IBD

Question 1

How might a kid with IBD present?

Answer 1

With diarrhoea
Rectal bleeding
Abdo Pain
Fever
Weight loss
Growth failure
Arthritis
Mass

Question 2

Difference between UC & Crohn’s presentation?

Answer 2

UC predominantly features diarrhoea, bleeds and abdo pain

Crohn’s features more systemic symptoms incl arthritis, fever, growth problems and erythema nodosum

Question 3

What else would you want to know about a kids history if we suspect IBD?

Answer 3

FH
Growth development
Sex development
Nutritional Status
Intestinal and other symptoms

Question 4

How do you approach a kid you suspect of IBD?

Answer 4

Exclude an inf with stool culture etc

FBC, ESR, CRP, Albumin

Stool Calprotectin

MRI or Barium Meal

Endoscopy & Biopsy

Question 5

What would blood tests show in IBD?

Answer 5

FBC - Anaemia & Thrombocytosis
ESR & CRP - raised
Albumin - Low

Question 6

When would we use a barium meal in place of an MRI?

Answer 6

Barium meal is good for younger kids who can’t sit through an MRI

Question 7

Which tests are definitive for IBD?

Answer 7

MRI/Barium Meal

Endoscopy & biopsy

Question 8

How do we manage IBD?

Answer 8

• Anti-inflammatories e.g. 5ASA mesalazine
• Steroids (for flare ups)
• Immunosuppressants e.g. azathioprine
• Biologics e.g. Infliximab
• Surgery

Also a polymeric diet is first line for crohn’s

Nutrional supplements and immunomodulation can help