crohn's & ulcerative colitis Flashcards
what is the main difference between crohn’s and ulcerative colitis?
crohn’s is both large and small bowel, colitis is only large
what age are IBD common?
15-25y/o
50-80 y/o
what is the gender risk for IBD?
crohn's = male>female colitis= female>male
what are the risk factors for IBD?
food intolerance
persisting viral infection/immune activation
smoking
genetic
what are the crohn’s disease sites
any part of GIT and mouth
ileo-caecal region common
-causes vitB12 malabsorption
what are the colitis sites?
always in rectum, extends up large bowel
continuous
only colon
which is more likely to extend onto skin? (fissures)
crohns
which is superficial?
colitis, crohns entire wall of intestine
which is vascular?
colitis
what are the microscopic features of colitis?
mucosal
vascular
mucosal abcesses
what are the microscopic features of crohns?
transmural
granulomas
oedematous
-blockage of lymphatics occupying drainage channels
what causes lymphatic obstruction in crohns?
inflammatory changes
lymphocytes
large multinucleated giant cells
where does the inflammatory change occur in ulcerative colitis?
submucosa
what are the symptoms of ulcerative colitis?
darrhoea
abdominal pain
PR bleeding
what are the symptoms of crohns?
diarrhoea abdominal pain PR bleeding small bowel disease -pain-obstruction -malabsorption - anal disease mouth -orofacial granulomatosis
what are the investigations for IBD?
blood tests
-anaemia, CRP, ESR
faecal calprotectin
endoscopy
what can be used if endoscopy no possible?
leukocyte scan
barium studies
bullet endoscopy
what are the complications of UC?
carcinoma
risk increases w/ time
judgement if colectomy justified
what tx is available to IBD?
medical-immunosuppressive systemic steroids- prednisolone local steroids anti-inflammatories -pentasa, mesalazine, sulphalazine non steroid immunosuppressants -azathioprine -methotrexate anti TNF-a therapy -infliximab -adalimumab
when is surgery used?
when obstruction/blockage colectomy cures UC crohns-palliate symptoms -remove obstructed segment -drain abcesses -close fistulae usually results in stoma
what is orofacial granulomatosis?
separate from crohns not single condition can present before crohn's in children granuloma formation blocks lymphatics lip & oral swelling -trigger can be food preservatives/additives
