IBD Flashcards
How has the incidence of Crohn’s disease changed in Scottish children?
Dramatically increased and continues to
What are the presenting features of Crohn’s in children?
Main
- Weight loss
- Growth failure
Some
- Abdominal pain
- Diarrhoea
- Rectal bleeding
- Arthritis
- Mass
Rare
-Fever
What are the presenting features of UC in children?
Main
- Diarrhoea
- Rectal bleeding
Some
- Abdominal pain
- Arthritis
Rare
- Fever
- Weight loss
- Growth failure
No mass
What history and examination is required when diagnosing IBD?
- Intestinal symptoms
- Extra-intestinal manifestations (can include erythema nodosum)
- Exclude infection (negative stool culture with 2/52 history)
- Family History
- Growth and sexual development (growth chart plotting and Tanner staging)
- Nutritional status
What laboratory investigations should be carried out?
Full blood count & ESR
- Anaemia
- Thrombocytosis
- Raised ESR
Biochemistry
- Stool calprotectin
- Raised CRP
- Low Albumin
Microbiology
-No stool pathogens
How does Crohn’s usually present in children?
- Lack of specific symptoms (present with weight loss and growth failure)
- Abnormal blood tests and high calprotectin
How does UC usually present in children?
- Symptomatic with bloody diarrhoea
- Do not necessarily have abnormal growth or blood tests
- High calprotectin
What are the definitive radiological investigations for IBD?
- MRI (usually >5 years due to the need to keep still without a GA)
- Barium meal and follow through (younger kids)
What types of endoscopy are used in the definitive diagnosis of IBD?
- Colonoscopy
- Upper GI endoscopy
- Mucosal biopsy
- Capsule endoscopy
- Enteroscopy
What are the aims of treatment in IBD?
- Induce and maintain remission
- Correct nutritional deficiencies
- Maintain normal growth and development
What are the treatment for IBD in children?
Medical
- Anti-inflammatory
- Immuno-suppressive
- Biologicals ( Infliximab)
Nutritional
- Immune modulation
- Nutritional supplementation
- Milkshake diet
Surgical
