Inflammatory Bowel Disease Flashcards
Describe the morphology and pathological consequences of Crohn’s disease and Ulcerative Colitis
Crohns - any part of GI tract, Oral & perianal, Discontinuous, Deep ulcers and fissures in mucosa (cobblestone) Transmural inflammation, Granulomas 50%
UC - Colon only, starts in rectum and continuously extends, red mucosa, easily bleeds, ulcers & pseudopolyps, mucosal inflammation
Common presenting symptoms
Crohns - Small bowel - Pain, Weight loss. Ileum - Acute abdomen (appendicitis) Colon - Diarrhoea, Bleeding and Pain on defecation
UC - Diarrhoea with blood and mucus
Extra-colonic manifestations of IBD
Mouth ulcers, Clubbing, Conjunctivitis, Arthritis, Malnutrition, Renal stones, Erythema nodosum, Ankylosis spondylitis, Chronic liver disease
Investigations
FBC (anaemia bleeding/iron/B12/folate, Platelet, ESR, CRP)
Sigmoidoscopy + biopsy, Colonoscopy, Small bowel imaging, US, Xray
Operative procedures used to treat IBD
Tend not to operate in Crohns due to high relapse rate
UC - Colectomy with ileoanal anastamosis