IBD Flashcards
Two subtypes?
Crohn’s disease
Ulcerative colitis
Where do the subtypes affect?
UC= only colon CD= Any part of GI tract
Possible aetiology?
Combo of genetic susceptibility and environmental factors and mucosal immunity
Environmental triggers?
Smoking
NSAIDS
Stress
Diet
Mucosal immune system cause?
IBD occurs due to an overactive response to luminal antigens eg bacteria
IBD patients have a leaky epithelium. True or false?
True
Increased chance of detection of antigens by immune cells
Antigen will be presented to the other T cells = inflammation in the mucosa
- An absence of regulatory T cells
- Overactive effector T cell response
Crohns mediated by?
TH1
UC mediated by?
TH1/TH2
IBD increases the risk of what GI conditions?
- Developing colon
- Toxic megacolon in UC
- Bowel obstruction
- Sclerosing cholangitis
Systemic manifestations of IBD?
Eyes= uveitis, episcleritis, conjunctivitis
Skin= Erythema nodosum, pyoderma gangrenosum
Joints= Arthralgia, ankylosing spondlitis
Liver & biliary tree= Sclerosing cholangitis, fatty liver, chronic hepatitis, cirrhosis, GS
What is most commonly affected in Crohn’s disease?
Terminal ileum
Signs and symptoms of CD?
- Abdo pain
- Diarrhoea (less common blood or mucous)
- Wt loss/ reduced growth
- Fatigue
- Malaise
- Fever
- Mouth ulcers
- Angular stomitis
- Peri-anal disease (later disease development) abscesses, fistulas, strictures
CD will only present as chronic. True or False?
FALSE
Chronic or actute but chronic more common in OSCEs
Risk factors for CD?
Fam history
Smoking
Investigations for IBD?
- Wt loss?
- RIF mass
- Peri-anal signs
- Bloods= CRP, ESR, ferritin, B12
- Endoscopy= OGD/Colonoscopy (cobble stoning, skip lesions=C)
- Biopsy for diagnosis- pathcy, granuloma, loss of villi
- Bowel imaging= MRI, CT (To look for fistulas, strictures)
What type of inflammation is seen in Crohn’s?
Transmural inflammation
Cobble stoning