Med in Small Doses - Inflammatory Bowel Disease


This is part of the Med in Small Doses series, which aims to give you a snapshot of a disease or disorder. For information about the series, or common abbreviations click here. Run through how to perform gastrointestinal exam to refresh your memory, and link in clinical features.

Two major disorders: Ulcerative Colitis (UC) and Crohn's disease (CD)
There are other forms.     Indeterminate IBD (10-15%) 
Crohn's incidence rising.      Higher incidence of IBD in Jews, less in Black/Hispanics. 


PATHO: 
  • Genetics (better defined in CD); NOD2, ATG16L1, IRGM. 
  • Mucosal immune responses (not autoimmune). 
  • Epithelial defects: UC (ECM1) and CD (NOD2) 
  • Microorganisms: massive numbers 



CFs: A PIE SACK - Extraintestinal manifestations. 
A phthous ulcers 

P yoderma gangrenosum 
I ritis 
E rythema nodosum 

S clerosing cholangitis 
Arthritis (Ankylosing Spondylitis) 
C lubbing of fingertips 
K idney 

CROHNS UC
Bowel Region
Ileum/colon
Colon
Distribution
Skip Lesions
Continious/diffuse
Wall
Thick
Thin
Uclers
Deep
Superficial
Fat/Vitamin Malsorption
Yes
No
Malignant Potential
Yes
Yes
Toxic Megacolon
No
Yes

RFs: FHx (1st degree relative), Smoking (↓UC, ↑CD), Perinatal illness/health event.

Tx: Comparison Table - Wikipedia (IBD)
         Wikipedia.com
IBD: surgery indications "I CHOP".
I nfection 
C arcinoma 
H aemorrhage 
O bstruction 
P erforation

0 comments: