inflammatory bowel disease Flashcards
inflammatory bowel disease features: list the major forms of IBD and explain how they differ in terms of pathology and responsiveness to treatment
2 major forms of IBD (10% of diagnosis incomplete)
ulcerative colitis (UC) and Crohn’s disease (CD)
genetic predisposition to IBD
incomplete but white European are most susceptible (CD more studied as more serious, with over 201 loci identified; combination of cell types and molecular mechanisms involved in pathogenesis of IBD interacting with environment)
11 environmental risk factors of IBD
smoking, medication, diet, sleep, stress, physical activity, air pollution, UV/vitamin D exposure, microbiome, appendectomy, heavy metal
effect of IBD on muscoal immune system and gut flora
defective interaction between mucosal immune system and gut flora (infection)
IBD autoimmune disease pathway
complex interplay between host and microbes -> disrupted innate immunity and impaired clearance -> pro-inflammatory compensatory responses -> physical damage and chronic inflammation
layers of GI tract
intestinal lumen -> mucus layer -> epithelial barrier -> lamina propria
CD vs UC: main cell and inflammatory cytokine in autoimmune disease
CD: Th1-mediated (worse inflammatory response), TNFa, UC: Th2-mediated, IL-13
CD vs UC: gut layers affected
CD: all layers (more serious), UC: mucosa/submucosa
CD vs UC: regions of gut affected
CD: any part of GI, UC: rectum, spreading proximally
CD vs UC: describe inflamed areas
CD: patchy (can have healthy, then inflamed, then healthy area etc.), UC: usually continuous
CD vs UC: presence of abscesses/fissures/fistulae (causing seepage)
CD: common, UC: uncommon
CD vs UC: is surgery curative
CD: not always curative (limited due to being patchy), UC: curative
10 clinical features of IBD (systemic as well as local)
diarrhoea (blood and mucus), skin rash, mouth ulcers, anaemia, uveitis, fevers (and sweats), jaundice, abdominal pain, arthritis, weight loss
