Inflammatory Bowel Disease Flashcards
State the two types of inflammatory bowel disease.
Ulcerative Colitis. Crohn’s disease.
What is ulcerative colitis?
Inflammatory bowel disorder effecting the mucosa of the large colon.
Give 3 symptoms for ulcerative colitis.
Abdominal pain. Rectal bleeding. Urgency. Diarrhoea.
State 3 things found on examination.
Raised C reactive protein. Anaemia. Low albumin. Faecal calprotectin (present in faeces when inflammation present). Increase in erythrocyte sedimentation rate.
Give 3 treatments for ulcerative colitis.
Steroids e.g. prednisolone.
Aminosalicylates (oral and rectal) e.g. mesavant, octasa
Immunosuppressants e.g. azathioprine, methotrexate
Biologics:
Anti-TNF’s - infliximab, adalimumab, golimumab,
Anti-integrin - vedolizumab
Surgery e.g. colectomy (removal of part of the colon)
Why does the erythrocyte sedimentation rate (ESR) increase in ulcerative colitis?
Inflammation causes red blood cells to become more sticky, therefore more dense and stick together. Therefore they settle faster and increase erythrocyte sedimentation rate.
What is Crohn’s disease?
Crohn’s disease is a type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract from mouth to anus. It is transmural (across entire wall of organ).
State 3 symptoms of Crohn’s disease.
Diarrhoea. Rectal bleeding. Weight loss. Abdominal pain. Perianal abscesses (collection of pus develop near anus). Oral ulceration (mouth ulcer).
State 3 signs of Crohn’s disease.
Cachexia (weakness and wasting of body). Scars. Stomas - opening in body which diverts faeces. Parenteral nutrition - intravenous nutrition outside the body e.g. protein, carbs and fat.
State 3 things you would find on a Crohn’s disease blood test.
Anaemia (as vitamins B12 and B9 are not absorbed to make red blood cells). Low B12. Low B9 (folate). Low ferritin. Low albumin (as albumin excreted).
State 3 treatments for Crohn’s disease.
Steroids e.g. prednisolone.
Antibiotics e.g. ciproflaxin, metronidazole
Immunosuppressants e.g. azathioprine, methotrexate
Modulen - anti-inflammatory drugs
Biologics:
Anti-TNF’s - infliximab, adalimumab, golimumab,
Anti-integrin - vedolizumab
Surgery e.g. stricturoplasty (removal of small bowel stricture), colectomy (removal of all/part of the colon), diverting colostomy (bowel diversion to an opening in abdomen), removal of fistula.
What’s the difference in the histology between Ulcerative Colitis and Crohn’s Disease?
Ulcerative Colitis - crypt abscesses (neutrophilic exudate is found in glandular lumens of crypts) and mucosal inflammation
Crohn’s Disease - granulomas and transmural inflammation
What are crypts?
Crypts are grooves between the villi, which are the small fingerlike projections that line the small intestine and promote nutrient absorption.
What is crypt hyperplasia?
Crypt hyperplasia is when the grooves are elongated compared to a normal intestinal lining which has short crypts. Found in Crohn’s disease and celiac disease.
Fistulas and strictures (narrowing in intestines) are both found in Ulcerative Colitis or Crohn’s Disease?
Crohn’s Disease.
