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Summary Irritable Bowel Disease physiology and drug summaries
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Summary of the physiology and drugs of IBD
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By: elliotmatura • 3 months ago
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Irritable Bowel Diseasehttps://www.youtube.com/watch?v=UJw2WUtHLIk
Two types:
Ulcerative Colitis
Crohn’s disease
To know:
A chronic progressive condition in ages 15-40
Diarrhoea is the most common.
Definition: chronic inflammation of the gastric mucosa
Crohn’s disease
The whole GI tract is affected.
Skip lesions: patchy.
All layers of the intestinal wall (transmural)
Inflammation leads to thickening of the intestinal walls, ulceration and narrowing of
the lumen.
UC
Mucosa of large intestine only (colon and rectum)
Mucosal and submucosal layers.
Pathophysiology
Unknown cause
Triggered by a weaker immune system.
Alteration in the composition of gut bacteria.
Causing ongoing inflammation
Risk factors
Stress
Diet
smoking
medicine
genetic
altered gut microbiota.
Symptoms
diarrhoea
blood in faeces (UC)
abdominal pain
tiredness
, weight loss
anaemia
fever
nausea and vomiting
bloating (Crohn’s is more obstruction-like)
swollen joints
eye problems
erythema nodosum: swollen fat under the skin
pyoderma gangrenosum: skin ulceration
Complications of Crohn’s
narrowed segments of the bowel
blockages caused.
Fistulas: GI tract fusing together
Diagnosis:
Full history
Full blood count:
o inflammatory markers
o urea and electrolytes
o thyroid function
o liver function
o bone profile
stool culture: rule out clostridium difficile.
coeliac screen
faecal calprotectin: released when inflammation present in the intestines (distinguish
between IBD and IBS)
endoscopy
colonoscopy
biopsies
UC severity index
Truelove and Witt’s Severity index
Mild moderate or severe
Looks at symptoms.
determines treatment.
Crohn’s severity index
Crohn’s disease activity index
Like UC but with different questions.
Severe flare-up: step up treatment.
Active flare-up: lots of symptoms that need treatment to stop.
Monitoring during a flare up
Faecal calprotectin
Stool frequency
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