IBD- crohns and ulcerative colitis

Question 1

what sites can crohns disease affect?

Answer 1

anywhere from mouth to anus (common in ileum)

Question 2

what sites can ulcerative colitis affect?

Answer 2

colon and rectum-starts in rectum and can extend upwards through large intestine/colon in continuous manner

Question 3

what are the differences between chrons and ulcerative colitis?

Answer 3

chrons- discontinuous, affects full thickness of wall, can extend externally (anal fissures, abscesses), causes oedema and cobbled mucosa, narrowed lumen due to oedema

colitis- continuous, affects superficial mucosa, only in colon/rectum. increased vascular supply due to inflammation, causes mucosal ulceration

Question 4

can chrons affect the oral cavity, if so how?

Answer 4

yes- causes same things seen in gi tract- cobbled mucosa- oedema of lips/mouth-inflammation of face=orofacial glanulomatosis

Question 5

do you always have GI problems with orofacial granulomatosis?

Answer 5

no- if along side GI chrons= oral chrons disease

Question 6

what are the symptoms of colitis?

Answer 6

-diarrhoea
-abdominal pain
-rectal bleeding

Question 7

what are the symptoms of chrons?

Answer 7

same as colitis
+ malabsorption if in small intestine
+ acute pain if blockage of small intestine due to oedema
+ orofacial granulomatosis (cobbled mucosa, facial inflammatory changes, oedema of lips/face/mouth)

Question 8

how is chrons/colitis investigated?

Answer 8

-faecal samples
-endoscopy- biopsy
-blood tests- inflammatory markers/ anaemia

Question 9

what is the treatment of chrons/colitis?

Answer 9

nsaids- pain/inflammation
systemic steroids-prednisolone
localised steroids
none steroidal immunosuppressants- dmards-methotrexate
anti TNFa therapy- “biologics” “babs”

surgery- colectomy (colitis only)- relives all symptoms