Crohn's Disease and Ulcerative Colitis Flashcards
what is the aetiology of inflammatory bowel disease?
food intolerance, persisting viral infection/immune activation, smoking, genetic
where can Crohn’s disease occur?
anywhere in the GI tract although the ileocaecal region is popular
where does ulcerative colitis occur?
distal part of the bowel and moves upwards through the large intestine, always in the rectum and can then travel
what are the features of ulcerative colitis?
continuous disease, rectum always involved, anal fissures 25%, ileum involved 10%, mucosa is granular and ulcers present, vascular disease, serosa is normal
what are the features of Crohn’s disease?
discontinuous, rectum involved 50%, anal fissures 75%, ileum involved 30%, mucosa cobbled and fissures, non-vascular, serosa inflamed
what are the microscopic features of ulcerative colitis?
mucosal, vascular, mucosal abscesses
what are the microscopic features of Crohn’s disease?
transmural, oedematous, granulomas
what does Crohn’s disease look like?
cobblestone mucosa with oedema between fibrous bands
what causes obstruction and oedema with Crohn’s disease?
large multi-nucleated giant cells
what layers of the bowel are involved in Crohn’s disease?
all layers all the way to the surface of bowel in peritoneum
what is the appearance of Crohns disease?
oedema around mouth and lips, skin and mucosa tagging in face and mouth, tissue oedema separated by fibrous bands
what layers of the bowel does ulcerative colitis affect?
superficial layers
comment on the vascular supply of ulcerative colitis
increased
what are the symptoms of ulcerative colitis?
diarrhoea, abdominal pain. PR bleeding
what are the symptoms of Crohn’s disease?
for a colonic disease - diarrhoea, abdominal pain, PR bleeding
for small bowel disease - pain due to obstruction, malabsorption due to anal disease
for mouth - orofacial granulomatosis
what are the investigations used for inflammatory bowel disease?
blood tests, faecal calprotectin, endoscopy, leukocyte scan, barium studies, bullet endoscopy
what are the complications of ulcerative colitis
develops into carcinoma over time
what medical treatment is available for inflammatory bowel disease?
systemic steroids, local steroids, anti-inflammatory drugs, non-steroid immunosuppressants, anti TNFa therapy
what surgical treatment is available for ulcerative colitis and what does it do?
colectomy - remove obstructed bowel segments, drain abscesses, close fistulae
with OFG what results due to granuloma formation?
blockage of lymphatics
what does OFG look like?
lip and oral swelling
which haematinic can you be deficient in with Crohn’s disease?
vitamin B12
