Inflammatory bowel disease: key differences

Question 1

Ulcerative colitis symptoms

Answer 1

blood diarrhoea
abdominal pain in LLQ
tenesmus (feeling of needing to shit but no shit to pass)

Question 2

crohn’s symptoms

Answer 2

non-bloody diarrhoea 
weight loss more prominant 
mouth ulcers 
perineal disease 
abdominal mass palpable in the right iliac fossa

Question 3

extra-intestinal UC

Answer 3

primary sclerosing cholangitis

Question 4

extra-intestinal crohn’s

Answer 4

gallstones are more common secondary to reduced bile acid reabsorption

Question 5

complications of UC

Answer 5

colorectal cancer more common

Question 6

complications of crohn’s

Answer 6

obstruction fistula

colorectal cancer

Question 7

UC pathology

Answer 7

inflammation always starts at rectum and never spreads beyond iceocaecal valve

Question 8

crohn’s pathology

Answer 8

lesions may be seen anywhwere from anus to mouth

skip lesions may be present

Question 9

IC histology

Answer 9

no inflammation beyond submucosa
inflammatory cell infiltrate in lamina propia, neutrophils migrate through the walls of the glands to form crypt abscesses.
depletion of goblet cells.
granulomas are infrequent

Question 10

crohn’s histology

Answer 10

inflammation in all layers from mucosa to secrosa

• increased goblet cells
• granulomas

Question 11

UC endoscopy

Answer 11

widespread ulceration with preservation of adjacent mucosa which has the appearance of polyps.

Question 12

chrohn’s

Answer 12

deep ulcers, skip lesions, cobble stone appearance