WEEK 4 - Inflammatory Bowel Conditions Flashcards
What are the differences between Crohn’s Disease and Ulcerative Colitis?
UC: colon only, continuous retrograde inflammation beginning at rectum, mucosal inflammation, no granulomas, crypt distortion, loss of haustra , pseudopolyps
CD: anywhere (mouth to anus), discontinuous inflammation (skip lesions), transmural inflammation, granulomas may be present, extracolonic disease (abscesses, fistulae, perianal disease), thickened wall, “cobble stoning”
What is chronic inflammation?
Inflammation doesn’t resolve normally - prolonged inflammatory response.
Lack of clear resolution.
Inflammation is self perpetuating.
Persistent.
Damage of tissue.
New connective tissue formation (scarring, fibrosis).
Granuloma formations in CD
What is ulcerative colitis?
Diffuse inflammation of the mucous membrane of the colon.
Confined to colon only.
Clinical manifestations vary with location, extent and severity of disease.
What is ulcerative proctitis?
Inflammation confined to the rectum.
Main symptom = passing fresh blood of blood stained mucous.
May have diarrhoea, normal stools or constipation.
Inflammation can causes urgent need to pass stool.
Tenesmus - feeling of incomplete stool excretion.
What is left sided colitis (distal colitis)?
Inflammation starts in the rectum and extends up through the left side of the colon up to the splenic flexure.
Symptoms = bloody diarrhoea, mucous, pain in L) side of abdo, urgency, tenesmus.
What is pancolitis?
Inflammation of an extensive length of the colon.
Symptoms = frequent diarrhoea with blood, mucous, sometimes pus, severe abdo cramps & pain, tenesmus, weight loss.
What is acute severe ulcerative colitis?
Very severe diarrhoea with blood, mucous, sometimes pus.
Severe abdo cramps & pain, tenesmus, weight loss.
Nocturnal diarrhoea.
Medical emergency - usually requires hospitalisation.
What are complications of ulcerative colitis?
Change of structure & function of bowel Anaemia Haemorrhage Perforation Toxic megacolon
What is Crohn’s Disease?
Affects any part of the GIT from mouth to anus.
Most common = terminal ileum (1st) then colonic (2nd).
Patchy inflammation, skip lesions.
Inflammation of the bowel wall.
Clinical manifestations vary with extent, severity of disease & complications.
What are S&S of terminal ileo and ileo-caecal Crohn’s disease?
Right lower abdo pain
Impaired bile salt absorption
Impaired vit B12 absorption
Diarrhoea or constipation
What are S&S of small bowel Crohn’s disease?
Abdo pain and diarrhoea.
The diarrhoea is unlikely to be blood stained as blood will be degraded by digestive processes.
What are S&S of colonic Crohn’s disease?
Blood stained diarrhoea.
Frequent bowel actions, especially if sigmoid & rectum involves.
Often called Crohn’s colitis.
What are S&S of penetrating Crohn’s disease?
Anal fissures Skin tags Fistulas Abscesses Perforation
What is stricturing Crohn’s disease?
Ongoing episodes of inflammation & healing - fibrotic tissue - stricture.
Symptoms = cramping abdo pain, nausea, abdo bloating, constipation, loud bowel noises.
Strictures can lead to partial or complete bowel obstruction.
Solutions: dilatation, strictureplasty, bowel resection.
What are complications of IBD?
Malnutrition Osteoporosis Anaemia Fatigue IBS Psychosocial
