Lecture 15 Flashcards
inflammatory bowel disease is mainly 2 conditions
Crohn’s/ UC
both have similar symptoms…
diarrhoea, rectal bleeding, abdominal pain, weight loss and fatigue
crohn’s can affect…
any part of the Gi tract- most common part is the terminal ileum
there are skip lesions in
Cronh’s-
UC only affects the
large intestine but will affect the rectum
UC affecting just the rectum=
proctitis
UC affecting bottom part of the colon=
distal colitis
both also cause…
extra intestinal manifestations
fistulae is the…
connection between 2 loops of bowel or bowel/skin
deep fishering ulcers form in
Crohns’ cause it can go all the way through bowel wall
UC is a superficial mucosa disease-
generally confined to bowel surface
in UC neutrophils form in the
crypt abscesses
IBD has variable….
age of onset and behaviour
UC- _ will have one or more relapse after first attack
90%
UC- early relapse in first 2 years associated with
worse disease course later
Cd- _ will undergo surgery within 10 years of diagnosis
50%
CD- at 20 years only _ will have experienced long term remission
10%
CD- steroids within 3 months of diagnosis predictive for…
need of surgery
CD behaviour varies over time:
inflammation -> stricturing ( narrowing down of blood lumen)/penetrating
IBD is prevalent in…
industrial countries/ ones with westernised food habits
we known that iBD is an _ response to _ or _ in a genetically pre-disposed individual
aberrant inflammatory
host microbial
environmental factors
have many genes have been associated with IBD
around 300
smoking makes _ worse but _ less likely
Crohn’s worse but UC less likely
medications could mimic IBD- e.g., ….
non-steroidal anti-inflammatory drugs (ibroprofen) can cause ulceration internally
having an appendicectomy is more common in people who develop _ but protective in _
Crohn’s
UC
IBD- there are defects in the _- loss of _ and do there is translocation of microbes through tissue- activating immune cells
barrier function
loss of mucus
genetic architecture sub-stratifies and defines relationship of IBD location (,,,)
NOD2, MHC, MST1, 3p21
NOD2 is particularly associated with
Crohn’s at ileum
strong genetic distinction between _ and _
colonic and ileal Crohn’s
invasive investigations remain gold standards for diagnosis/ongoing assessment:
- ileo-colonoscopy
- MRI/CT/US
- others: capsule endoscopy/MRCP/ERCP
in IBD white speckles seen in branching blood vessels =
mucus
in severe colitis there is loss of the _ and there are _. also loss of _ and bleeding
vessels
erosions
epithelium
_ and _ are predominant in IBD
Th17 and Th1
top-down approach use the…
powerful medications first
azathioprine suppresses the…
immune response
step up approach starts with….
gentle anti-inflammatories
what therapy coats the lining of the colon
5-ASA
NOD2 gene drives the highest…
risk of IBD-its a bacterial sensing gene
