[Gastro] Inflammatory Bowel Disease Flashcards
what is ulcerative colitis (UC)?
a form of inflammatory bowel disease (IBD) associated with continuous inflammation of the large bowel only
what are the features of acute, severe disease in a flare of UC?
- > 6 stools
- frank blood
- temperature, HR ≥ 90
- anaemia
- ESR ≥30
how is an acute, severe UC flare managed?
admit + IV hydrocortisone
what happens if there is no improvement of the acute, severe flare in 72 hours?
- IV ciclosporin + surgical input
- biologics e.g. infliximab
if the extent of the disease includes proctitis, proctosigmoiditis or L sided colitis, what is the mx?
topical aminosalicylate
if no improvement in 4 weeks: oral aminosalicylate
if the extent of the disease is pancolitis, what is the mx?
topical + oral aminosalicylate
if no improvement in 4 weeks: oral corticosteroids
what is the complication of UC or infectious colitis (C.difficile)?
toxic megacolon
what is toxic megacolon?
colonic dilatation + systemic toxicity with risk of bowel perforation
what is the “3-6-9” rule for toxic megacolon?
3cm small bowel; 6cm large bowel; 9cm caecum
what is the mx for toxic megacolon?
IV hydrocortisone, infliximab or surgery
ulcerating lesion on lower limb, PMH of IBD. dx?
pyoderma gangrenosum
acute red eye, hypopyon, intense photophobia. dx?
acute uveitis
IBD hx, asymmetrical jt swelling and HLA-B27. dx?
enteropathic arthritis
what ix do you do if you suspect IBD?
faecal calprotectin
what ix do you do if pt presents with bloody diarrhoea?
colonoscopy
