Inflammatory Bowel Disease (IBD)

Question 1

inflammatory bowel disease

Answer 1

• inflm of large and small intestine

- chronic and progressive disease

Question 2

2 chronic diseases

Answer 2

• Crohn’s disease

- Ulcerative Colitis

Question 3

etiology

Answer 3

• genetic susceptibility
• lose self-tolerance for normal gut flora d/t affected HLA/MHC genes; immune system targets bacteria attached to gut wall –> inflm
• environmental triggers (d/t complex trait etiology)

Question 4

Crohn’s disease type of lesions and affected area

Answer 4

• granulomatous, inflammatory skip (non-continuous) lesions seen in small and large intestine
• primarily affects submucosa of terminal ileum
• slowly progressive, non-aggressive disease

Question 5

submucosa

Answer 5

2nd layer of dense irreg CT

Question 6

terminal ileum

Answer 6

end of small intestine

Question 7

mnfts of Crohn’s disease

Answer 7

• intermittent diarrhea
• colicky pain (spasmodic) in abd
• weight loss
• fluid & electrolyte imbal d/a diarrhea

Question 8

why is weight loss mnft of Crohn’s disease

Answer 8

• Crohn’s disease mainly affects the terminal ileum
• ileum’s major Fx is absorption
• damage to intestinal wall impairs absorption Fx (nutrients not absorbed as effectively)
• also d/t diarrhea

Question 9

cmplx of Crohn’s disease

Answer 9

• fistulas
• abscesses
• bowel obstruction
• stricture

Question 10

fistulas

Answer 10

refers to an abn passage b/w hollow of tubular organ and body surface or b/w 2 hollow or tubular organs

Question 11

abscesses

Answer 11

swollen area of body containing accumulation of pus (perianal area)

Question 12

stricture

Answer 12

constriction of tube (aka intestine, may result in obstruction)

Question 13

Ulcerative Colitis lesion and affected area

Answer 13

• continuous ulcerative lesions (ulcers)
• at terminal part of large intestine
• primarily affects mucosa of colon & rectum (inner lining of lumen)

Question 14

continuous lesions

Answer 14

• crypt abscesses
• bleeding ulcers
• thickened and inflamed tissue
• pseudopolyps

Question 15

crypt abscesses

Answer 15

• crypts normally secrete digestive Es and regenerate new tissue when damaged
• accum of pus in crypts prevents regrowth of new tissue (leads to colorectal CA)

Question 16

pseudopolyps

Answer 16

• polyps = invagination of granulation tissue into lumen (opposite of outpouching)
• contains inflammatory tissue and large amount of exudate produced
• can result in edema & fluid in lumen –> congestion

Question 17

mnfts of ulcerative colitis

Answer 17

• intermittent, bloody diarrhea (d/t ulcers)

- abd cramping

Question 18

Dx of ulcerative colitis

Answer 18

• Hx, Px
• scoping (colonoscopy, sigmoidoscopy)
• lab tests to exclude GI infections

Question 19

Tx (long-term management) for ulcerative colitis

Answer 19

• meds: anti-inflm, steroids, immunoregulatory drugs, Abx
• Sx if needed
• lifestyle modifications

Question 20

why Abx needed (ulcerative colitis)

Answer 20

to control overgrowth of normal flora

Question 21

when is Sx required (ulcerative colitis)

Answer 21

• fistulas causing bowel obstruction
• draining bleeding ulcer
• bowel resection (remove part of or entire bowel)