Inflammatory Bowel Disease Flashcards
types of IBD
crohn’s dz (refractory enteritis) and ulcerative colitis
chron’s dz
genetic predisposition
may involved small and large bowels, mouth, esophagus, stomach, terminal ileum and right colon involved, skips the rectum
skip areas characteristic
complications of chron’s dz
fistuals, abscesses, aphthous ulcers, renal stones, predisposition to colon cancer
common sx of chrons
abdominal cramps, D in pt younger than 40
low-grade fever, polyarthralgia, anemia, and fatigue
blod
chrons dx
colonoscopy
bx-show entire bowel wall involvments
*granulomas common
** contrast and endoscopic procerdures should be avoid in pts w. fulminant (explosive sudden) dz - worry about toxic megacolon/perforation
more blood tests for chrons
ESR, anemia, nutritional/electrolye imbalance during exacerbations
acute chrons attack treatments
oral corticosteroids +/- aminosalicylates
**elemental diet is nearly as effecitve, but relapse is more likely
when to add abx to chrons
metronidazole or ciprofloxacin- perianal dz, fissures or fistulas
**influximab can be used in refractory caes
what is the best option for maintenance therapy for chrons
mesalamine
mesalamine adr
ulcerative colitis exacerbation, anaphylaxis, angioedema, drug rxn, SJs, interstial neprhitis, all the other itis
Lupus like syndrome
agranulocytosis
aplastic anemia
reye syndrome
malabsorptive disorder w/ chrons dz
vit b12, folic acid, vit D
ulcerative coltis
generally starts distally, at the rectum, and progresses proximally
disease is continous, skip areas are not seen
onset is generally gradual- also can be abrupt
UC cf
tenesmus and bloody, pus-filled D
pain is less common, but may occur in the more severe dz
severe UC CF
weight loss, maliase, and fever
toxic megacolon and malignancy are more likely in what?
UC
other comlications of UCdz?
scleritis, episcleritis, arthritieds, sclerosing cholangitis, and skin manifestations (erythema nodosum and pyoderma gangrenosium)
smoking and IBD
crohn’s-smokin is bad
smokin is protective in UC
how to dx UC
abdominal plain -film may show colonic dilation,
best method- sigmoidoscopy
what to avoid in UC (acute disease)
colonoscopy or barium enema- risk of perforation and toxic megacolo
what are the best treatment methods?
oral or tolical aminosalicylates ( balsalazide, mesalazine, olsalazine and sulfasalazine) and corticostteroids
adr of sulfasalazine
anorexia, HA, GI, fever, abnormal LFTs, photosynsitivity, oligospermia, crystalluria, hematuria,cyanosis
what is curative in UC?
total protocolectomy
depth of location in UC>
just mucosal
