Inflammatory Bowel Disease Flashcards
Name the inflammatory bowel diseases.
Ulcerative Colitis
Crohn’s disease
Which part of the bowel does Ulcerative Colitis affect?
The colon only (including the rectum)
Which part of the bowel does Crohn’s affect?
Anywhere from the mouth to anus
When does IBD usually present?
Usually teens and twenties, but not always
What 3 factors contribute to the development of IBD?
- Genetic susceptibility
- Environmental factors such as smoking, stress
- Host immune response
What is the pathogenesis of the immune system in IBD?
IBD is an autoimmune condition
The immune system produces an abnormal response to antigens usually found in the lumen
Effector T cells overpower regulatory T cells
Pro-inflammatory cytokines stimulate release of TNF
Activation of mast cells, neutrophils, eosinophils
All of these lead to cell damage
In UC, is the inflammation patchy or widespread?
Widespread, the inflammation begins at the rectum and gradually travels up the colon
You see distinct cut of points between healthy and affected colon
Continuous: no ‘skip lesions’ - bits of the bowel that are skipped and left unaffected
In Crohn’s is the inflammation patchy or widespread?
Patchy
Skip lesions
In UC what layers of the bowel wall are affected?
Mucosa only
In Crohn’s what layers of the bowel wall are affected?
The whole wall can be affected
Trans-mural
Which features granulomas? UC or Crohn’s?
Crohn’s, but only in 50% of patients
What is the effect of smoking on the risk of developing UC and Crohn’s?
Increases risk of getting Crohn’s
Decreases risk of getting UC
What would you see looking down a microscope at some bowel affected with UC?
No granulomata
Goblet cell depletion
Crypt damage:
- distortion
- abscesses
- cryptitis
What would you see looking down a microscope at some bowel affected with Crohn’s?
Granulomata
Trans-mural inflammation
What would you see during an endoscopy of a person with UC?
Loss of vascular appearance
Erythema, bleeding
Ulcers
Pseudopolyps
