Inflammatory Bowel Disease

Question 1

General info

Answer 1

Both Crohn’s and UC are generally more severe and wide spread when presenting in children. (e.g. children with UC generally have the pancolitis pattern)They can also be difficult to tell apart and so a larger proportion of children have IBDU (inflammatory bowel disease unspecified) than adults.

Crohn’s is the most common and IBD in children occurs more in boys.

Question 2

Symtpoms of Crohn’s

Answer 2

Diarrhoea
Rectal bleeding
Abdo pain 
WEIGHTLOSS
GROWTH FAILURE
ERythema Nodosum
Arthritis
Mass
Fever
Rolled edge ulcer
Elephant ear tags

anemia
RASIED STOOL CALPROTEIN
LOW ALBUMIN

Question 3

What are teh symptoms of Ulcerative colitis?

Answer 3

BLOODY DAIRRHOEA
ABDO PAIN
Anemia
HIGH STOOL CALPROETIN

Sometimes:
fever 
growth faliure
weightloss
arthitis

Question 4

Investigations

Answer 4

MRI or Barium meal

Stool calproetin

Colonoscopy and Upper GI endoscopy

Mucosal biopsy
Capsule enterscopy

Question 5

Treatment of IBD

Answer 5

Diet changes e.g. Polymeric diet and nutritional supplements
Anti-inflammatories e.g. prednisolone or steroid sparing agents e.g. Methotrexate
Biologics e.g. Infliximab
Surgery- (not curative in Crohn’s)- could be resection of unresolving segment withe end to end anastamosis or removal of large segment and stoma.