IBD and IBS

Question 1

Define IBS?

Answer 1

No organic cause
Diagnosis of exclusion
Symptoms persisting for over 6 months

Question 2

Name four symptoms associated with IBS?

Answer 2

Bloating
Abdominal distension
Change in bowel habit - (mucous like poo)
Abdominal pain - often alleviated with defection

Question 3

Name four extra-instestinal symptoms associated with IBS?

Answer 3

Nausea
Lethargy
Headache
Backache

Question 4

Name six investigations to conduct in suspected IBS?

Answer 4

FBC
CRP
ESR
Ca-125 (ovarian cancer marker)
Faecal calprotectin (inflammation of GI)
Coeliac screen

Question 5

Name four red flag symptoms associated with IBS?

Answer 5

Weight loss
Rectal bleeding
FHx of cancer
60 years old with 6 week Hx of CIBH

Question 6

Name four cardinal characteristics of UC?

Answer 6

Continuous inflammation (NO skip lesions)
NO granulomas
Submucosa and mucosa affected ONLY
Inflammation never extends further proximal than the iliocecal valve

Question 7

What are the peak ages of onset of UC?

Answer 7

15 -25

35 - 65

Question 8

Name four symptoms of UC?

Answer 8

Bloody diarrhoea (episodic and chronic)
Colicky abdominal pain
Urgency
Tenesmus
(proctitis - may present with constipation and rectal bleeding)

Question 9

Acutely what are patients with UC at risk of developing?

Answer 9

Toxic megacolon

Question 10

Name five signs O/E of a patient with UC?

Answer 10

Errythema nodosum (raised red lesions on shins)
Episcleritis
Pyoderma grangrenosum (painful and large ulcers)
Anterior uveitis
Clubbing

Question 11

What specific GI marker may help within investigations for UC?

Answer 11

Faecal calprotectin

Question 12

Name five cardinal characteristics of Chron’s disease?

Answer 12

Transmural inflammation (all layers)
Granulomatous
Focal lesions
Asymmetrical (patchy) = skip lesions
Inflammation at ANY part of the GI tract

Question 13

Which area of the GI tract does Chron’s most commonly affect?

Answer 13

Terminal ileum

Proximal colon

Question 14

What is the average peak onset of age for developing Chron’s?

Answer 14

15-30
60-80
Children (G>B)
Adults (M>F)

Question 15

Name four symptoms associated with Chron’s?

Answer 15

Diarrhoea (bleeding = UN-common)
Abdominal pain
Weight loss
Urgency

Question 16

Name six intra-intestinal signs O/E of a patient with Chron’s including the four perianal signs?

Answer 16

Apthous ulcerations
Abdominal tenderness
Perianal - skin tags
Perianal - fistulae (VERY COMMON)
Perianal - abscesses
Perianal - strictures

Question 17

Name six extra-intestinal signs O/E and Hx of a patient with Chron’s?

Answer 17

Clubbing
Errythema nodosum
Pyoderma gangrenosum
Sacroilitis 
Osteomalacia
Increased risk of renal stones

Question 18

Name the two major risk factors for Chron’s disease?

Answer 18

FHx

Smoking