Crohns disease and ulcerative colitis Flashcards
What ages are more susceptible to IBD? (2 points)
- 15-25 years
- 50-80 years
Are males or females more susceptible to Crohn’s disease?
- Males
Are males or females more susceptible to ulcerative colitis?
- Females
What are the possible causes of IBD? (4 points)
- Immunological
- Psychological
- Smoking (reduces chances of IBD)
- Genetic
What are immunological causes of IBD?
- People who seem to be predisposed due to the way they have an immune response
What are psychological causes of IBD?
- IBD could be a consequence of psychological factors nut not very clear
Does smoking increase or decrease the chances of someone getting IBD?
- Decreases
Are there genetic causes of IBD?
- Yes, there is a clear tendency that it runs in families
- You are at a slightly higher risk if your parents have it
What is the histology of Crohn’s disease?
- Histologically there are granulomas inside the tissue (collection of multi-nucleated giant cells that form together in a clump) (granulomatous inflammation)
- Something is happening in the tissues which is causing immune stimulation which the body is unable to deal with
What can cause Crohn’s disease? (2 causes)
- Food intolerance (something passing through the gut which is causing irritation e.g. benzoic acid)
- Persisting viral infection/immune activation
What is Johne’s disease?
- Problem which cattle get which is similar to Crohn’s disease
Where in the body can you fins Crohn’s disease?
- Any part of the bowel from the mouth all the way down to the bottom end
Where are 3 common places to find Crohn’s disease?
- Mouth
- Ileo-caecal region
- Rectum
Where is ulcerative colitis found and where does it originate from?
- Found ONLY in colon
- Always starts in rectum and works its way up
- If starts anywhere else it is not this
In relation to Ulcerative colitis and Crohn’s disease, which is continuous and which is discontinuous?
- UC = continuous
- CD = discontinuous
In relation to Ulcerative colitis and Crohn’s disease, when is the rectum involved?
UC = always
CD = 50% of the time
In relation to Ulcerative colitis and Crohn’s disease, when do they have anal fissures?
UC = 25% of the time
CD = 75% of the time
In relation to Ulcerative colitis and Crohn’s disease, when is the ileum involved?
UC = 10%
CD = 30%
In relation to Ulcerative colitis and Crohn’s disease, what is the mucosa like?
UC = Granulomas and ulcers
CD = Cobbled and fissures
In relation to Ulcerative colitis and Crohn’s disease, are they vascular?
UC = Vascular
CD = non-vascular
In relation to Ulcerative colitis and Crohn’s disease, what is the serosa like?
UC = normal
CD = inflamed
What are the microscopic features of ulcerative colitis? (3 points)
- Mucosal
- Vascular
- Mucosal abscesses
What are the microscopic features of Crohn’s disease? (3 points)
- Transmural
- Oedematous
- Granulomas (in the gut)
In relation to Ulcerative colitis and Crohn’s disease, where are they inflamed?
UC = Very superficial
CD = Entire thickness of the bowel wall inflamed (narrows lumen)
What is Proctitis ulcerative colitis?
- Involves only the rectum
What is Proctosigmoiditis ulcerative colitis?
Involves the rectum and the sigmoid colon (the lower segment of the colon before the rectum)
What is Distal colitis ulcerative colitis?
- Involves only the left side of the colon
What is pancolitis ulcerative colitis?
- Involves the entire colon
What is Backwash ileitis ulcerative colitis?
- Involves the distal ileum
What are common symptoms of ulcerative colitis? (3 points)
- Diarrhoea
- Abdominal pain
- PR bleeding (friable, easily damaged surfaces as they are stripped and will bleed as the bowel contents pass)
What are the symptoms of colonic Crohn’s disease? (3 points)
- Diarrhoea
- Abdominal pain
- PR bleeding
What are the symptoms of small bowel Crohn’s disease? (4 points)
- PAin
- Malabsorption
- Obstruction
- Anal disease
What are the symptoms of mouth Crohn’s disease? (1 point)
- Orofacial granulomatosis
Orofacial granulomatosis is not a single condition. What does this mean? (2 points)
- Granuloma formation blocks lymphatics
- Lip & oral swelling then noted from other causes of increased capillary leakage (food preservatives and additives, some have no identifiable trigger)
What are the clinical features or orofacial granulomatosis? (6 points)
- Lip swelling
- Angular cheilitis
- Cobblestoneing
- Gingivitis
- Ulceration
- Microscopic granulomas
What investigations can be carried out for IBD? (6 points)
- Blood tests (anaemia, CRP, ESR)
- Faecal calprotectin
- Endoscopy
- Leukocyte scan
- Barium studies
- Bullet endoscopy
What are the complications of ulcerative colitis? (2 points)
- Develops into carcinoma
- Risk increases with time
- Judgement as to whether colectomy is justified
What are the possible medical treatments of IBD (immunosuppressives)? (5 points)
- Systemic steroids (Prednisolone)
- Local steroids (rectal administered)
- Anti-inflammatory drugs (5-ASA based drugs - Pentasa, mesalazine, sulphasalazine)
- Non steroid immunosuppresants (azathioprine, methotrexate)
- Anti TNF-alpha therapy (Infliximab, adalimumab)
What surgery treatments of IBD are there? (3 points)
- Colectomy
- Crohn’s disease - palliate symptoms (remove obstructive bowel segments, drain abscesses, close fistulae)
- Usually results in a stoma/bag
Can a colectomy cure Ulcerative Colitis?
- Yes
What is an oral issue with Ulcerative colitis?
- Oral ulceration
- Ulcers worse when UC is worse
Look at the slide IBD for exams
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