W1- Inflammatory bowel disease (IBD)
What are the two inflammatory bowel diseases? – answer Crohn's disease and
ulcerative colitis
what is the pathophysiology of IBD? – answer TBD is a toxic response to the contents
of the lumen
what are 4 contents of the lumen that could trigger IBD? - answer-specific microbial
pathogen
-abnormal luminal contents or increased absorption of luminal macromolecules
-enhanced immune response to normal constituents of the bowel
-autoimmune response to epithelial cells, mucus glycoproteins or immune cells
why is incidence and prevalence of IBD increasing in developing countries? -
answerimproved sanitation and health means that there is reduced exposure to enteric
infections, leading to an immature immune system
what are the 3 components involved in the development of IBD? - answer-luminal
antigens
-genetic susceptibility
-environmental agents (eg infection- TB, measles)
what does diagnosis of IBD depend on? - answerclinical, laboratory (serology, culture),
radiological, endoscopy and histological findings
what are some examples of extra-intestinal manifestations of IBD? - answer-liver
pathology
-cholelithiases (solid concentrations in the gallbladder) and primary sclerosing colangitis
(disease of biliary tract)
-skin changes- pyoderma gangrenosum (ulcers), erythema nodosum (inflammation of
subcutaneous fat)
-eyes- irisitis, uveitis, episcleritis
-joints- ankylosing spondylitis
, what is Crohn's disease? - answera chronic inflammatory bowel disease that affects the
lining of the digestive tract.
what is the epidemiology of Crohn's disease? - answer-highest in northern Europe and
US, incidence rising in Asia
-varies from 4-65 per 100,000 population)
-peak incidence between 20-30 and between 60-70
-becoming more prevalent than ulcerative colitis
what causes the genetic predisposition to Crohn's disease? - answer-HLA-DR1 and
DQw5 gene mutations
-prevents a controlled and effective immune response to a causative agent
what is the pathophysiology of Crohn's disease? - answer-begins with crypt
inflammation and abscesses
-progresses into tiny focal aphthoid ulcers
-these mucosal lesions may develop into longitudinal and transverse ulcers with
intervening mucosal oedema, creating a characteristic 'cobblestone' appearance
what are 3 potential causes of Crohn's disease? - answer-cigarette smoking- increases
risk in genetically susceptible individuals
-microvascular infarction (eg from oral contraceptive pill use)
-infective agent triggers (eg mycobacteria, measles)
where in the GI tract is most commonly affected in Crohn's disease? - answersmall
intestine
(but any part of intestinal tract may be affected)
what does the presentation of Crohn's disease depend on? - answerdisease location in
the GI tract
what is the presentation of Crohn's disease when the upper GI tract/small intestine is
affected? - answer-severe abdominal pain
-vomiting
What are the two inflammatory bowel diseases? – answer Crohn's disease and
ulcerative colitis
what is the pathophysiology of IBD? – answer TBD is a toxic response to the contents
of the lumen
what are 4 contents of the lumen that could trigger IBD? - answer-specific microbial
pathogen
-abnormal luminal contents or increased absorption of luminal macromolecules
-enhanced immune response to normal constituents of the bowel
-autoimmune response to epithelial cells, mucus glycoproteins or immune cells
why is incidence and prevalence of IBD increasing in developing countries? -
answerimproved sanitation and health means that there is reduced exposure to enteric
infections, leading to an immature immune system
what are the 3 components involved in the development of IBD? - answer-luminal
antigens
-genetic susceptibility
-environmental agents (eg infection- TB, measles)
what does diagnosis of IBD depend on? - answerclinical, laboratory (serology, culture),
radiological, endoscopy and histological findings
what are some examples of extra-intestinal manifestations of IBD? - answer-liver
pathology
-cholelithiases (solid concentrations in the gallbladder) and primary sclerosing colangitis
(disease of biliary tract)
-skin changes- pyoderma gangrenosum (ulcers), erythema nodosum (inflammation of
subcutaneous fat)
-eyes- irisitis, uveitis, episcleritis
-joints- ankylosing spondylitis
, what is Crohn's disease? - answera chronic inflammatory bowel disease that affects the
lining of the digestive tract.
what is the epidemiology of Crohn's disease? - answer-highest in northern Europe and
US, incidence rising in Asia
-varies from 4-65 per 100,000 population)
-peak incidence between 20-30 and between 60-70
-becoming more prevalent than ulcerative colitis
what causes the genetic predisposition to Crohn's disease? - answer-HLA-DR1 and
DQw5 gene mutations
-prevents a controlled and effective immune response to a causative agent
what is the pathophysiology of Crohn's disease? - answer-begins with crypt
inflammation and abscesses
-progresses into tiny focal aphthoid ulcers
-these mucosal lesions may develop into longitudinal and transverse ulcers with
intervening mucosal oedema, creating a characteristic 'cobblestone' appearance
what are 3 potential causes of Crohn's disease? - answer-cigarette smoking- increases
risk in genetically susceptible individuals
-microvascular infarction (eg from oral contraceptive pill use)
-infective agent triggers (eg mycobacteria, measles)
where in the GI tract is most commonly affected in Crohn's disease? - answersmall
intestine
(but any part of intestinal tract may be affected)
what does the presentation of Crohn's disease depend on? - answerdisease location in
the GI tract
what is the presentation of Crohn's disease when the upper GI tract/small intestine is
affected? - answer-severe abdominal pain
-vomiting
