Inflammatory bowel disease Flashcards
What is inflammatory bowel disease
chronic relapsing and remitting condition of entire GI tract due to inappropriate immune activation in the mucosa
What is ulcerative colitis
Where body attacks own cells
what is crohns
bacteria causes innapporproate immune response
Who is IbD more likely ot affect
Teens and young adults, equal sex distribution, eastern European ashkenazi jews
What is the rise in incidence of IBD be due to
Hygiene hypothesis
Where are goblet cells more likely seen
Large intestine
Where are panet cells found
small intstine
What cells lie behind epithelium
-What do these act as
dendritic cells
-Act as antigen presenting cells
what do dendritic cells do
Activate T helper cells which initiate immune response
Which factors can lead to a barrier defect
- Genetic susceptibility to barrier defect
- These hyperreactive immune cells then secrete more cytokines (TNF and interleuins) which increases inflammation
- This causes further impaired bacterial handling and further defect in barrier which allows more gut bacteria to enter submucosa
what does a barrier defect do
Allows gut micorbes to enter submucosal layer where immune cells are present
-dendritic cells present this microbe to t cell. T cells then activated and start immune cycle
Which polymorphisms cause IbD
NO2d gene mutation
SYmptoms of ibd
-fever
-night sweats
-Not able to eat
-vomiting
-Lack of appetite, -Nausea, summer -cramps
Weight loss- could be due to malnutrition (inadequate absorption)
-Blood in stools/on wiping
-Water loss and diarrhoea
-Change in bowel movements
-Presence of pus or mucus in stools
Symptoms of crohns
Ulcerations in mouth
Anal skin tags and ulcers
Abdo tenderness and diarrhoea common
Malnutrition
Which IBd is bloody diarrhoea more common
UC
Symptoms of UC
anaemia
Most commonly involved sites in crohns
Terminal ileum
R colon
Can affect any part of GI tract (from mouth)
What is ileo-colitis
Ileo-colitis (distal ileum and proximal colon)
-Ileitis (
what is ileitis
terminal ileum or entire ileum
What is ileojejunitis
continuous involvement of small bowel or skip areas separated by normal bowel
What is perianal disease
crohns limited to anal area
Difference between uC and crohns
UC continuous however crohns can be patchy and always involves the rectum
Macroscopic features of crohns
Skip lesions cobblestone appearance Aphthous and serpentine ulcers fat stranidng development of fistulas
What do bloods look like in IBD
Raises CRP and ESR
LFT and coagulation can be changed in fistula formation
pANCA (serological markers) are positive esp in UC
