Inflammatory bowel diseases (Crohns Disease and Ulcerative Colitis) Flashcards
What is Crohns Disease?
Granulomatous Inflammation that occurs anywhere in the GI tract (from mouth to anus).
Discontinuous spread of disease.
What are the causes of Crohns Disease?
Food intolerance
Persistent viral infection/immune system activity
Mycobacterium (paratuberculosis) infection
Describe granulomatous inflammation and its role in Crohns disease.
A collection of multinucleate cells - which are not easily phagocytosed - form together.
The immune system continuously tries to phagocytose these cells which results in irritation and damage to the bowel.
Who’s is commonly affected by Crohns disease?
Young individuals
What areas of the GI tract are commonly affected by Crohn’s disease?
The terminal ileum, the ileocaecal junction, the mouth and the rectum.
What does Crohns of the terminal ileum and ileocaecal junction cause?
Malabsorption of Vitamin B12.
What is the physical presentation of Crohns in the bowel?
Inflammation
Oedema - from the granulomas blocking the lymphatic system.
Narrowing of the lumen
Cobblestoning
Thickening of the bowel wall
Abscesses that extend outside of the bowel wall
Describe how fistulas occur in Crohn’s disease.
Since the bowel loops are closely packed together - inflammation in one area spreads to a loop nearby and creates a fistula between the 2 loops.
What are the symptoms of Crohns disease?
Depends which are of the GI tract is affected.
Colon:
Abdominal pain
Diarrhoea
Bleeding
Small Bowel:
Pain from the narrowing/obstruction
Malabsorption
Mouth:
Oral granulomas - no discomfort
Gingivitis
What is the medical treatment for Crohns disease?
Medical: Immunosuppressants: Systemic steroids e.g. prednisolone - useful since Crohns extends throughout the whole bowel wall. Non-steroidal immunosuppressants
Anti-inflammatory drugs
Anti TNF drugs - prevents inflammation
What is the surgical treatment for Crohn’s disease?
Remove obstructed part of the bowel
Drain abscesses
Close the fistula
Usually fitted with a stoma bag.
What causes Ulcerative colitis?
Immune system
Genetics
What areas of the GI tract are affected by Ulcerative colitis?
Rectum and colon
Starts at the rectum and moves up into the colon.
Continuous spread of disease.
What are the symptoms of ulcerative colitis?
Abdominal pain
Bleeding
Diarrhoea
What are the complications of ulcerative colitis?
Carcinoma can develop
The longer the disease is active the higher the risk
What is the medical treatment for Ulcerative colitis?
Immunosuppressants:
Topical steroids - rectally administered
Non-steroidal immunosuppressants
Anti-inflammatory drugs
Anti TNF drugs
What is the surgical treatment for Ulcerative colitis?
Colectomy - cures UC
What areas are affected by ulcerative colitis in proctitis?
The rectum only
What areas are affected by ulcerative colitis in proctosigmoiditis?
The rectum and the sigmoid colon
What areas are affected by ulcerative colitis in distal colitis?
The left side of the colon (descending end)
What areas are affected by ulcerative colitis in Pancolitis?
The entire colon
What areas are affected by ulcerative colitis in backwash ileitis?
The distal ileum/terminal
Compare the features of Crohns to Ulcerative colitis.
Crohns:
Discontinous
Affects anywhere in the GI tract mouth to anus
Extends throughout the entire bowel wall
Non-vascular
Ulcerative Colitis: Continuous Affects the rectum and the colon. Superficial - only affects the surface layer of the bowel. Vascular
Compare the microscopic features of Crohns to Ulcerative colitis.
Crohns:
Transmural - extends throughout the whole bowel wall
Oedematous
Granulomatous
Ulcerative Colitis:
Vascular
Mucosal abscesses
Mucosal
