Inflammatory Bowel Disease
What are the two types of IBD? - answer Ulcerative Colitis and Crohn's disease
Compare and contrast the two types of IBD by describing the type of inflammation and
where it occurs. - answerUC is a inflammation of superficial mucosal layer (epithelium,
mucosa, submuscosa) of rectum and colon.
CD is a transmural inflammation of the GIT that can affect any part from the mouth to
the anus (terminal ileum is the most common site)
What are the different etiologies of IBD? - answer Environment (infection, smoking,
stress, abx, NSAIDS)
Genetic Susceptibility (caucasians especially Jews, seen in family histories!)
Immunological factors
Hallmark symptoms of UC - answer Blood diarrhea (hallmark!!), rectal urgency,
tenesmus (painful spasm of rectal spinchter), abdominal cramping during defecation
Clinical features of Crohn's dz - answerAbdominal pain, diarrhea (only 50% bloody, not
as severe as UC), low grade fever, malaise, weight loss, fistulas, perirectal abscesses,
malabsorption, palpable mass
Initial evaluation of IBD (labs, imaging, etc)? - answerTake CBC (look for anemia from
bleeding), CrP, CMP (electrolyte loss from diarrhea, LFTs), stool studies (culture- rule
out infx; check for blood; check for lactulose intolerance), Vitamin D and B12, TPMT
enzyme.
Endoscopy, colonoscopy, EGD, ileoscopy
CT enteroclysis is gold standard (SBFT if cannot get CTE)
Local complications of UC - answerhemorrhoids, anal fissures, RARE fistula formations,
perirectal abscesses, toxic megacolon, colonic hemorrhage, colon cancer
Local complications of CD - answersmall bowel stricture, intestinal obstruction, fistulas
(common), bleeding
Hepatobiliary complications of both types of IBD - answer-Hepatic: fatty liver,
pericholangitis, chronic active hepatitis, cirrhosis
-Biliary: sclerosing cholangitis, cholangiocarcinoma, gallstones (more common with CD)
Joint and bone complications of IBD - answerarthritis, arthralgias, migratory, affects
large joints > small joints
-metabolic bone disease, osteoporosis
What are the two types of IBD? - answer Ulcerative Colitis and Crohn's disease
Compare and contrast the two types of IBD by describing the type of inflammation and
where it occurs. - answerUC is a inflammation of superficial mucosal layer (epithelium,
mucosa, submuscosa) of rectum and colon.
CD is a transmural inflammation of the GIT that can affect any part from the mouth to
the anus (terminal ileum is the most common site)
What are the different etiologies of IBD? - answer Environment (infection, smoking,
stress, abx, NSAIDS)
Genetic Susceptibility (caucasians especially Jews, seen in family histories!)
Immunological factors
Hallmark symptoms of UC - answer Blood diarrhea (hallmark!!), rectal urgency,
tenesmus (painful spasm of rectal spinchter), abdominal cramping during defecation
Clinical features of Crohn's dz - answerAbdominal pain, diarrhea (only 50% bloody, not
as severe as UC), low grade fever, malaise, weight loss, fistulas, perirectal abscesses,
malabsorption, palpable mass
Initial evaluation of IBD (labs, imaging, etc)? - answerTake CBC (look for anemia from
bleeding), CrP, CMP (electrolyte loss from diarrhea, LFTs), stool studies (culture- rule
out infx; check for blood; check for lactulose intolerance), Vitamin D and B12, TPMT
enzyme.
Endoscopy, colonoscopy, EGD, ileoscopy
CT enteroclysis is gold standard (SBFT if cannot get CTE)
Local complications of UC - answerhemorrhoids, anal fissures, RARE fistula formations,
perirectal abscesses, toxic megacolon, colonic hemorrhage, colon cancer
Local complications of CD - answersmall bowel stricture, intestinal obstruction, fistulas
(common), bleeding
Hepatobiliary complications of both types of IBD - answer-Hepatic: fatty liver,
pericholangitis, chronic active hepatitis, cirrhosis
-Biliary: sclerosing cholangitis, cholangiocarcinoma, gallstones (more common with CD)
Joint and bone complications of IBD - answerarthritis, arthralgias, migratory, affects
large joints > small joints
-metabolic bone disease, osteoporosis
