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IBD

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by

Kinga André

on 8 March 2014

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Transcript of IBD

Inflammatory bowel disease
Symptoms
diffuse mucosal inflammation limited to the colon
Ulcerative colitis
Crohn's disase
can involve any component of the gastrointestinal tract from the oral cavity to the anus, characterized by transmural inflammation
"classic triad":
abdominal pain
diarrhoea
weight loss

nowadays less common
Diagnostic approach to IBD
Suspect the diagnosis
Exclude other etiologies
Classify
Determine location
Identify extraintestinal manifestations
history
examination
laboratory
FBC, ESR, CRP
LFT's (esp. albumin)
fecal calprotectin, lactoferrin

pANCA
(Perinuclear antineutrophil cytoplasmic antibody)
ASCA
(Anti-Saccharomyces Cerevisiae Antibody)

Treatment
UC
CD
mild/moderate
moderate/severe
- ASA
- enteral feeds
- corticosteroids
- enteral feeds
- corticosteroids
- immunomodulators (6-MP, AZA)
- biologics:
anti-TNF agents: infliximab

enteral formulas:
elemental
semielemental
polymeric
stool cultures
stool test for Clostridium diff. toxins
abdominal tenderness, masses
perianal area (skin tag, fissure)
upper endoscopy
colonoscopy
SBFT (small-bowel follow-through)
skin : erythema nodosum, pyoderma gangrenosum
arthritis & arthralgia, sacroileitis
eye: uveitis, episcleritis
oral: aphthous lesions, cheilitis
hepatobiliary: primary sclerotizing cholangitis (UC)
Full transcript