IBD clinical Flashcards
What are the 2 idiopathic chronic inflammatory diseases?
Ulcerative Colitis
Crohn’s disease
What is the difference in clinical presentation of Crohns and ulcerative colitis?
Crohns - abdominal pain and peri-anal disease
Ulcerative colitis - Diarrhoea and Bleeding
What two countries have the highest incedence of IBD?
America
Britain
What are the 3 factors that contribute to IBD?
Genetic predisposition
Mucosal immune system
Environmental triggers
What is the incedence of UC?
10/100000
What are the three names for the areas that Ulcerative colitis effects?
Proctitis
Left-sided colitis
Pancolitis
What are the symptoms of UC?
Diarrhoea + Bleeding Increased bowel frequency Urgencuy Tenesmus Incontinence Night rising LIF Pain Constipation
What are the important facts in the history for diagnosing UC??
Recent Travel Antibiotics NSAID's Family history Smoking Skin, eyes, joints
What is the % risk of colectomy in sever ulcerative colitis?
30%
According the Truelove and Witt criteria what is severe ulcerative colitits?
>6 bloody stools/24hrs \+ 1 or more of: Fever Tachycardia Anaemia Elevated ESR
What further investigations must be done for UC?
Bloods: CRP and Albumin
Plain AXR
Endoscopy
Histology
What is looked for in an AXR?
Stool distribution - abscency in inflamed colon
Mucosal oedema/thumb-printing
Toxic megacolon - transverve > 5.5cm, Caecum >9cm
What is looked for on endoscopy?
Confluent inflammation extending proximally from anal margin to transition zone
Loss of vessel pattern
Granular mucosa
Contact bleeding
Can pseudopolyps occur in UC?
yes
What are the changes in histology that occur in UC?
Absence of goblet cells
Crypt distortion and abcess
Affecting the mucosal layer only
What does UC increase the risk of?
Colorectal cancer determined by: severity of inflammation Duration of disease Disease extent
What are the sites of extra intestinal manifestations of UC?
Skin Joints Eyes Deranged LFT's Oxalate renal stones
What does PSC stand for?
Primary sclerosing cholangitis
What is PSC?
Chronic inflammatory disease of the biliary tree
What percentage of people with PSC have IBD?
80%
What are signs of PSC?
Cholestatic LFTs
Itch
Rigors
Asymptomatic
Crohns disease is more commonly diagnosed over the age of 40? True/False
False
90% before age 40
Where in the GI can crohns affect?
Anywhere from mouth to anus
What is peri-anal disease?
Recurrent abscess formation
Pain
Fistula with persistent leakage
Damaged Sphincters
