Inflammatory bowel disease Flashcards
Crohn’s features
Diarrhoea usually […]-[…]
Weight loss
Upper GI symptoms, […] […], […] disease - anal granuloma
[…] […] palpable in the […] iliac fossa
Crohn’s features
Diarrhoea usually non-bloody
Weight loss
Upper gastrointestinal symptoms, mouth ulcers, perianal disease
Abdominal mass palpable in the right iliac fossa
UC features
[…] diarrhoea more common
Abdominal pain in the […] lower quadrant
[…]
Bloody diarrhoea more common
Abdominal pain in the left lower quadrant
Tenesmus
Crohn’s Extraintestinal
Reduce bile salt reabsorption:
Gallstones
Oxalate stones
UC Extraintestinal
PSC
Crohn’s complications
Obstruction, fistula,
UC complications
colorectal cancer
Crohn’s histology
Inflammation in all layers from mucosa to serosa
Goblet cells
granulomas
UC histology
No inflammation beyond submucosa
crypt abscesses
depletion of goblet cells
Crohn’s endoscopy
Deep ulcers, skip lesions - ‘cobble-stone’ appearance
UC endoscopy
pseudopolyps
Crohn’s radiology
[…] […] enema
high sensitivity and specificity for examination of the […] […]
strictures: ‘[…] […] sign’
proximal bowel dilation
‘[…] […]’ ulcers
fistulae
Small bowel enema
high sensitivity and specificity for examination of the terminal ileum
strictures: ‘Kantor’s string sign’
proximal bowel dilation
‘rose thorn’ ulcers
fistulae
UC radiology
[…] enema
loss of […]
superficial ulceration,
‘[…]’
long standing disease: colon is narrow and short -‘drainpipe colon’
Barium enema
loss of haustrations
superficial ulceration, ‘pseudopolyps’
long standing disease: colon is narrow and short -‘drainpipe colon’
UC management
1. Proctitis / Proctosigmoiditis
2. Extensive
3. Severe relapse
- Topical ASA, then oral ASA, then oral steroid
- Topical ASA AND oral ASA
- Oral azathioprine or mercaptopurine
Crohn’s mx
1. Remission
2. Maintain remission
3. Definitive
- oral prednisolone, then 5-ASA
- Stop smoking, azathioprine or mercaptopurine
- Surgery - ileocaecal resection
Mx of perianal fistulae in Crohn’s
PO metronidazole
