Irritable bowel disease

Question 1

Genetics and IBD

Answer 1

First degree relatives of IBD patients 3-20x more likely

Does not occur in Maori or PI

Question 2

Environmental

Answer 2

Common in western countries
Smoking increases risk of Chrons
Decreases risk of UC

Question 3

Pathophysiology

Answer 3

Disruption of the integrity of epithelial barrier
Dysregulation of innate and adaptive immunity leading to abnormal inflammation.
Certain microbes maybe pathogenic and initiate IBD

Question 4

UC pathology

Answer 4

Limited to colon

Mucosal inflammation, diffuse and granularNo macroscopic ulceration except in severe disease

Question 5

Histology

Answer 5

Lucosal inflammation only
Crypt branching and atrophy
Neutrophils invade crypts (abscess)
Loss of goblet cells
Invasion of paneth cells

Question 6

Clincal

Answer 6

Diarrhoea with bleeding
Frequent bowel motions
Adbo pain
Fever malaise weight loss

Question 7

Labs

Answer 7

Raised inflammatory markers ESR/CRP, platlets, neutrophils
Mild anaemia
Raised ferritin; if prolonged low ferritin

Question 8

Toxic megacolon

Answer 8

Dilated colon, treatment is surgery.