Inflammatory Bowel Disease (IBD)
PNN NAPLEX
Inflammatory Bowel
Disease (IBD) - answer.
inflammation of the colon and small intestine.
Two types:
Ulcerative colitis & Crohn's disease
ulcerative colitis (UC) - answeris an inflammatory disease
of the large intestine. Ulcers
form in the inner lining,
or mucosa, of the colon or
rectum, often resulting in
diarrhea, blood, and pus.
Crohn's disease - answeris an
inflammation that extends into
the deeper layers of the
intestinal wall. It is most often in
the ileum and the
cecum (ileocecal region
Ulcerative Colitis symptoms - answerBlood in the stool
Lower abdominal cramps
Relieved with bowel movement
Crohn's disease symptoms - answerNO blood in the stool
* Constant pain often in the right lower quadrant
* Not relieved with bowel movement
Ulcerative Colitis
Distal disease - answer(left-sided
colitis): colitis confined to the
rectum and sigmoid colon.
Distal colitis, potentially
treatable with enemas
More extensive disease
includes: *left-sided colitis*
(up to the splenic flexure),
extensive colitis (up to the
hepatic flexure)
, Pancolitis- affecting the
whole colon.
Ulcerative Colitis
Pathophysiology: - answerEtiology unknown
Inflammation localized to mucosa only (Crohn's
disease involves all the layers of bowel wall).
Involves rectum and extends to sections of colon.
Symptoms:
Intermittent bloody diarrhea
Rectal urgency
Abdominal pain
Rectal bleeding (helps to differentiate from Crohn's)
Treatment options for IBD - answerAnti-diarrheals: Loperamide (Imodium)
Salicylate drugs (more useful for UC)
Corticosteroids
Immunosuppressives (Azathioprine, 6-Mercaptopurine)
TNF-a-blockers
Infliximab, Adalimumab (Humira), Certolizumab (Cimzia)
Antibiotics (effective in long-term use for Crohn's only)
Surgery: UC patients are usually cured by removal of the
affected part of the colon.
CD symptoms return even after removal of the affected area.
Management of Mild-Moderate Disease
Mild to Moderate - answerno signs of dehydration, weight loss, or
abdominal tenderness.
Salicylates (5-ASA preparations):
* Mesalamine (Lialda, Apriso, Asacol, Asacol HD,
Deizicol, Pentasa, Canasa, Rowasa)
* Colazal (Balsalazide)
* Olsalazine (Dipentum) 500 mg PO bid
*Sulfasalazine (Azulfidine) (Do Not use in Sulfa Allergy)*
Oral Corticosteroids:
PNN NAPLEX
Inflammatory Bowel
Disease (IBD) - answer.
inflammation of the colon and small intestine.
Two types:
Ulcerative colitis & Crohn's disease
ulcerative colitis (UC) - answeris an inflammatory disease
of the large intestine. Ulcers
form in the inner lining,
or mucosa, of the colon or
rectum, often resulting in
diarrhea, blood, and pus.
Crohn's disease - answeris an
inflammation that extends into
the deeper layers of the
intestinal wall. It is most often in
the ileum and the
cecum (ileocecal region
Ulcerative Colitis symptoms - answerBlood in the stool
Lower abdominal cramps
Relieved with bowel movement
Crohn's disease symptoms - answerNO blood in the stool
* Constant pain often in the right lower quadrant
* Not relieved with bowel movement
Ulcerative Colitis
Distal disease - answer(left-sided
colitis): colitis confined to the
rectum and sigmoid colon.
Distal colitis, potentially
treatable with enemas
More extensive disease
includes: *left-sided colitis*
(up to the splenic flexure),
extensive colitis (up to the
hepatic flexure)
, Pancolitis- affecting the
whole colon.
Ulcerative Colitis
Pathophysiology: - answerEtiology unknown
Inflammation localized to mucosa only (Crohn's
disease involves all the layers of bowel wall).
Involves rectum and extends to sections of colon.
Symptoms:
Intermittent bloody diarrhea
Rectal urgency
Abdominal pain
Rectal bleeding (helps to differentiate from Crohn's)
Treatment options for IBD - answerAnti-diarrheals: Loperamide (Imodium)
Salicylate drugs (more useful for UC)
Corticosteroids
Immunosuppressives (Azathioprine, 6-Mercaptopurine)
TNF-a-blockers
Infliximab, Adalimumab (Humira), Certolizumab (Cimzia)
Antibiotics (effective in long-term use for Crohn's only)
Surgery: UC patients are usually cured by removal of the
affected part of the colon.
CD symptoms return even after removal of the affected area.
Management of Mild-Moderate Disease
Mild to Moderate - answerno signs of dehydration, weight loss, or
abdominal tenderness.
Salicylates (5-ASA preparations):
* Mesalamine (Lialda, Apriso, Asacol, Asacol HD,
Deizicol, Pentasa, Canasa, Rowasa)
* Colazal (Balsalazide)
* Olsalazine (Dipentum) 500 mg PO bid
*Sulfasalazine (Azulfidine) (Do Not use in Sulfa Allergy)*
Oral Corticosteroids:
