IBD Flashcards
Define Irritable Bowel Disease (IBD)
chronic
idiopathic
relapsing and remitting
What genes are associated with ___?
a. Crohn’s
b. IBD in general
c. UC
a. NOD2, IL-27
b. PTGER4, IL-12B
c. ECM1, IL-8/2/21, LAMB1
How can smoking affect IBD?
UC onset occurs following cessation, nicotine patches as effective as 5-ASA
smoking accelerates Crohn’s progression and is less likely to respond to treatment –> smoking cessation is an effective treatment
What is Ulcerative Colitis (UC)?
a long-term condition resulting in inflammation of colon and rectum
continuous inflammation limited to lamina propria
14 per 100,000
M=F
20-40yrs and >60yrs
How does the route of transmission vary throughout the treatment of UC?
just proctitis –> suppositories
Left-sided –> enemas
Oral therapy –> pancolitis
What are the S&S of UC?
urgent diarrhoea blood fatigue weight loss cancer abdo pain --> LIF pallor tachycardic leukonychia
extra-intestinal manifestations: ulcers around mouth uveitis arthritis, spondylitis erythema nodeusum, gangrenosum
What bloods results might suggest UC?
microcytic anaemia low ferritin low albumin faecal calprotectin inflammatory markers raised platelets
What imaging is done to diagnose UC?
colonoscopy
plain AXR –> ‘lead pipe’ = featureless + smooth
Describe the histology of UC
just epithelial
crypt distortion –> chronic inflammation
crypt abscess –> neutrophils in centre
How is UC treated?
steroids to induce remission
5-ASA as maintenance eg mesalazine, sulphasalazine
probiotics
if mod/severe —> azathioprine/6-mercaptopurine
if then –> methotrexate then –> biologicals
if still resistant –> surgery - sub-total colectomy
What is Crohn’s Disease?
non-continuous transmural inflammation which can affect anywhere in the GI tract
M=F
15-30 yrs
What are some S&S of Crohn’s?
depends on where it is colitis terminal ileum - MOST COMMON - mass, colic pain post-prandial weight loss fatigue
What complications can arise from Crohn’s?
obstruction –> chronic inflammation –> scarring –> strictures
penetrating ulcers
increased risk of bowel cancer
What blood results would you expect to see in Crohn’s patient?
anaemia
low ferritin, folate, B12
raised inflammatory markers
low albumin
How would you diagnose Crohn’s?
S&S
Bloods
Faeces –> MC&S, OC&P, calprotectin
Plain AXR –> loops of SB, megacolon
Barium follow-through –> rose-thorn
CT –> terminal ileum thickening, abscesses
MRI –> SB, perianal abscesses
