Irritable bowel disease Flashcards
What are the symptoms of IBD?
- Abdominal pain
- Diarrhoea
- Rectal bleeding
- Fever
- Anal fissure
- Weight loss
What are the two types of IBD?
Chrons and Ulcerative colitis
What are the risks associated with IBD?
- Gi tract narrows and causes perforation
- Fistula - abnormal connection between 2 body parts
- Malnutrition
- Anaemia
- Arthritis & osteoporosis
Where is the pain typically for chrons ?
typically pain is lower right side of abdomen
What is the treatment for Chrons?
Mnemonic : ACT BAD
* Aminosalicylates – sulfasalazine , mesalazine, olsalazine
* Corticosteroids – prednisolone, methylprednisolone, budesonide, hydrocortisone
* Thiopurine (immunosuppressants) – azathioprine, mercaptopurine, methotrexate
* Biological agents (Monoclonal antibodies) – infliximab, adalimumab, goli
* Antibiotics
* Diarrhoea (loperamide + codeine) and constipation (osmotic laxative)
Where is the pain typically loacted for Ulcerative colitis?
Ulcerative colitis - typically pain is lower left side of abdomen
What is the treatment for acute mild to moderate UC?
Proctitis – 1st line (topical Aminosalicylates (enemas)), if remission not achieved add oral aminosalicylate
If no improvement within 4 weeks then add oral or topical corticosteroid for 4 – 8 weeks
What is the treatment for proctosigmoiditis?
Proctosigmoiditis & left sided UC – 1st line (topical aminosalicylate) (mild to moderate)
if remission not achieved within 4 weeks - consider adding a high dose oral aminosalicylate.
What is the treatment for Extensive UC?
1st line (topical aminosalicylate and high dose oral aminosalicylate
What is the treatment for Severe acute UC?
IV corticosteroids & infliximab
What drugs are contraindicated in acute ulcerative colitis?
loperamide and codeine as it can cause toxic megacolon
What is the treatment for maintaining remission in UC ?
- Use Aminosalicylates
- Avoid corticosteroid
- Thiopurines used when two or more inflammatory exacerbation in a 12-month period that required systematic corticosteroids
