GI 142 IBD Flashcards
What is Crohns Disease?
AN IBD affecting the whole thickness of the bowel wall anywhere along the GIT
What do you see histologically in Crohns Disease?
Skip lesions, granulomas, possible strictures, fissures and fistulae
What area of the GIT is most commonly affected in Crohns?
Ileum and colon
How might Crohns disease present?
Abdominal pain, bloating, flatulence, diarrhoea +/- blood, weight loss, dietary deficiency symptoms
How would you investigate suspected crohns?
Blood: FBC, inflammatory markers, antibody serology
Xray: BArium follow through
Colonoscopy/ Gastroscopy +/- biopsy
What are corticosteroids used for in IBD?
To induce remission but are for short term only
What are 5’ASA’s e.g. mesalazine first line treatment for?
Ulcerative Colitis
How does Mesalazine work?
It is anti-inflammatory - inhibits prostaglandins, thromboxane, platelet activating factor and is a scavenger of oxygen free radicals
What are 5’ASA’s used for in ulcerative colitis?
Maintaining remission
What is infliximab and when is it used?
It is monoclonal antibodies used in sever or active crohns disease
What is azathioprine and when is it used?
An immunosuppresant and is used to induce and maintain (1st line) remission but takes time to reach optimal effect
What is the 2nd line of treatment for maintaining remission in crohns disease
Methotrexate
What does infliximab target?
TNF - alpha
What is Ulcerative Colitis?
An inflammatory disease affecting only the mucosal layer of the rectum +/- colon
What is UC characterised histologically by?
Continuous distribution, non granulomatous always beginning in the rectum and working its way up
