Inflammatory Bowel Disease Flashcards
Which IBD is more common in children?
Crohns
Where is crohns most common?
Terminal ileum
But can occur anywhere in the GI tract
Crohns thickness?
Transmural
Histology of Crohns?
Skip lesions
Cobble stoning
Rose thorn ulcers
Extra-intestinal features of crohns?
** Mouth ulcers
Uveitis **
Erythema nodosum
Ankylosing spondylitis
What are the complications of having crohns in a child?
Nutritional deficiencies
Anaemia
Strictures
Abdomen wall fistulae
What are the symptoms of Ulcerative Colitis?
Abdominal pain
PR bleeding
Where is UC affecting the gut?
Continuous lesions from rectum to ileocaecal valve
thickness affected in UC?
Mucosa and submucosa only
Histology of UC?
Pseudopolyps
Continuous inflammation
Ulceration with loss of haustra
Crypt damage
Extra-intestinal features?
Primary sclerosing cholangitis
Pyoderma grangrenosum
Erythema nodosum
Enteric arthritis
Complications that can be seen in a child with ulcerative colitis?
Nutritional deficiencies
Anaemia
Toxic megacolon
Colonic perforation
Haemorrhage
How to investigate for IBD?
Stool sample
Faecal calprotectin
What bloods are done for IBD?
Raised ESR and CRP
Anaemia
B12 deficiency in crohns
What is seen on blood test in those with crohns?
B12 deficiency
As terminal ileum is affected
Imaging for IBD?
Colonoscopy and biopsy
What is seen on imaging for crohns?
Non caseating granulomas
What is seen on imaging for UC?
90% of children have pancolitis
Crypto abscesses and goblet cell depletion
Which scoring systems is used to score for UC?
Paediatric ulcerative colitis activity index = PUCAI
Truelove and Witts score
What aspects need to be considered when managing IBD?
Need to induce remission
Maintain remission
Consider surgery
Manage complications
How to induce remission in crohns?
Enteral NG/NJ feeding to not tolerating food
Prednisolone 1st line
- if steroid not tolerated 2nd line 5-ASAs
How to maintain remission in crohns?
Stop smoking
Immunosuppressants
Vaccinations
Examples of immunosuppressants?
Azathioprine
Mercaptopurine
Anti-TNFa
How to induce remission in a child with UC?
5-ASA (Mesalazine)
Depending on area affected:
Proctitis: topical 5-ASAs
Proctosigmoiditis: topical 5-ASAs
Extensive UC: Topical + oral 5-ASAs
