Inflammatory Bowel Disease Flashcards
Inflammatory bowel disease is an umbrella term encompassing which two conditions?
- Crohn’s disease
- Ulcerative colitis
Which three main factors contribute to IBD?
- Mucosal immune system
- Genetic predisposition
- Environmental triggers
Which gene, when mutated, gives a greatly increased risk of Crohn’s disease?
NOD2
(it codes for bacterial recognition)
Crohn’s disease is mediated by which immune cell type?
TH1
Ulcerative colitis is mediated by which immune cell types?
TH1 and TH2
How does smoking affect both Crohn’s and UC?
Crohn’s - aggravates
UC - protects
How do NSAIDS impact IBD?
Causes aggravtion
What are the main symptoms of UC?
- Diarrhoea and bleeding
- Increased bowel frequency
- Tenesmus
- Incontinence
- Lower abdominal pain
A rash on the front of the shins is indicative of what?
UC
How is severe UC defined?
>6 bloody stools daily plus 1 of:
- Fever (>37.8 degrees)
- Tachycardia (>90/min)
- Anaemia (haemoglobin <10.5g/dl)
- Elevated ESR (>30mm/hr)
How can UC be investigated and assessed?
- Bloods - CRP, albumin
- Plain CXR - thumb printing
- Endoscopy
- Histology
Why is there an increased risk of cancer long term with UC?
- Severity of inflammation
- Duration of disease
- Disease extent
Where else in the body may UC signs manifest?
- Skin - erythema nodosum, pyoderma gangrenosum
- Joints - axial and peripheral
- Eyes
- Deranged LFTs
- Oxalate renal stones
Which disease can affect the whole GI tract?
Crohn’s
Why is resection minimised for Crohn’s patients?
It is a non curative disease and can recur
What are the main symptoms of Crohn’s disease?
- Abdominal cramps
- Diarrhoea - with or wthout blood
- Weight loss
- Painful mouth ulcers
- Swollen lips
- Angular cheilitis
- Peri-anal pain and abscess
What can happen to red blood cells if the terminal ileum is affected in IBD?
They become macroscopic
Vitamin B12 absorption is disrupted
How does the greater omentum interact with the colon during Crohn’s?
It has a cobblestoning effect and wraps arong the colon
In which IBD are the haustra of the colon lost?
UC
Which IBD involves a thickened gut wall?
Crohn’s
How can the small bowel be assessed?
Barium follow through
Small bowel MRI
Technetium-labelled white cell scan - such cells can be followed to areas of inflammation
