Inflammatory Bowel Disease Flashcards
What are the different types of IBD?
- Ulcerative Colitis,
- Crohn’s Disease,
- Indetermined colitis,
- Coeliac disease,
- Psudomembranous colitis,
- Diverticulitis,
- Appendicitis,
- Enteritis
What is ulcerative colitis?
It is characterised by superficial inflammatory changes in the colon which starts at the rectum and continues up the colon (at variable lengths). It appears with pseudopolyps and ulcers
What clinical signs will ulcerative colitis present with?
- Other than patient symptoms it will present with;
- Iron deficiency anaemia,
- Raised inflammatory markers,
- Dehydration
Where is the submucosa located?
Between the muscularis propria and muscularis mucosa
What is Crohn’s disease?
It is inflammatory changes anywhere in the GI tract which results in discreet, focal ulcerations called ‘skip lesions’. The inflammation is full thickness. Often presents with terminal ileitis
What are clinical signs that Crohn’s diease will present with?
Other than patient symptoms;
- Anaemia - adsorption/blood loss,
- Raised inflammatory markers,
- Dehydration
What is an unpleasant complication of Crohns?
Inflammation can travel to adjacent organs causing fibrosis. this can create fistulas.
What are some extraintestinal manifestations of IBDs?
- Inflammatory arthropathies,
- Erythema nodosum (Crohn’s),
- Pyoderma gangrenosum,
- Primary sclerosing cholangitis (UC),
- Iritis/Uveitis,
- Aphthous stomatitis (mouth ulcers)
Describe some of the differences in symptoms/signs between UC and Crohn’s
Abdominal pain in Crohn’s is severe and worse after eating. UC doesn’t have this.
UC - mucoid, bloody diary and more commonly has tenesmus.
Crohn’s - watery diarrhoea
Describe the difference between pathology of UC and Crohn’s
UC - colon only, continuous, effects only mucosa, have brad based ulcers and no mesentery involvement or fistulas.
Crohn’s - Mouth to anus, Skip lesions, transmural, linear ulcerations, thickened mesentery and fistulas present
Describe the difference in histopathologies in between UC and Crohn’s
UC - Shortened cryps, cryp abscesses, no vili involvement, no granulomas.
Crohn’s - Shortened cryps, vili atrophy, and granulomas present
Describe the association between cancer and IBD
Chronic inflammatory changes damages cells which leads to dysplasia and an increased risk of colonic carcinoma (more common in UC)
What are the different types of diagnostic uncertainty
- Indeterminate colitis (unsure it UC or crohn’s),
- IBD unclassified
Describe some features of coeliac disease
- Autoimmune inflammation in the small intestines due to the presence of gluten proteins. T lymphocyte mediated so if untreated can lead to T cell lymphoma
