Inflammatory bowel disease

Question 1

IBD is an umbrella term for which two condirions?

Answer 1

• Crohn’s disease

- Ulcerative colitis

Question 2

What are the key features to remember about Crohn’s disease?

Answer 2

• Affects entire GI tract (from mouth to anus)
• Transmural inflammation
• “Skip lesions”

Question 3

What are the key features to remember about ulcerative colitis?

Answer 3

• Only affects colon and rectum
• Only superficial mucosa affected
• Continuous inflammation

Question 4

Smoking is a risk factor for…

Answer 4

Crohn’s disease

Question 5

What are the symptoms of IBD?

Answer 5

• Abdominal pain
• Diarrhoea
• Blood and mucus
• Weight loss

Question 6

Strictures and fistulas are complications of which type of IBD?

Answer 6

Crohn’s disease

Question 7

Which screening test can be used to detect IBD?

Answer 7

Faecal calprotectin

Question 8

What is the diagnostic investigation for IBD?

Answer 8

Endoscopy (OGD and colonoscopy) with biopsy is diagnostic

Question 9

Describe the medical management of Crohn’s disease for inducing and maintaining remission

Answer 9

Inducing remission:
- 1st line: steroids

Maintaining remission:
- Immunosuppressants, e.g. azathioprine

Question 10

Describe the medical management of ulcerative colitis for inducing and maintaining remission

Answer 10

Inducing remission:
- 1st line: aminosalicylates (topical) e.g. mesalazine

Maintaining remission:

• Aminosalicylates, e.g. mesalazine
• Immunosuppressants, e.g. azathioprine

Question 11

What medication is used to treat a flare of ulcerative colitis?

Answer 11

IV steroids, e.g. IV hydrocortisone

Question 12

Which scoring tool can be used to assess the severity of ulcerative colitis?

Answer 12

Truelove-Witts Severity Index