Crohn's and Colitis Flashcards
What inflammatory markers are raised in Crohn’s and colitis
2 points
CRP
ESR (erythrocyte sedimentation rate)
Raised faecal calprotectin may indicate __________
Active inflammation
1st line to induce remission at first presentation or single exacerbation in 12 months in Crohn’s disease (3 points)
Corticosteroids:
- Prednisolone
- Methylprednisolone
- IV hydrocortisone
Add on options (added to steroids) in Crohn’s with 2 or more exacerbations in 12 months
(3 points)
- Azathioprine/Mercaptopurine
- Methotrexate (if can’t tolerate thiopurines or TPMT activity
deficiency) - Biologics (specilaist)
True or false:
Corticosteroids can be used for both induction and maintenance of remission in Crohn’s
FALSE
Corticosteroids should not be used long term!
What treatments are used in active fistulating Crohn’s
3 points
- Abx (metronidazole or cipro)
- Immunosuppressants (thiopurines)
- Infliximab (if intolerant, do not respond or CI to conventional therapy)
What drugs are used to maintain remission in Crohn’s
2 points
1) Azathioprine or Mercaptopurine
2) Methotrexate
1st line for mild to moderate presentations of ulcerative colitis?
Topical aminosalicylates
1st line for extensive ulcerative colitis
Topical AND oral (high dose) 5-ASA drugs
Treatment options for acute severe UC? (1st and 2nd line)
1st line IV corticosteroids
2nd line IV ciclosporin or surgery
(consider 2nd line if no improvement in 72 hours)
Second line therapy is added if no response to treatment after ______ in mild to moderate UC and extensive UC
4 weeks
Drugs used for maintenance of remission in:
a) UC (1st and 2nd line)
b) acute severe UC
a) 1st line topical 5-ASA
2nd line add an oral 5-ASA to topical
b) Azathioprine or mercaptopurine
Treatment options for maintenance of remission in UC if the patient has had 2 or more flare ups in the last year?
Azathioprine or Mercaptopurine
True or false:
Laxatives are safe to use in Crohn’s and UC
FALSE
