Inflammatory Bowel syndrom 2- د.مازن عبد الله Flashcards
what the defination of the of diarrhea ?
- pass 3 or more bowel each day
- loose or liquid movement
when we called diarrhea persistant ?
last for 14 days or longer
what the inflammtory bowel disease include ?
1- ulcerative colitis
2- crohn’s disease
3- indeterminate colitis
which age group will have ulcerative colitis ?
30 and 40
which age group will have crhon disease ?
young ( 15 and 30)
elderly (55and 60)
what’re the causes of the inflammatory bowel disease?
1- enviromental as diet , infection , smoking , aclcohol, oral contaceptive
2- family history 10-30%
3- Autoimmune mechanism
4- bacterial as
Mycobacterium paratuberculosis
Listeria monocytogenes
5- virus paramyxovirus and measles
whats the dignosis of the ulcerative colitis ?
uc —
-histology
colonic mucosa and submucosa are infiltrated with inflammatory cells with atrophy of the mucosa and crypt abccess with continuous involvement of the rectum and colon;
-Endoscopy & proctoscopy
mucosa is frequently friable with multiple inflammatory pseudopolyposis.
mucos is edmatous in first stage
then ulcerative in the advanced stage
Barium enema
In long standing UC, the colon is foreshortened and lacks haustral marking (lead pipe colon).
-long standing ulcerative colitis the colon is foreshortened
and (lead pipe )the mucosa replaced by scar but in quiescent ulcerative colitis , the colonic mucosa may appear normal
endoscopically and microscopically
does the ulcerative colities involve the colon ?
-affact colon but doesn’t involve the small intestine, but the terminal ileum may demonstrate inflammatory changes (backwash ileitis).
-continuous involvement of the rectum and colon is the key feature of the ulcerative colitis
but the rectal Sparing or skip lesions suggest a diagnosis of Crohn’s disease.
Clinical features of the ulcerative colitis ?
syptomas
- bloody diarrhea and crampy abdominal pain ,fever
- tenesmus produce by Proctitis
signs
- minimal abdominal tenderness
- distension to frank peritonitis
whats the crohn disease ?
is a transmural inflammatory process that can affect any part of the GI tract from mouth to anus.
with skip lesion while the ulcerative colitis is contious
Chronic inflammation can ultimately
result in fibrosis, stricture, and fistulas
in either the colon or small intestine
dignisis of the crhon disease ?
histology
- transmural inflammation all the layers involve with skipped lesions
- deep serpiginous ulcers قرح زاحفه
- cobblestone appearance.
- Skip lesions and rectal sparing are common.
whatre the features of the crhon disease ?
1-diarrhea, crampy abdominal pain, and fever
2-Strictures may produce symptoms of
obstruction
3- Weight loss is common because of:
- obstruction
- protein loss.
4-Extra intestinal manifestations
•Liver is common site
-Fatty infiltration(reversible with medical treatment)
-Cirrhosis
-Primary sclerosing cholangitis
-Pericholangitis
-Bile duct carcinoma
• Arthritis, sacroiliitis and ankylosing spondylitis
• Erythema nodosum, pyoderma gangernosum
• Ocular lesion such as uveitis, iritis and conjunctivitis
Ulcerative colitis is characterized..
by remissions and exacerbations.
The onset of UC may be
onset of UC may be insidious with minimal bloody stool or the onset
can be abrupt with severe diarrhea and bleeding, tenesmus, abdominal pain and fever.
what the differnatial dignosis of the Crhons disease ?
- Indeterminate colitis
- Infectious colitis as Entamoeba histolytica, C. difficile, Salmonella and Shigella
