IBD Flashcards
location of inflammation in ulcerative colitis
starts in the rectum, never spreads beyond ileocaecal valve and is continuous
presentation of ulcerative colitis
bloody diarrhoea
urgency
tenesmus
abdominal pain, left lower quadrant
investigations for ulcerative colitis
colonoscopy + biopsy
flexible sigmoidoscopy for severe disease
findings on colonoscopy in ulcerative colitis
red, raw mucosa
no inflammation beyond submucosa
pseudopolyps
crypt abscesses
depletion of goblet cells
risk factors for ulcerative colitis flare
stress
medication: NSAIDs, abx
cessation of smoking
inducing remission treatment for mild/moderate ulcerative colitis
topical aminosalicylate (add oral aminosalicylate, add oral corticosteroid)
inducing remission treatment for severe ulcerative colitis
admit to hospital
IV steroids first line
- IV ciclosporin if contraindicated
- or add it if no improvement in 72 hours
maintaining remission in ulcerative colitis
topical aminosalicylate
or add oral aminosalicylate
following severe relapse: oral azathioprine or oral mercaptopurine
location of crohn’s disease
commonly terminal ileum and colon
but can be anywhere gum to bum
presentation of crohn’s disease
presents young
weight loss and lethargy
diarrhoea can be bloody
abdo pain
perianal disease
investigations in crohn’s disease
raised inflammatory markers
increased faecal calprotectin
anaemia
low vit B12 and vit D
colonoscopy
findings in crohn’s disease on colonoscopy
deep ulcers
skip lesions
inflammation in all layers of mucosa to serosa
goblet cells
granulomas
findings on small bowel enema of crohn’s disease
strictures: kantor’s string sign
proximal bowel dilation
rose thorn ulcers
fistulae
inducing remission treatment for crohn’s disease
glucocorticoids
enteral feeding
second line: 5-ASA drugs (mesalazine)
azathioprine or mercaptopurine add on, methotrexate
crohn’s disease maintaining remission management
azathioprine or mercaptopurine
+TPMT activity should be assessed before starting: methotrexate second line
end up having surgery
extra-intestinal conditions more common in crohn’s
gallstones
oxalate renal stones
extra-intestinal conditions more common in ulcerative colitis
primary sclerosing cholangitis
