Large Intestines Flashcards
Conditions
What is ulcerative colitis?
Inflammatory condition of the large bowel, only affects the large intestine
What pattern of inflammation is indicative of ulcerative colitis?
Continuous, from rectum extends proximally
What is it called if the inflammation is confined to the rectum?
Proctitis
What histological changes are seen in ulcerative colitis?
Reduced number of goblet cells
Increased number of Paneth cells
Crypts become longer and branched
Random ulceration in mucosal layer
How does ulcerative colitis usually present?
Diarrhoea containing fresh blood
Presence of pus/mucus
Abdominal pain
What complications can arise from ulcerative colitis?
2% risk of colorectal cancer
Rises to 10% if UC >25yrs
Haemorrhage can be life threatening
Chronic blood loss leading to iron deficiency anaemia
What is used to investigate suspected colitis?
Colonoscopy
What is used to treat ulcerative colitis?
5-aminosalicylic acid (5-ASA) e.g. sulfasalazine
What is Crohn’s disease
Inflammatory disease that can affect any of the intestine
What pattern of inflammation is indicative of Crohn’s?
Skip lesions
Areas of inflammation with healthy patches of tissue in between
Which areas of the GI tract can be affected in Crohn’s disease?
Anywhere from the mouth to the anorectum
Which areas are most affected in Crohn’s?
60% of cases affect the terminal ileum
Preferentially affects terminal ileum, colon and/or anorectum
What treatments are used in Crohn’s?
Steroids promote remission
long term prevention from azathioprine and 6-mercaptopurine (AZA & 6MP)
What causes gut ischaemia
atheromatous damage to blood vessels supplying the colon, causing necrosis
What predicts the prognosis of gut ischaemia?
Level of necrosis:
Mucosal
Mural
Transmural
