MP322 - MANAGEMENT OF IBD

Question 1

inflammatory bowel disease

Answer 1

ulcerative colitis and Crohn’s disease
- both characterised by inflammation, swelling and ulceration of intestinal tissue
- symptoms include stomach pain, weight loss, diarrhoea (blood/mucus) and tiredness

Question 2

ulcerative colitis

Answer 2

only affects the large bowel and the inflammation is on the inner lining

Question 3

Crohn’s disease

Answer 3

can affect any area of the GI system and all layers of tissue can be inflamed

Question 4

causes of IBD

Answer 4

• genetic links
• autoimmune disease
• environmental
• previous infection

Question 5

Corticosteroids

Answer 5

hydrocortisone, beclomethasone, budesonide, prednisolone
- anti-inflammatory
- administered orally or rectally
- GR or MR formulations or enemas and foams

Question 6

cautions of corticosteroids

Answer 6

congestive heart failure
hypothyroidism
osteoporosis
untreated infection

Question 7

side effects and interactions of corticosteroids

Answer 7

insomnia, dyspepsia, impaired hearing, Cushing’s syndrome, adrenal suppression
(long-term use)

grapefruit juice increases plasma concentration of oral budesonide, corticosteroids antagonise diuretics effects

Question 8

aminosalicylates

Answer 8

balsalazide, mesalazine, olsalazine, sulfasalazine
- administered orally or rectally
- limit the inflammation in the lining of the GI tract
- renal function needs to be checked before starting oral therapy

Question 9

immunosuppressants

Answer 9

Azathioprine, ciclosporin, mercaptopurine, methotrexate
- dampens the body’s immune response
- administered orally or by injection

anticancer drugs with blood and liver toxicity so require regular monitoring of blood counts and oral function

Question 10

non-drug treatment

Answer 10

• smoking cessation
• attention to diet (low residue duet, trigger foods)
• surgery (stoma, resection operations)