Inflammatory Bowel Disease Flashcards
what is Inflammatory Bowel disease
Chronic, non specific inflammatory disorder of the gastrointestinal tract
what are two examples of inflammatory bowel disease
Crohns disease
Ulcerative colitis
when is the peak occurance of IBD
15 - 40 years old
do we know the cause of IBD
no but both are described as autoimmune disorders meaning there must be a trigger to hte inflammation
what are the risk factors of IBD
Hygiene Diet Sleep Medications Microbiome Genetic susceptibility physical activity appendectomy smoking stress vitamin D uv exposure
what is the initial evaluation
exclude other diseases
what blood test should be taken
general signs of inflammation and for anaemia and vitamin and mineral deficiencies
what can stool test be used to do
rule out infections
what is crohns disease
chronic inflammatory disease of gastrointestinal tract
where does the inflammation extend from in chrons disease
inflammation extends all the way through the intestinal wall from mucous to serosa
what are the causative agents of pathogensis
bacteria
virus
dietary
what are the modifying factors of pathogenesis
environment
genetic
what are the luminal factors of pathogenesis
luminal bacteria
digestive enzymes
bile acids
describe pathogenesis in chrons disease
causative agents trigger an immune response which then causes inflammation and amplification leading to a tissue injury
what is the best way to define chrons disease
relapsing and remitting of a disease through the GI tract
what are symptoms of chrons disease
patients present with diarrhoea and insidious abdominal pain
pain is often exacerbated after feeding
diarrhoea is usually non bloody
patients can frequently have fever and weight loss
what can non intestinal manifestation include for crohns disease
mout hulcers
arthritis
erythema nodosum
what are the complications of Crohns disease
narrowing of intestine can lead to blockage of obstruction
- severe cramping and abdominal pain, nausea, vomiting and constipation treated surgically
localized collection of pus or infections
- this causes pain and a fever
an abscess may also develop into a fistula
how can fistulas be treated
diet , analgesics or with surgery
what is proctitis
when only the rectum is affected
what is distal colitis
when the descending colon is affected along with the rectum
what is total colitis
everything affected in colon
what is ulcerative colitis
condition that causes inflammation and ulceration of the inner lining of the rectum and colon
small ulcers develop on the surface of the intestinal lining and these may bleed and produce pus
what are the symptoms of ulcerative colitis
loss of appetite and loss of weight
diarrhea often with blood and mucus and pus
cramping pains in the abdomen
tiredness and fatigue
feeling genrally unwell
anaemia
from least to most agressive rank the methods IBD interventions from least to most
Aminosalicylates Antibiotics Corticosteroids Methotrexate Cyclosporine Infliximab Experimental therapies
what do aminosalicylates do
inhibit production of reactive oxygen species scavenge of free radicals which inhibit the function of lymphocytes and monocytes and plasma cell production of immunoglobulins
what are the side effects of aminosalicylates
nausea vomiting watery diarrhoea headache indigestion mild allergic reactions with rash itchiness fever
what can sulphasalazing cause
male infertility by reducing the sperm count; resolves on stopping
what can sulphasalazine reduce
absorption of folates (blood cell formation)
what is sulphasalazine
aminosalicylates
what do corticosteroid act on
immune system and block release of the substances that trigger allergic and inflammatory responses.
what are some examples of corticosteroid
prednisolone, prednisone, hydrocortisone, methylprednisolone
what are some common side effect of corticosteroids
puffy face excessive facial hair night sweats insomnia hyperactivity
what are the serious side effects for corticosteroids
high blood pressure type 2 diabetes osteoporosis bone fratures cataracts increased susceptibility to infects
what are the main immunosuppresant drugs
azathioprine mercaptopurine methotrexate mycophenolate meofetil ciclosporin tacrolimus
when should azathioprine be used
when 5 ASAs and steroids have failed to produce results
what are the side effects of azathiprine used for
nausea
flu like illness
fever
diarrhoea
what are some examples of biologic interventions
anti tumour necrosis factor alpha
humanized monoclonal antibodies
