IBD Flashcards
Diarrhoea + fatigue + osteomalacia
Coeliac’s disease (Raised ALP, low Ca, Vit D and phosphate +/- anaemia)
Causes of anorectal abccess
E.coli, staph aureus
Positions: Perianal, Ischiorectal, Pelvirectal, Intersphincteric
Crohn’s managment
- Corticosteroids e.g. prednislone
(short term) - Antibiotics e.g. ciprofloxacin
(short-term) - Immunosurpressants e.g. Azthioprine
- Biologics e.g. infliximab (anti-TNF)
Crohn’s presentation
Abdo pain, Diarrhoea, rectal bleeding, oral ulcers, weight loss
Crohn’s investigations
-High faecal calprotectin
-Endoscopy shows granulomas
Acute watery non-bloody diarrhoea + cramps + nausea after foreign travel
enterotoxigenic E.coli infection
Acute watery bloody diarrhoea + abdo pain post foreign travel
Campylobacter jejuni
UC + cholestasis
Primary sclerosing cholangitis
Cholestasis sx
Jaundice, pruritus, raised bilirubin and ALP
Primary sclerosing cholangitis sx + investigations
Cholestasis + RUQ pain + fatigue
Investigations: magnetic or endoscopic cholangiopancreatography (ERCP/MRCP) shows ‘beaded apperance)
-p-ANCA positive
Primary sclerosing cholangitis associations
-Ulcerative colitis
-Crohn’s (less than UC)
-HIV
-Cholangiocarcinoma develops in 10% of patients with increased risk of colorectal cancer
Chronic mesenteric ischemia (intestinal angina) triad +RF + investigation
severe, colicky post-prandial abdominal pain, weight loss, and an abdominal bruit - by far the most common cause is atherosclerotic disease in arteries supplying the GI tract
RF: AF, CVD
Investigation: CT
Ischaemiac colitis
Ischaemic colitis describes an acute but transient compromise in the blood flow to the large bowel. This may lead to inflammation, ulceration and haemorrhage. It is more likely to occur in ‘watershed’ areas such as the splenic flexure that are located at the borders of the territory supplied by the superior and inferior mesenteric arteries.
Investigations
‘thumbprinting’ may be seen on abdominal x-ray due to mucosal oedema/haemorrhage
Management
- usually supportive
Chronic pancreatitis x-ray + managment
Multiple small calcific foci but CT more sensitive +/- faecal elastase
pancreatic enzyme supplements
Perianal fistula imaging
A perianal fistula is an abnormal connection between the rectum and the perineum. MRI pelvis- to map out fistula extent and abscesses
Condition associated with gallstone development
Crohn’s disease can result in terminal ileitis, this is the section of the bowel where bile salts are reabsorbed. When this area is inflamed and the bile salts are not absorbed and people are prone to development of gallstones.
incomplete evacuation after defecation
Ulcerative colitis
Abdominal guarding, severe left lower quadrant pain, fever, and an elevated white blood cell count. esp older patient
Diverticulitis
