L24 Lower GI pathology Flashcards
Coeliac disease: characteristics
autoimmune
damages mucosa of small intestine which leads to generalized malabsorption because folds are flattened
Coeliac disease: pathogenesis
uptake and processing of gluten peptides
T cell activation
tissue damage
Coeliac disease: what are gluten peptides made up of
proline rich and glutamine rich proteins
Coeliac disease: symptoms
diarrheoa, pain, deficiencies, fatigue, bloating
extra-intestinal: altered LOC, anaemia, malignancies
Coeliac disease: diagnosis
gluten challenge diet, blood tests, endoscopy + biopsy (essential to confirm)
Coeliac disease: treatment
GF diet
Coeliac disease: complications
other autoimmune, chronic inflammation in other organs, deficiencies, malignancies
Pathogenesis of IBD
defective host interactions with intestinal microflora, epithelial dysfunction, mucosal inflammatory response
IBD complications
osteoporosis, skin problems, arthritis
Crohn’s: characterisitcs
familial, more females than males, TNF-alpha major is a factor, more common in smokers
Crohn’s: symptoms
intermittent attacks, malabsorption, weight loss, extra-intestinal manifestations
Crohn’s: macroscopic
skip lesions (cobblestone appearance), transmural inflammation (abcesses), strictures, thickened mesentery, creeping fat
Crohn’s: microscopic
transmural inflammation, acute inflammation, crypt abscesses, oedema, chronic mucosal damage (granulomas without caseous necrosis)
Crohn’s: complications
bowel obstruction, ulcers, malabsorption, fistulas to other organs, carcinoma, anaemia
Crohn’s: treatment
no cure, corticosteroids, biologics, surgical resection
Ulcerative colitis: characteristics
bimodal distribution of onset (middle age and older) more common in non-smokers only affects colon predominantly only mucosa can be divided by location
Ulcerative colitis: symptoms
pain, blood in stool, diarrhoea
Ulcerative colitis: stages and macroscopic appearance
- early: mucosal surface is red, oedema, granular, covered with yellow exudates and bleeds, superficial ulcers
- progressive: mucosal folds atrophy, inflammatory polps (all normal layers of mucosa), pseudopolyps (granulation tissue)
- advanced: shortening of LI, mucosal folds are indistinct (cobblestoneing or smooth)
Ulcerative colitis: clinical features
mild - rectal bleeding
moderate - loose, bloody stools and pain and anaemia
severe - lots of bad bowel movements, anaemia, dehydration
Ulcerative colitis: treatment
mild - 5-aminosalicylate-based compounds
moderate - corticosteroids, immunosuppressive + regulatory agents
severe - surgery
