Crypt hyperplasia
- Increase in lymphocytes in the small intestine
- Inflammation of the small intestine
Examples of three inflammatory bowel diseases
- Ulcerative colitis
- Crohn’s disease
- ## Ischaemic colitis
What is Crohn’s disease?
An idiopathic, chronic inflammatory bowel disease - meaning its cause is unknown. There is evidence that suggests that it is linked to genetics because relatives of sufferers have an increased risk of developing it.
What is the difference between IBS and IBD?
- IBS is inflammatory bowel syndrome
- IBD is inflammatory bowel disease
What is the the improved hygiene hypothesis?
- Improved hygiene in susceptible individuals leads to a reduction in enteric infections
- As a result, they are less immune to pathogen
- Therefore, they display an exaggerated immune response which damages the mucosal surface.
What increases the risk of having Crohn’s disease?
- Migration from a low risk population to a high risk population
- Western countries have higher risk than Asian and African countries
- Smoking
What are the clinical features of Crohn’s disease?
- Abdominal pain (relieved by opening bowels)
- Prolonged non-bloody diarrhoea
- Weight loss
What does Crohn’s disease affect?
Any part of the GI tract (mouth to anus)
Microscopic features in Crohn’s disease
- Inflammation
- Mucosal ulceration
- Granulomas (collection of macrophages)
- Fibrosis
What complications can be caused by Crohn’s disease?
- Fistula (passage between two structures).
- Abscess (swollen area and contains pus)
- Obstructions caused by adhesions and fibrosis
What is ulcerative colitis?
- Chronic inflammatory bowel disease that only affects the large intestine (caecum to rectum)
- The inflammatory process is limited to the mucosa and submucosa
When does UC arise?
It can arise at any age but is rare to be before the age of 10
What causes UC?
Unknown cause but it can be linked to genetics
What are the clinical features of UC?
- Bloody diarrhoea
- Mucoid diarrhoea (lots of mucus)
- Weight loss
What are the microscopic features of UC?
- Inflammation confined to the mucosa (acute and chronic)
- Crypt architectural distortion
What is toxic megacolon?
Complication of UC and the bowel becomes dilated and haemorrhagic
What is transmural inflammation?
- Inflammation that spans the whole depth of the intestinal wall
- The type of inflammation that occurs in Crohn’s disease
