Inflammatory bowel disease Flashcards
What is the general presentation of Crohn Disease?
Lethargy and general ill health - with or without GI symptoms can be presentation - especially in older children.
What are the clinical feature of CD? (7)
- Abdo pain
- Diarrhoea
- Weight loss
- General ill health: - Fever,lethargy, weight loss
- Extra-intestinal manifestations:Oral lesions/perianal skin tags, uveitis, arthralgia, erythema nodosum
- Growth failure
- Puberty delay
What blood results are helpful in diagnosis of CD?
Increased platelets, ESR and CRP.
Decreased serum albumin
Iron-deficiency anaemia
What part of the GI tract can be affected by CD?
What part is most common?
Any part, from mouth to anus
Most common = distal ileum and proximal colon.
Describe CD
Transmural, focal, subacute or chronic inflammatory disease.
What pathological changes occur in CD?
Initially - areas of acutely inflamed, thickened bowel
Subsequently, strictures of bowel and fistulae form between adjacent loops of bowel, between bowel and skin or between bowel and other organs.
What is the histological hallmark of CD?
A non-caseating epithelioid cell granulomata.
What changes can be seen on small bowel imaging in CD?
Narrowing, fissuring, mucosal irregularities and wall thickening.
Describe Ulcerative colitis
Recurrent, inflammatory and ulcerating disease involving mucosa of colon.
How does UC characteristically present? (3)
- Rectal bleeding
- Diarrhoea
- Colicky pain
Where can inflammation be found in UC?
Confined to colon.
Confluent colitis extending from rectum proximally.
What are the histological features of UC? (3)
- Mucosal inflammation
- Crypt damage (Cryptitis, architectural distortion, abscesses and crypt loss)
- Ulceration
