Wk 11: IBD Flashcards
What is crohn’s disease?
- In distal ileum/colon but can affect entire tract
- Inflammatory lesion -> ulceration of mucosa -> deeper layers
- Skip lesions - cobbled appearance
What is ulcerative colitis?
- Most common
- Affects colon (colonic mucosa)
- Characterised by diffuse inflammation + crypt abscesses
- 20% suffer from pancolitis
What are the signs and symptoms of CD + UC?
- Abdominal pain/cramping
- Diarrhoea
- Fever
- Fatigue
- Weight loss
- Mouth sores
What is the difference between abdominal pain in UC vs CD?
- UC: lower abdomen (colicky type pain)
- CD: RLQ + more prevalent
Why do patients with UC + CD get abdominal pain/cramping?
Inflammation/ulceration affect normal movement of intestines/colon, results in pain
What type of diarrhoea do patients with UC tend to present with?
Bloody, mucoid diarrhoea due to inflammation of mucosa
What is fatigue caused by in patients with UC + CD?
Development of anaemia
What is weight loss caused by in patients with UC + CD?
- Red ability to digest/absorb food
- Malasb
- Results in reduced BMI
Give examples of extra-intestinal manifestations that patients with UC + CD may experience
- Ankylosing spondylitis (spine/hip joint)
- Arthritis
- Erythema nodosum (skin flushing/tenderness)
- Uveitis (inflammation of eye)
- Aphthous ulcers (painful open ulcers)
- Failure to have children
What are the potential complications of both UC and CD?
- Inc risk of colon cancer
- Malnutrition - excess di + malabs
- Anaemia - bleeding from GI tract
- Meds
- Blood clots - pro-coaguable state during flare
- Primary sclerosing cholangitis
What are the risks associated with medication?
- Cancer (biological agents)
- Hypertension
- Osteoporosis - steroids w/ low BMI + malabs
What are the potential complications of crohn’s disease?
Bowel wall narrowing:
- Obstruction: strictures caused by spasms, scarring + oedema
- Fistulas: abnormal connection btw 2 areas of intestine
- Ulcers
- Anal fissures + perianal lesions (skin tags + abscesses)
What are the potential complications of UC?
Toxic megacolon
- Dilation of colon causing severe abdominal pain + tenderness
- High risk of bowel perforation
- Perforated colon
What are the risk factors of UC + CD?
- Age (UC 20-40, CD 15-40)
- Fx
- Infection
- Smoking
- Meds (NSAIDs)
What are the causes of UC + CD?
- Genetics
- Env
- Autoimmune (esp CD)
Outline how smoking has an effect on developing UC + CD
- Smoker: CD
- Non-smoker: UC
Which food have an affect on the already damaged mucosal lining?
- Caffeine
- Spicy
- Fatty
How is UC + CD diagnosed?
- Examination + history: abdomen tender + distended, blood
- Colonoscopy/sigmoidoscopy: 2 biopsies from 5 diff. sites
- Stool cultures: during flare
- Blood test
- Abdominal x-ray: rule out toxic megacolon
- Endoscopy: if inflammation high up in GI tract
What will be found in a normal blood test of a patient with UC + CD?
- Anaemia: FBC for iron/B12 deficiency
- Inflammation: inc WCC, platelet, ESR + CRP
- LFTs: red albumin, raised ALP, AST, ALP + bilirubin
- U+Es: dehydration
- Faecal calprotectin
Why are LFTs abnormal in a patient with UC or CD?
- Red albumin: malabs
- Raised ALP, AST, ALP + bilirubin: primary sclerosing cholangitis
What is calprotectin?
Protein released into faeces when neutrophils gather at inflammation site
Give examples of differential diagnosis that may be similar to UC + CD
- Colorectal cancer
- Infection
- Diverticular disease
- Irritable bowel syndrome
- Appendicitis
- Ectopic pregnancy
- Pelvic inflammatory disease
