Inflammatory Bowel Disease (LM) Flashcards
Inflammatory bowel dsease?
- IBD is a group of idiopathic chronic, relapsing-remitting inflammatory intestinal conditions
- Disrupts the body’s ability to digest food, absorb nutrition and eliminate waste
Types of inflammatory bowel disease?
- Crohns
- Ulcerative colitis
Ulcerative colitis?
- Disease is limited to the large intestine (colon) and the rectum
- The inflammation occurs only in the innermost layer of the intestinal lining,
Spread of ulcerative colitis?
Usually begins in the rectum and the lower colon but may also spread continuously to involve the entire colon; but may spread continuously to involve the entire colon.
Truelove and Witts severity index for ulcerative colitis?
THE MHB
1. Temperature
2. Heart rate
3. ESR
4. Movements/day (bowel movements)
5. Hb
6. Blood in stool
Mild UC?
T - apyrexia
HR <70/min
ESR<30
Movements<4
Hb>11g/dl
Blood in stool - none or small
Moderate UC?
T - 37.1-37.8
HR - 70-90/min
ESR<30
Movements - 4-6
Hb - 10.5-11g/dl
Blood in stool - moderate
Severe UC?
T>37.8
HR>90/min
ESR>30
Movements - 7-6
Hb <10.5g/dl
Blood in stool - large
Crohns disease?
There is transmural inflammation of the GI mucosa which can affect any part of the GI tract
Spread of Crohns disease?
- Most commonly affects the terminal ileum and colon
- Skip lesions present (affects some areas of the GI tract while leaving other sections completely untouched)
- prone to strictures, fistulas and adhesions
Why is CD associated with strictures?
inflammation occurs in all layers down to the serosa
UC vs CD?
CD - skip lesions
UC - continuous colonic involvement beginning in rectum
Indeterminate colitis?
- In some, it is difficult to determine whether their symptoms are due to Crohn’s disease or ulcerative colitis.
- There is no evidence of small bowel involvement, fistula or perianal disease. There is no diagnostic criteria for CD or UC by microscopy.
Epidemiology?
The peak age of onset of UC and CD is 15 to 30 years.
Second peak 60 to 80
Male:female UC 1:1 and CD 1.1:1.8
Smoking is associated with a two-fold increased risk of CD
If one has IBD the lifetime risk that a first degree relative will be affected is 10%.
More common in white people than in African or Asians ; higher risk in Jews- Ashkenazi jews have higher risk than Sephardic jews
Risk factors in IBD?
- Smoking associated with earlier age of onset of disease and more frequent need for immunosuppression among women with Crohn’s disease but not men
- Smoking cessation is associated with an increased risk of ulcerative colitis.
