Inflammatory Bowel Disease Flashcards
What are the 2 types of IBD?
Ulcerative Colitis
Chrohn’s Disease
What causes IBD?
Mostly idiopathic
Environmental trigger or genetically susceptible people
Symptoms of UC?
Bloody diarrhoea
Abdominal pain
Weight loss
What is ulcerative colitis?
Continous inflammation which only affects the colon. It starts in the rectum and works proximally
What are the clinical features of UC?
Temp >37.5 Pulse >90 Albumin <30g/l >6 stools/day with blood Hb <10g/l ESR raised
What is Crohn’s?
Patchy inflammation affecting mouth to anus with skip lesions. Can cause ulcers, strictures and fibrosis
What are the symptoms of Crohn’s?
Diarrhoea Weight loss Abdominal pain Malaise Lethargy
What are the clinical features of Crohn’s?
High ESR and CRP High platelet count High WCC Low Hb Low albumin
What are the main histological differences between UC and Crohn’s?
UC is transmural
Crohn’s will have non caveating granulomas
More crypt abscesses in UC
Goblet cells depleted in UC
What extra-intestinal manifestations could occur in IBD?
Eyes Joints Renal calculi Liver and biliary tree Skin
What disease can present very similarly to Crohn’s?
Ileo-caecal TB
What disease is associated with UC?
Sclerosing cholangitis
Colonic carcinoma
What method is used to continue surveillance of IBD?
Colonoscopy
What drugs are aminosalicylates (5ASA)?
Mesalazine Pro drugs (Balsalazide, Olzalazide, Sulfasalazide)
How are 5ASA used in UC?
> 3g/day
Reduces number and severity of relapses
Reduces CRC risk
How is 5ASA used in Crohn’s
Used for Crohn’d colitis
What steroids are used in IBD?
Prednisolone (40mg per day then tapering reduction)
Budenoside
What thiopurine is used in IBD?
Azathioprine (Side effects incl leucopenia, pancreatitis and hepatotoxicity)
How is methotrexate used in IBD?
Unlicensed use in Crohn’s
Requires specialist follow up
Name some immunosuppressants used in IBD?
Ciclosporin
Mycophenolate
Tacrolimus
What are the Anti-TNF alpha antibodies in IBD treatment called?
Infliximab (8 weekly infusions)
Adulimumab (bi weekly SC injections)
What is the alpha4b7 intern blocker used in IBD called?
Vedolizumab
What are the surgical indications for Crohn’s?
Failure of medical treatment Relief of obstructive symptoms Fistulae management Intra-abdominal abscesses Anal conditions management
