IBD 1

Question 1

What is inflammatory bowel disease?

Answer 1

Chronic, relapsing life long condition which causes ulceration and inflammation

Question 2

Where does ulcerative colitis affect?

Answer 2

Colon and rectum - causes watery diarrhoea

Question 3

Where does Crohn’s disease affect?

Answer 3

Any part of the GI - difficult to differentiate

Question 4

Where does microscopic colitis affect?

Answer 4

Affects colon and rectum - can only be seen through microscope

Question 5

What is the peak incidence of UC, CD and MC?

Answer 5

UC = 15-25 years old
CD = 10-40 years old - more common in women and smokers
MC = 50-60 years old

Question 6

What causes IBD?

Answer 6

Inflammatory response in the GI tract to environmental triggers in genetically susceptible individuals

• microorganisms
• high intake of over processed foods
• genetic
• abnormal gut reaction
• trigger

Question 7

Ulcerative colitis…

Answer 7

1. Affects colon and rectum
2. Inner lining of bowel
3. Continuous

Question 8

Crohn’s disease…

Answer 8

1. Affects whole GI tract - mouth to anus
2. Transmural: all layers of intestinal wall affected
3. Discontinuous - one section inflamed one not

Question 9

Microscopic colitis…

Answer 9

1. Affects the colon and rectum
2. No ulceration
3. Changes seen in biopsy

Question 10

Where does pancolitis affect?

Answer 10

Whole large colon

Question 11

Remission…

Answer 11

Asymptomatic

Question 12

Mild UC…

Answer 12

<4 stools/day, little bleeding, normal pulse, Hb, ESR, temp

Question 13

Moderate UC…

Answer 13

4-6 stools/day, moderate bleeding, normal pulse, Hb, ESR and temp

Question 14

Severe UC…

Answer 14

> 6 stools/day, visible bleeding, pulse >90bpm, Hb <10.5g/dL, temp >37.8 and ESR >30mm/h

Question 15

Acute severe UC…

Answer 15

Is a potentially life threatening condition requiring immediate hospitalisation, intensive management and has a high risk of VTE

Use low MW heparin/enoxaparin

Question 16

What are the main symptoms of IBD?

Answer 16

1. Diarrhoea - sometimes mixed with blood, mucus and pus
2. Abdominal cramping pains - often very severe and can occur before passing a stool
3. Tiredness and fatigue - due to illness, anaemia, S/E’s or disturbed sleep
4. Feeling generally unwell - fever
5. Loss of appetite and weight - decreased nutrient absorption
6. Anaemia
7. Mouth ulcers

Question 17

What are the intestinal complications of IBD?

Answer 17

1. Fistula
2. Abscess
3. Perforation
4. Toxic megacolon
5. Stricture
6. Obstruction
7. Carcinoma
8. Peri-anal disease

Question 18

What are the extra-intestinal complications?

Answer 18

1. Joint disease
2. Liver
3. Growth retardation
4. Skin
5. Eye
6. Osteoporosis
7. Anaemia

Question 19

What is the prognosis of IBD?

Answer 19

Relapsing condition with associated disabilities - normal life expectancy

Increased risk of carcinoma