Ulcerative colitis, CD

Question 1

Inflammatory bowel disease

Answer 1

1. Mc - Chrons
2. Ulcerative colitis
3. Bloody diarrhoea
4. Inc CRP, ESR,
   Dxt - sigmoidoscopy, colonoscopy, ileoscopy
5. 2nd yearly colonoscopy with multiple biopsies after 7-10yrs of development of disease
   -to exclude colon cancer

Question 2

Ulcerative colitis

Answer 2

1. Colon exclusively
2. Blood in stools
3. DOC - Mesalazine/5-ASA (amino salycilic acid)
   ●bound to
   another 5-ASA (Olsalazine) Sulfapyridine (salzopyrin)
   Mesasal/salofalk Suppository - Pentasa
   ●Rx and maintanence
   ●Protective against colorectal CA
4. Steroids - 2nd line
5. Immunosupression - methotrexate/azathioprine
   ●In chronically active cases
   ●Where mesalazine not enough
6. Sx: Rectum, colon removed. Ileal pouch formed
   ●Complications:
   Pouchitis, 4-5watery diarrhoea per day

Question 3

Chrons disease

Answer 3

1. More complicated than UC
2. *STOP SMOKING
3. Immunosupp - azathioprine (takes 3-6mo to act)
4. Steroids (DOC) given until azathioprine starts acting
5. Antibiotics
6. Infliximab