Gastro: Chron's Disease Flashcards
What is IBD?
Inflammatory Bowel Disease
Crohn’s disease
Where is it most prevalent?
it is a relapsing systemic inflammatory disease, mainly affecting the gastrointestinal tract with extraintestinal manifestations and associated immune disorders.
leads to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.
Mostley in the US and Europe, then Australia.
What area’s can it effect?
Where does it usually start?
Crohn’s can affect any part of the gastrointestinal tract,
from mouth to anus.
often spreads deep into the layers of affected bowel tissue. Crohn’s disease can be both painful and debilitating, and sometimes may lead to life-threatening complications.
While there’s no known cure for Crohn’s disease
a majority of the cases start as ileitis terminalis
Crohns disease microsopically:
What does it effect?
•Crohn’s disease affects the full thickness of the bowel wall.
Full thickness of the bowel wall lesions is called transmural inflammation.
It can be panintestinal - so it may affect any part of the gastrointestinal tract.
Symptoms
In some people with Crohn’s disease, only the last segment of the small intestine (ileum) is affected. In others, the disease is confined to the colon (part of the large intestine). The most common areas affected by Crohn’s disease are the last part of the small intestine and the colon.
Signs and symptoms of Crohn’s disease can range from mild to severe. They usually develop gradually, but sometimes will come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission).
Diagnosis:
Many factors used.
- lab tests for signs of infection, inflammation, internal bleeding, and low levels of substances such as iron, protein, or minerals.
- A barium X-ray can show where and how severe Crohn’s disease is. It is especially helpful for finding any problems in parts of the small intestine that can’t be easily viewed by other techniques.
CT scans can help detect abscesses that might not show up on other X-rays. Abscesses are small pockets of infection.
Colonoscopy and sigmoidoscopy allow the doctor to directly view the large intestine, which is the lower part of the digestive tract. These techniques can often provide the most accurate information about the intestines.
When the disease is active, signs and symptoms may include:
Diarrhea, Fever, Fatigue, Abdominal pain and cramping
Blood in your stool, Mouth sores, Reduced appetite and weight loss
Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)
Other signs and symptoms
People with severe Crohn’s disease also may experience:
Inflammation of skin, eyes and joints
Inflammation of the liver or bile ducts
Delayed growth or sexual development, in children
Cause’s of Crohn’s Disease
heredity and a malfunctioning immune system, likely play a role in its development.
Immune system. It’s possible that a virus or bacterium may trigger Crohn’s disease. When your immune system tries to fight off the invading microorganism, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.
Heredity. Crohn’s is more common in people who have family members with the disease, so genes may play a role in making people more susceptible. However, most people with Crohn’s disease don’t have a family history of the disease.
Risk factors for Crohn’s disease may include:
Before age 30
whites and Jewish most prevalent
family history
cigerette smoking
Nonsteroidal anti-inflammatory medications (advil)
Where you live. If you live in an urban area or in an industrialized country, you’re more likely to develop Crohn’s disease. This suggests that environmental factors, including a diet high in fat or refined foods, may play a role in Crohn’s disease.
Treatment:
If mild, can use antibiotics. May have to stay on it.
- The two main ones are ciprofloxacin and metronidazole.
- Use anti flammatory drugs to reduce infalmmation as well as cortisteroids if severe.
- Biologics:
drugs made from living organisms. Biologics work on your immune system. They target specific proteins in your body that cause inflammation.
- Taking vitamins since you may not be getting all nutritiants due to the inflammation.
Complications from Crohn’s disease
Bowel obstruction. Crohn’s disease affects the thickness of the intestinal wall. Over time, parts of the bowel can scar and narrow, which may block the flow of digestive contents. You may require surgery to remove the diseased portion of your bowel.
Ulcers. Chronic inflammation can lead to open sores (ulcers) anywhere in your digestive tract, including your mouth and anus, and in the genital area (perineum).
Fistulas. Sometimes ulcers can extend completely through the intestinal wall, creating a fistula — an abnormal connection between different body parts. Fistulas can develop between your intestine and skin, or between your intestine and another organ. Fistulas near or around the anal area (perianal) are the most common kind.
Anal Fissure, Colon cancer.
Surgical treatment
75% will need it. Especially if complications caused bowel perforation, mega colon, blockage or uncontrolled bleeding.
- a bowel resection, which involves removing the damaged portion of the intestine
- a proctocolectomy, which consists of removing the colon and rectum and often involves creating an ostomy to collect waste products.
- a strictureplasty, which involves shortening and widening the intestines to reduce the effects of scarring.
Most common.
- A colostomy (large intestine) and an ileostomy (small intestine)involve creating a hole in your abdomen. In some cases, the surgeon can reverse this procedure once the bowel has had time to heal.
