Inflammatory Bowel Disease

Question 1

Where does Crohn’s disease most commonly affect?

Answer 1

Terminal ileum and the colon.

It can affect anywhere from the mouth the the anus

Question 2

What are the classic presentations of Crohn’s disease?

Answer 2

Abdo pain
Small bowel obstruction
Diarrhoea
Bleeding PR
Anaemia
Weight loss

Question 3

Explain a tupical patient with Crohn’s.

Answer 3

22 y/o
Male
Abdo pain
Bloody diarrhoea for 3/12
Tender abdo

Question 4

What are the main complications of Crohn’s disease?

Answer 4

Malabsorption -(Vitamin deficiency, anaemia)
Gallstones
Fistulas
Anal disease (Sinuses, fissures, skin tags, abscesses, perineum falls apart)
Intractable disease - (Failure to respond to medical therapy, continuous pain or diarrhoea)
Obstructions
Perforations
Malignancy
Amyloidosis
RARELY Toxic megacolon

Question 5

Where is Ulcerative Colitis confined to?

Answer 5

Colon and Rectum

Question 6

What levels of the gut lining does Ulcerative Colitis inflame?

Answer 6

Mucosa and Submucosa

Question 7

What are the clinical presentations of Ulcerative Colitis?

Answer 7

Diarrhoea

Mucus and Blood PR

Question 8

Describe a typical Ulcerative Colitis patient?

Answer 8

32 y/o
Female
Bloody Diarrhoea and Mucus PR
Toilet 25 times a day.

Question 9

What are the complications of Ulcerative Colitis?

Answer 9

Intractable disease - (Continuous diarrhoea, total colectomy needed)
Toxic megacolon (Will rupture unless removed, emergency colectomy needed)
Colorectal Carcinoma
Blood loss
Electrolyte disturbance
Anal fissures
Extra GI manifestations (Eyes - Uveitis, Liver - Primary sclerosing cholangitis, Joints - Arthritis, Ank Spondylitis, Skin - Pyoderma gangrenosum, erythema nodusum)

Question 10

How does Crohn’s disease affect the lining of the GI tract?

Answer 10

Thickened bowel and stricture.

Transmural inflammation.