IBD Flashcards
what is a history of crohn’s disease described as
may be unrecognised for years
recurring periods of flare ups and remission
what is a history of UC described as
history of weeks
gradual onset of diarrhoea with blood and mucus +/- weight loss and blood on rectal examination
where does crohns disease affect
any part of the Gi tract including the mouth
where does UC affect
colon
what are the three parts of the colon that UC can affect
rectum alone (proctitis)
extend proximally form the rectum to involve the sigmoid and descending colon (distal colitis/left-sided colitis)
whole colon (extensive colitis)
(also inflammation of distal ileum (backwash ileitits))
what happens to the part of the bowel affect by Crohn’s disease
bowel is thickened and narrowed
deep ulcers and fissures in the mucosa
fistulae and abcesses may be seen which reflect penetrating disease
how is the colon affect by UC
mucosa looks reddened, inflamed and bleeds easily
in severe disease there is an extensive ulceration with the adjacent mucosa appearing as inflammatory (pseudo) polyps
which layers of tissue are affected by crohn’s disease
al inflammation extends through all layers (transmural)
what layers of tissue are affected by UC
superficial inflammation is seen
mucosa shows chronic inflammation cell infiltrate in the lamina propria
crypt abscesses and goblet cell depletion also seen
what chronic inflammatory cells are seen in crohns
increase in chronic inflammatory cells and lymphoid hyperplasia in 50-60% of patients granulomas present
granulomas are non-caseating epitheliod cell aggregates with Langhans’ giant cells
what is CUTE
colitis of undetermined type and aetiology
what is the difference in the inflammation in crohn’s disease and UC
crohn’s disease deep-transmural and patchy
UC mucosal and continuous
are granulomas present in crohns disease or ulcerative colitis
crohn’s disease
how are goblet cells affected in crohns and UC
present in crohns disease but depleted in UC
what should always be performed if a diagnosis of IBD is suspected
stool cultures including clostridium difficile if diarrhoea is present
how is crohns disease managed
aim to induce and then maintain clinical remission and achieve mucosal healing to prevent complications
how is remission induced in crohns disease
oral of IV glutocorticoids (if moderate to severe Prednisolone if less sever then budesonide)
enteral nutrition
anti-TNF nutrition
what are extraintesitnal symptoms of BD
spondylartyropathy apthous ulcers pyoderma gangrenosum uveitis anaemia
what are some of the oral presentations of crohns disease
mucosal tags
cobblestone mucosa
swollen lips
angular cheilitis
how should you treat severe colitis
in hospital start with IV steroids
benefits of suppositories
better mucosal adherence then enemas
what is more common with gallstones UC or crohns
crohns
where does the inflammation extend to in UC
no inflammation beyond submucosa, inflammatory cell infiltrate in lamina propria
what cells are involved in forming crypt abscesses
neutrophils migrate through walls of glands to form crypt abscesses
when do you get cobblestoning
crohns
what are psuedopolys formed from
theses are surviving normal mucosa in UC
