IBD Flashcards
What are the three types of IBD?
- UC
- Crohn’s
- Indeterminate Colitis
What are the features of Crohn’s Disease?
NESTS (Crows Nests)
No blood or mucus Entire GI tract Skip lesions Transmural inflammation Smoking is a RF
What other features are seen in Crohn’s?
- WL
- Strictures
- Fistulae
Where does Crohn’s usually affect?
Terminal Ileum
What are the features of UC?
CLOSE-UP
Continuous inflammation Limited to colon and rectum Only superficial Smoking protects Excrete blood and mucus Use aminoalicylates PSC association
How does IBD present?
- Diarrhoea
- Abdominal pain
- Passing blood
- Weight loss
What bloods should be done in IBD?
- FBC (anaemia, white cells)
- Thyroid function
- UsEs (Kidney function, bleeds)
- LFTs
- CRP (active disease/inflammation)
What orifice tests should be done for IBD?
- Faecal calprotectin
- Colonoscopy with biopsy
What is faecal calprotectin?
- Measure of inflammation anywhere in the GI tract
How specific and sensitive is faecal calprotectin for IBD?
90%
What can also raise faecal calprotectin?
- Diverticulitis
- Colorectal Ca
- RTI
What imaging is useful for IBD?
CT (for complications)
- Fistulae
- Abscesses
- Strictures
How is remission induced in CROHN’S?
Steroids (PO Pred/IV Hydro)
If steroids alone don’t induce remission in CROHN’S, what can you do?
Add an immunosuppressant
What drugs are first line for maintaining remission in CROHN’S?
- Azathioprine
- Mercaptopurine
