Inflammatory Bowel Disease Flashcards
Irritable Bowel Syndrome
– Gastrointestinal motility response to external stressors – Abnormal visceral sensation
– Lower visceral pain threshold
requirements to diagnose IBS
– 1 day/week in last 3 months of abdominal pain associated with ≥2 of –
• Associatedwithdefecation
• Change in frequency of stool • Change in form of stool
external environmental factors for IBS aetiology
smoking drinking diet
internal environmental factors for IBS aetiology
gut microbiota
Ulcerative Colitis
median age 30
- relapsing/remitting course
- characterised by inflammatory changes in the colon
- rectum > variable length of the colon
- contiguous, circumferential, superficial inflammation
entire colon - ulcerative colitis is known as
pancolitis
complications of ulcerative colitis
anaemia - iron def
raised inflammatory markers
dehydration
crohns disease
median age 30
- usually relapsing/remitting course
- characterised by an inflammatory change anywhere in the GI tract
- discreet. focal ulceration
- skip lesions
- terminal ileitis
complications of crohns disease
anaemia - absorption/blood loss
raised inflammatory markers
dehydration
Extraintestinal Manifestations of IBD
- Inflammatory arthropathies
- Erythema nodosum (Crohn’s)
- Pyoderma gangrenosum
- Primary sclerosing cholangitis (UC) • Iritis/Uveitis
- Aphthous stomatitis
Cancer in IBD
• Chronic inflammatory change damages cells
• This leads to dysplasia – loss of growth control
within cells
• Increased risk of colonic carcinoma
• More common in UC but also in extensive Crohn’s colitis
• Indeterminate colitis
– Colectomy specimens
• IBD unclassified (IBDU)
– Colonoscopic biopsies
Coeliac Disease
Autoimmune inflammation in small intestine due to presence of gluten proteins (resistant to digestion).
• Genetic susceptibility related to HLA-DQ2 and DQ8.
• T lymphocyte-mediated response to gliadin peptides with intraepithelial inflammation, production of tissue transglutaminase(anti- TTG) antibodies and cytokine cascade.
