Inflammatory Bowel Disease Flashcards
What is the pertinent pathophysiology of Inflammatory Bowel Disease?
IBD is not IBS
Includes Ulcerative Colitis and Crohn’s Disease
The immune response disrupts the intestinal mucosa and leads to a chronic inflammatory process
What is ulcerative colitis?
Limited to the Colonic mucosa. An inflammatory pseudo-polyp is an island of normal colonic mucosa which only appears raised because it is surrounded by atorphic tissues.
What is ccrohn’s disease?
Can affect nay segment of the gastrointestinal tract from the mouth to the anus.
Skip lesions
Transmural
What is transmural inflammation?
Seen in Crohn’s disease
Complete inflammation of all layers of a structure
inflammatory changes/ulceration of all layers of the bowel wall
What is mucosal inflammation?
Involves only the mucosal layer of bowel wall
Seen in ulcerative colitis
Physiology of IBD?
may be associated in 50% of paitnets with a nubmer of extraintestinal manifestations
Especially CROHN’s
What are the extraintestinal manifestations?
Crohns and ULcerative Colitis-erythema nodosum, pyoderma gangrensoum, thromboembolic events.
Crohn’s-Oral ulcers, anorectal disease
Ulcerative Colitis-Peripheral arthritis, spondylitis or sacroilitis, episcleritis or uveitis, hepatitis and sclerosing cholangitis
What are some physical findings of crohn’s disease?
ileitis or ilocolitis
low grade fever
malaise loss of energy
weight loss
cramping abdominal pain
How do you treat and manage Crohn’s disease?
no one definitive therapy
5-aminosalicylic acid derivatives
corticosteroids
immunomodulating and biologic agents
management
acute flairs may require surical intervention
counsel patient to discontinue tobacco products
consult to GI general surgery
What are some of the compllication of crohn’s disease?
Intraabdominal abcess formation
small bowel obstruction
fistulas peri anal and intra abdominal
increased risk of developing colon carcinoma
Bleeding is not common in crohn’s disease**
What is the physiology of ulcerative colitis?
chronic, recurrent disease
abnormal activation of the immune system
diffuse mucosal inflammaiton
Involves only the large intestine
can involve the rectum
may extend proximally in continuous fashion to involve part or all of the colon
What are the symptoms of ulcerative colitis?
Bloody diarrhea is the hallmark
lower abdominal cramps and fecal urgency
anemia, low serum albumin
negative stool cultures
What are the mild symptoms of ulcerative colitis?
gradual onset of infrequent diarrhea with intermittent recal bleeding and mucus
stoools may be formed or losose
because of infalmmation there is fecal urgency and tenesmus
left lower quadrant cromaps relieved by defecation are common, buth there is no significant abdominal tenderness
What are the symptoms of moderate UC?
more sever diarrhea with frequent bleeding
abdominal pain and tenderness may be present but are not sever
may be mild fever, anemia, and hypoalmuminemia
What are the symptoms of severe UC?
Have more than six to ten bloody bowel movements per day
abdominal pain and tenderness are present
