IBD Flashcards
When does Crohn’s occur?
Usually in teens to 20s
But can be at any age
What are some extraintestinal manifestations of Crohn’s?
Uveitis
Episcleritis
Seronegative spondyloarthropathy
Erythema nodosum
When does UC occur?
Peak at teens to 20s
Peak at 40s to 60s
What are some extraintestinal manifestations of UC?
Similar to Crohn’s disease
Primary sclerosing cholangitis
PSC with UC = what?
Higher risk of colon cancer and cholangioma
How does smoking affect IBD?
Worse for Crohn’s
Better for UC
How is Crohn’s diagnosed? What is found?
Colonscopy and tissue diagnosis
- Transmural inflammation - mucosa to serosa, skip lesions
- Fat wrapping around the bowel
- Neutrophils, crypt abscesses, granulomas
In which IBD is perforation more likely?
Crohn’s due to transmural inflammation
When is bowel cancer screening done in UC?
Yearly, starting 8 years after diagnosis
- Colectomy recommended if dysplasia is found
What is the treatment for proctitis UC?
Steroid enemas
When do you operate in Crohn’s?
Perforation
Strictures
Fistulas
What are the histopathological findings in UC?
Crypt abscesses
Lymphocyte infiltrates without granulomas
Goblet cell depletion
What are the clinical features of UC?
Bloody diarrhoea
Tenesmus
Abdominal cramps
Fever
Weight loss
How is UC treated?
Sulphasalazine and steroids for flares
Azathioprin, infliximab for less controlled disease
Local therapy - suppositories or enemas
What is the histopathology of Crohn’s?
Transmural inflammation with inflammatory cells (bluish infiltrates) extending from the ulcerated mucosa through submucosa and muscularis to the serosa, appearing as nodular granulomatous infiltrates on the serosal surface
(Robbins)
