GI 10 - IBD Flashcards
Name some triggers of IBD:
- Infection
- Diet
- Smoking
- Antibiotics
What is the typical presentation of ulcerative colitis?
- Young adult
- Urgent diarrhoea
- Mucous/bloody stools
May also have problems with:
- Skin
- Liver/biliary tree
- Eye
- MSK pain
What is the typical presentation of Crohn’s disease?
- Either 15-30yrs or 60+yrs
If ileum affected:
- Colicky abdominal pain
- Diarrhoea
- Malabsorption
- Weight loss
If colon affected:
- Bloody/mucous diarrhoea
- Malaise
- Anorexia
- Weight loss
- Perianal disease
What part of the GI tract is affected by ulcerative colitis?
- Continuous proximally from rectum, can affect whole colon
- Mucosa only
What part of the GI tract is affected by Crohn’s disease?
- Can affect any part of GI tract (with skip lesions)
- Transmural
Is there a higher risk of strictures with UC or Crohn’s? Why?
Crohn’s
Transmural disease leading to thickening of wall and narrowing of the lumen, whereas UC only affects mucosa
What skin conditions are commonly seen with IBD?
- Erythema nodosum
- Pyoderma gangrenosum
- Psoriasis
Which of IBD may be managed by dietary changes?
Crohn’s
What methods are commonly used to investigate IBD?
- Blood test
- Stool cultures
- Abdominal XRay
- CT scan
- MRI scan
- Colonoscopy
- Barium enema
Which IBD can cause perianal disease?
Crohn’s disease
What are the macroscopic changes associated with UC?
- Loss of haustra
- Pseudopolyps
- Loss of typical vascular pattern
What are the microscopic changes associated with UC?
- Crypt abscesses/distortion
- Decreased no. goblet cells
- Inflammatory infiltrate into lamina propria
What are the macroscopic changes associated with Crohn’s disease?
- Cobblestone appearance
- Fistulae of bowel + bowel/bladder/vagina/skin
- Ulcers
What are the microscopic changes associated with Crohn’s disease?
Granuloma formation
Which sign from a barium enema is associated with UC?
Lead pipe sign
Which sign from a barium enema is associated with Crohn’s disease?
String sign of Kantour
Name some medications which are available for IBD:
- Aminosalicylates ie Sulfasalazine
- Corticosteroids ie Prednisolone
- Immune system suppressors ie Azathioprine
- Antibiotics
- Anti-diarrhoea med
- Pain relief
- Iron/vit B12/Ca2+/vit D supplements
What is the surgical option for UC? IS it curative?
Proctocolectomy +/- Ileoanal anastamosis
Curative
What are the surgical options for Crohn’s disease?
Are they curative?
- Strictureplasty
- Resection +/- colostomy
- Abscess drain
Not curative
What is toxic megacolon, and with which IBD does it typically appear?
- Dilation of colon due to inflammation extending into smooth muscle layer, causing paralysis
- Neutrophils and macrophages produce NO = dilatation
Usually seen in ulcerative colitis
