Inflammatory Bowel Disease

Question 1

Inflammatory Bowel Disease

Answer 1

chronic, relapsing inflammation of the bowel due to abnormal immune response to enteric flora

• recurrent bouts of bloody diarrhea and abdominal main in young women
• subclassified as ulcerative colitis or Crohn disease

Question 2

Ulcerative Colitis

Answer 2

wall involvement: mucosal and submucosal
location: rectum and extends up to cecum
symptoms: L lower quadrant pain with bloody diarrhea
inflammation: crypt abscesses with neutrophils
gross appearance: pseudopolyps, haustra loss (lead pipe)
complications: toxic megacolon and carcinoma
smoking: protects against UC
extraintestinal manifestations: arthritis, uveitis, erythema nodosum, pyoderma gangreosum, primary sclerosing cholangitis, p-ANCA

Question 3

Crohn Disease

Answer 3

wall involvement: full-thickness, knife-like fissures
location: mouth to anus with skip lesions (terminal ileum- commone)
symptoms: R lower quadrant pain with diarrhea
inflammation: lymphoid aggregates with granulomas
gross appearance: cobblestone mycosa, creeping fat, strictures
complications: malabsorption with nutritional deficiency, calcium oxalate mephrolithiasis, fistula formation, carcinoma
smoking: increases risk for Crohn disease
extraintestinal manifestations: arthritis, uveitis, erythema nodosum, pyoderma gangreosum, primary sclerosing cholangitis, p-ANCA