Crohns & Colitis - 2 Flashcards
What does IBD stand for?
Inflammatory Bowel Disease
IBD includes conditions like Crohn’s disease and ulcerative colitis.
What are common symptoms of inflammatory bowel disease?
- Abdominal pain
- Diarrhea
- Rectal bleeding
- Weight loss
- Fatigue
Symptoms can vary based on the individual and the severity of the inflammation.
What is the primary concern of Jonathan’s doctor during his examination?
Jonathan may have Crohn’s disease in the ileum
This concern arises from his symptoms, weight loss, and physical examination findings.
What is a key factor that may lead to a delay in diagnosis of IBD?
Individuals may dismiss symptoms as non-serious or believe they are related to simpler conditions
This is often influenced by a lack of knowledge about abnormal symptoms.
What are flare periods in the context of IBD?
Periods of increased severity of symptoms followed by remissions
Patients may experience no symptoms during remission.
Fill in the blank: Ulcerative colitis primarily affects the _______.
large intestine
True or False: Blood in the stool is a common symptom of ulcerative colitis.
True
Blood in the stool is one of the most consistent manifestations of ulcerative colitis.
What type of pain is typically experienced by patients with ulcerative colitis during flare-ups?
Crampy abdominal pain
This pain often coincides with bowel movements and is associated with rectal urgency.
What are false urges in ulcerative colitis?
Strong urges to move the bowels with little or no stool production
This symptom can lead to frequent bathroom trips with minimal actual output.
List two atypical symptoms of Crohn’s disease.
- Fistulas
- Abscesses around the anus
These complications occur due to deeper penetration of inflammation in Crohn’s disease.
What is the significance of cytokines in inflammatory bowel disease?
Cytokines can cause fatigue and weight loss
They are proteins released during intestinal inflammation that affect metabolism.
What symptom might indicate a complication in a patient with ulcerative colitis?
Constant, unrelenting abdominal pain
This may suggest another diagnosis or a complication such as bowel perforation.
Fill in the blank: Patients with ulcerative colitis may avoid eating before going out due to _______.
increased bowel activity
What is a common presenting symptom of Crohn’s disease in children?
Failure to grow or thrive
This is often due to the disease’s impact on nutrient absorption.
Why might patients with ulcerative colitis feel fatigued?
Due to inflammation and potential anemia from blood loss
Chronic blood loss can lead to iron-deficiency anemia, causing fatigue.
What might patients with Crohn’s disease experience that is uncommon in ulcerative colitis?
Fistulas and abscesses
These occur due to the deeper inflammation characteristic of Crohn’s disease.
What should patients do to prepare for a doctor’s appointment regarding IBD?
Ensure there is enough time to discuss concerns
Being well-prepared can help maximize the effectiveness of the visit.
What is the first step in understanding and treating inflammatory bowel disease?
Symptoms
Understanding symptoms is crucial for effective treatment.
Why do some patients find their initial meeting with their doctor unsatisfactory?
Lack of time to ask all questions
Busy schedules of doctors can limit patient discussion.
What should you do if your concerns will take longer than the usual appointment time?
Ask for a longer meeting
What should patients focus on when describing their symptoms to a doctor?
Keep it focused and factual
What should you bring to your doctor’s appointment regarding medications?
A list of medications and their doses
How should patients prepare their list of questions for the doctor?
Keep it short and specific
Why is it helpful to prioritize your list of questions for the doctor?
To address the most concerning issues first
What is the benefit of bringing a friend or relative to a doctor’s appointment?
To help remember discussions and provide emotional support
What should you do during the appointment regarding key points discussed?
Make notes about key points
What is an abscess?
An infected area around the intestine due to ulcers
How does abdominal pain in Crohn’s disease differ from ulcerative colitis?
Pain may be more consistent due to deeper inflammation
What symptom may indicate a blockage due to Crohn’s disease?
Crampy abdominal pain after meals
What requires immediate medical attention in relation to abdominal pain?
Pain lasting more than 4 to 6 hours without gas or stool passage
What is a common symptom of Crohn’s disease regarding bowel movements?
Crampy abdominal pain around bowel movements
Is diarrhea a universal symptom of Crohn’s disease?
No, some patients may experience constipation instead
What is a common symptom in Crohn’s disease that is often difficult to reverse?
Fatigue
What can cause weight loss in patients with Crohn’s disease?
Changes in metabolism and reduced nutrient intake
What specific anal problems can patients with Crohn’s disease develop?
Anal fissures, abscesses, and fistulas
What nutrient deficiency can develop in patients with Crohn’s disease affecting the terminal ileum?
Vitamin B12 deficiency
What are extra-intestinal manifestations of IBD?
Symptoms outside of the intestine due to inflammation
What are the three different patterns of symptom onset in inflammatory bowel disease?
- Gradual
- Sudden
- Relapsing or remitting
What does a gradual onset of IBD typically involve?
Symptoms developing over weeks, months, or years
What characterizes sudden onset of IBD?
