IBD Flashcards
what i the treatment aims of IBD in children?
induce and maintain remission
correct nutritional deficiencies i.e. iron
maintain normal growth and development
what is the treatment to induce remission in crohns in children?
nutritional therapy
steroids
what is the treatment to induce remission in ulcerative colitis in children?
5-ASA’s i.e. sulfasalazine
steroids
what is the treatment to maintain remission in crohns in children?
thiopurines i.e. azathioprine
what is the treatment to maintain remission in ulcerative colitis in children?
5-ASA i.e. sulfasalazine
thiopurines i.e. azathioprine
when is surgery indicative in children with crohns and is it curative?
when there are complications, it isn’t curative
when is surgery indicated in children with ulcerative colitis and is it curative?
failure to respond to medical treatment
it is curative
what are the main differences in the presentation between crohns and ulcerative colitis in children?
ulcerative colitis presents with more diarrhoea and rectal bleeding
crohns causes greater weight loss and growth restriction
crohns may present with a mass
both present with the same degree of abdominal pain, fever and arthritis
what would you want to find out in the history if you suspect IBD in a child?
intestinal symptoms extra intestinal symptoms try and exclude infection FHx growth and sexual development nutritional status
what laboratory tests would you carry out to help in the diagnosis of IBD? what results would you suspect?
FBC
- thrombocytosis
- anaemia
ESR - raised
biochemistry
- CRP (raised)
- stool calprotectin (raised)
- albumin (low)
what imaging modalities would you carry out to help in the diagnosis of IBD in child?
MRI barium meal and follow through upper GI endoscopy colonoscopy enteroscopy mucosal biopsy
what is the gold standard test to diagnose IBD?
mucosal biopsy
why might some kids with crohns not present with diarrhoea?
cross is a patchy disease affecting the different parts of the GI tract therefore may not affect the colon
why might some kids with ulcerative colitis not be underweight or growth restricted at presentation?
UC is superficial therefore may not have the same degree of nutritional deficiency and malabsorption experienced in crohns
