Inflammatory Bowel Disease Flashcards
2 types of IBD
Ulcerative colitis
Crohns disease
Ulcerative colitis is
Inflammation of mucosa of large colon
Pathophysiology of ulcerative colitis
Exaggerated mucosal T cells response to host microbiota
Symptoms of ulcerative colitis
Rectal bleeding
Diarrhoea
Urgency
Diagnosis of ulcerative colitis
Blood tests- raised CRP/ESR
Anaemia
Low Alubumin
Faecal calprotectin
Endoscopy / gold standard
Inflammation in ulcerative colitis
Pro lit is
Left sided colitis
Pancolitis
Proctlitis is is where
Rectum
Progression of ulcerative colitis
Can progress in earlier years then seems to set afterwards
Treatment for UC
Steroids - prednisolone
Aminosalicylates (oral rectal)
mesavant, octasa
- immunosuppressants - azathioprine, methotrexate
Colectomy results in
Remove colon and sew up to form j pouch
Need to go toilet urgently
Can cause infertility in women
Pouch can get infected
Criteria for marking inflammatory bowel disease
Truly enjoyed and Witt criteria
Trullve and Witt criteria (when do you admit a patient)
When meet 2 or more sevrvere criteria
E.g
Over 6 motions (poos) a day
Rectal bleeding (much)
Temperature
Pulse over 90
Assessment for IBD
Exam for : dehydration ,abdominal tenderness, bowel sounds
Blood test Fbc
X-ray diaphragm
Stool test for c diff
Sigmoidoscopy - to exclude CMV superadded infection
Management for for IBD
Hydrocortisone 100 mg QDS
Dalteparin 5000 units
Daily clinical review, blood tests inc CRP and daily AXR
Where does crohns effect
Anywhere from mouth to anus
Signs of crohns
Cache is / skinny
Scars
Stomas
Parenteral nutrition
Diagnosis of crohns
Same as ulcerative colitis
Plus faecal calprotectin
And nutritional deficiencies
Which scan for crohns
MRI as these patients have build up of radiation due to constant scans
Treatment of chrons
Steroids- avoided
Antibiotics - short term
Immunosuppressants
Biologics
Modulen
Surgery
What % of Crohn’s disease patients will have surgery in their life time
70
Surgery type for Crohn’s disease
Stricturoplasty. / colectomy
You would start a Crohn’s disease patient on?
Ciprofloxin and metronidazole
