Crohn's Disease Flashcards
What is Crohn’s disease?
Inflammatory GI disease
Where does Crohn’s affect in the body?
Anywhere along the GI tract from the mouth to the anus
What is Crohn’s characterised by?
Transmural granulomatous inflammation
What is the pneumonic for the features of Crohn’s disease?
NESTS
What does NESTS stand for?
N- No blood or mucus E- Entire GI tract S- Skip lesions on endoscopy T-Terminal ileum most affected and transmural thickness S-Smoking is a risk factor
How does Crohn’s disease present?
Persistent diarrhoea Abdominal pain (RLQ) Weight loss Erythema nodosum Aphthous ulcers Peri-anal crohn's- Skin tags
What is the most common feature of crohn’s in children?
Persistent abdominal pain
What is short bowel syndrome?
Bile acid malabsorption
Patients present with fatty stools and diarrhoea
What is a risk factor of Crohn’s disease?
Smoking
preventative in UC
Which 2 age groups are affected by Crohn’s?
20-30
50-60
What will be raised in Crohn’s disease?
C-reactive protein
Faecal calprotectin
What will be low in Crohn’s disease?
Vitamin B12 and Vitamin D
What will be negative in Crohn’s disease?
P-ANCA
How is Peri-anal Crohn’s diagnosed?
MRI
What is the main diagnosis of Crohn’s?
Colonoscopy
What would you find on a colonoscopy of someone with Crohn’s?
Cobblestone appearance
Skip lesions
Granulomas
What are possible complications of Crohn’s?
Obstruction- small bowel
Fistulae
Strictures
How does small bowel enema present?
- strictures: ‘Kantor’s string sign’
- proximal bowel dilation
- ‘rose thorn’ ulcers
- fistulae
How is remission induced with Crohn’s disease?
Oral Prednisolone
IV hydrocortisone
How is remission maintained in Crohn’s disease?
Immunosuppressants:
- -Azathioprine
- -Mercaptopurine
When would you use surgery in the management of Crohn’s?
When Crohn’s affects the distal ileum
Treat strictures and fistulas (secondary to Crohn’s)