Abrupt development of severe symptoms
What is a relapsing or remitting course in IBD?
Episodes of flares followed by periods of remission
What are the common diagnostic methods for IBD?
- Blood tests
- Stool tests
- Imaging studies
- Endoscopies
- Biopsies
What do blood tests indicate in relation to IBD?
Infections and inflammatory conditions
What is the purpose of stool tests in diagnosing IBD?
To rule out bacterial infections and assess inflammation
What specific proteins can stool tests indicate active intestinal inflammation?
Calprotectin and lactoferrin
What are some common antibody tests used in IBD diagnosis?
- pANCA
- ASCA
What factors do doctors consider when recommending diagnostic tests?
- Symptoms
- Possible complications
- Accuracy of tests
- Availability of tests
- Patient needs
What is the significance of white blood cells in stool tests?
The presence of white blood cells almost always indicates some type of inflammatory condition in the intestine.
What proteins are tested in stool to indicate active intestinal inflammation?
- Calprotectin
- Lactoferrin
What does an elevated calprotectin level suggest?
It is very suggestive of an underlying inflammatory condition such as IBD.
How can stool tests be used in relation to treatment for IBD?
Stool tests can be used to monitor disease activity and response to treatment.
What is the purpose of using a contrast agent like barium in X-rays?
To fill the intestine so that the intestinal lining and wall can be seen in contrast to the barium.
What has largely replaced plain X-rays in examining the intestine?
Cross-sectional imaging studies such as ultrasound, CT scan, and MRI.
What is an Upper GI Series?
An X-ray examination of the small intestine where barium is ingested and images are taken as it passes through.
What is a Small-Bowel Enema?
A procedure where barium is administered directly into the small intestine via a tube for better imaging.
What does a Barium Enema do?
It provides images of the large intestine (colon).
True or False: All X-rays involve some degree of radiation exposure.
True
What are the advantages of imaging studies over conventional X-ray studies?
- Provide three-dimensional representations
- Show surrounding structures within the abdomen
What is the basic principle of ultrasound imaging?
It uses high-frequency sound waves reflected off structures within the abdomen to create images.
What is the purpose of a transanal ultrasound?
To evaluate patients for possible anal abscesses and fistulas.
What are the limitations of ultrasound in detecting IBD complications?
It is not the most sensitive imaging study for evaluating intestines.
What technology has replaced the small bowel follow-through procedure?
Computer-assisted tomography (CT scan) and MRI.
What is the role of contrast solutions in CT scans?
To provide better diagnostic images by highlighting blood supply and other structures.
What is a significant risk associated with CT scans?
Radiation exposure.
What is the primary advantage of MRI in IBD diagnosis?
It does not involve exposure to radiation.
What is the primary use of MRI in assessing Crohn’s disease?
To assess the anus and surrounding tissue for complications such as fistulas and abscesses.
What is gastroscopy?
An endoscopic procedure to examine the esophagus, stomach, and duodenum.
What is colonoscopy primarily used for?
To examine the rectum and colon, and often the ileum.
What is the typical preparation for a colonoscopy?
A special diet (usually clear liquids) and a special laxative.
What is wireless capsule endoscopy (WCE)?
A procedure that allows examination of the entire length of the small intestine using a swallowed capsule.
What are the risks associated with wireless capsule endoscopy?
The capsule could produce a blockage or bowel obstruction in strictures of the intestine.
What is double balloon enteroscopy (DBE)?
A technique that allows extensive examination of the small intestine through inflation and deflation of two balloons.
What is the purpose of biopsies during endoscopy?
To confirm the suspected diagnosis of IBD and to screen for precancerous changes.
Fill in the blank: Colonoscopy is an extremely useful diagnostic test in ______.
[IBD]
What is the primary purpose of a biopsy in the context of IBD?
To confirm the suspected diagnosis of IBD and to help rule out other conditions such as infection.
Biopsies are crucial for diagnostic accuracy in IBD.
What are the risks associated with the biopsy process?
Complications, such as serious bleeding, are extremely uncommon.
Biopsy is considered a very safe procedure.
Why might biopsies be performed in patients with IBD involving the large intestine for more than 8 to 10 years?
To screen for precancerous changes and assess the increased risk of colon cancer.
Regular colonoscopy with biopsies is recommended for surveillance.
What factors can provide more assistance in diagnosing IBD beyond biopsy results?
The location of the inflammation and other associated features.
Biopsies do not always provide 100% certainty, especially between Crohn’s disease and ulcerative colitis.
How does the diagnosis of IBD impact prognosis?
Information from the diagnosis can help determine the severity and prognosis of a patient’s particular IBD.
Prognosis can be unpredictable and varies from person to person.
True or False: Biopsies can always provide 100% certainty about the diagnosis of IBD.
False
Biopsies may not always distinguish between Crohn’s disease and ulcerative colitis.
Fill in the blank: Biopsies are usually taken to confirm the suspected diagnosis of IBD and to help _______.
rule out other conditions.
This is essential to ensure accurate treatment.
