The Pathology of IBD

Question 1

crohns disease

Answer 1

chronic inflammatory and ulcerating condition of the GI tract that can affect anywhere from the mouth to the anus

younger patients
more common in males

Question 2

crohns disease - presentation

Answer 2

abdominal pain 
small bowel obstruction
diarrhoea
bleeding PR
anaemia
weight loss

Question 3

crohns disease - clinical course

Answer 3

chronic
exacerbations and remissions
unpredictable response to therapy

Question 4

crohns disease - pathology

Answer 4

segmental disease - patchy
ileal and/or colonic chronic active mucosal inflammation (crypititis, crypt abscesses)

transmural inflammation

deep knife-like fissuring ulcers

granulomas - 50% non-caseating

Question 5

crohns disease - complications

Answer 5

malabsorbtion
iatrogenic
hypoproteinemia, vitamin deficiency, anaemia
gallstones

fistulas
vesicocolic, enterocoli, gasztrocolic, recto vaginal, tuboovarian abscess, blind loop syndrome

anal disease
sinuses, fissures, skin tags, abscesses, perineum falls apart

intractable disease
failure to tolerate or respond to medical therapy, continuous diarrhoea or pain, may require surgery

bowel obstruction
perforate
malignancy
amyloidosis

Question 6

ulcerative colitis

Answer 6

chronic inflammatory disorder confined to colon and rectum

mucosal and submucosal inflammation

almost always involving the rectum

Question 7

ulcerative colitis - presentation

Answer 7

diarrhoea, mucus and blood PR

Question 8

ulcerative colitis - clinical course

Answer 8

chronic course with exacerbations and remission, continuous low grade activity, single attack , acute fulminant colitis

Question 9

ulcerative colitis - pathology

Answer 9

continuous diffuse disease
rectal involvement
superficial ulceration and inflammation
chronic active colitis
no granulomas

Question 10

ulcerative colitis - complications

Answer 10

intractable disease
toxic megacolon
colorectal carcinoma
blood loss
electrolyte disturbacnc
anall fissures
extra GI manifestations