Inflammatory Bowel Disease Ppt May 2005

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Inflammatory Bowel Disease Ppt May 2005

  1. 1. Inflammatory Bowel Disease <ul><li>Immunologically-related disorders that include </li></ul><ul><ul><li>Crohn's disease </li></ul></ul><ul><ul><li>Ulcerative colitis </li></ul></ul>
  2. 2. Inflammatory Bowel Disease <ul><li>Characterized by chronic, recurrent inflammation of the intestinal tract </li></ul><ul><li>Clinical manifestations are varied for both conditions </li></ul><ul><ul><li>Long periods of remission interspersed with episodes of acute inflammation </li></ul></ul><ul><ul><li>Both diseases can be debilitating </li></ul></ul>
  3. 3. Inflammatory Bowel Disease <ul><li>Cause is unknown </li></ul><ul><li>Possible causes: </li></ul><ul><ul><li>Infectious agent (virus, bacteria) </li></ul></ul><ul><ul><li>Autoimmune reaction </li></ul></ul><ul><ul><li>Food allergies </li></ul></ul><ul><ul><li>Heredity </li></ul></ul>
  4. 4. Ulcerative Colitis Description <ul><li>Characterized by inflammation and ulceration of the colon and rectum </li></ul><ul><li>May occur at any age </li></ul><ul><li>Peaks between ages 15 and 25 years </li></ul><ul><li>Equally affects both sexes </li></ul>
  5. 5. Ulcerative Colitis Etiology and Pathophysiology <ul><li>Diffuse inflammation </li></ul><ul><ul><li>Involves mucosa and submucosa </li></ul></ul><ul><ul><li>Alternate periods of exacerbations and remissions </li></ul></ul>
  6. 6. Ulcerative Colitis Etiology and Pathophysiology <ul><li>Usually begins in the rectum and sigmoid colon and spreads up the colon in a continuous pattern </li></ul><ul><li>Mucosa is hyperaemic and oedematous in the affected area </li></ul>
  7. 7. Ulcerative Colitis Etiology and Pathophysiology <ul><li>Multiple abscesses develop in the intestinal glands </li></ul><ul><ul><li>Abscesses break through into the submucosa, leaving ulcerations </li></ul></ul>
  8. 8. Ulcerative Colitis Etiology and Pathophysiology <ul><li>Ulcerations destroy the mucosal epithelium, causing bleeding and diarrhoea </li></ul><ul><ul><li>Fluid and electrolyte losses </li></ul></ul><ul><ul><li>Protein loss </li></ul></ul><ul><ul><li>Pseudopolyps </li></ul></ul>
  9. 9. Ulcerative Colitis Etiology and Pathophysiology <ul><li>Granulation tissue develops </li></ul><ul><li>Mucosa musculature becomes thickened, shortening the colon </li></ul>
  10. 10. Ulcerative Colitis Clinical Manifestations <ul><li>Most commonly presents as a chronic disorder with mild-to-severe acute exacerbations that occur at unpredictable intervals over many years </li></ul>
  11. 11. Ulcerative Colitis Clinical Manifestations <ul><li>Major symptoms: </li></ul><ul><ul><li>Bloody diarrhoea </li></ul></ul><ul><ul><li>Abdominal pain </li></ul></ul>
  12. 12. Ulcerative Colitis Complications <ul><li>Complications may be classified as: </li></ul><ul><ul><li>Intestinal </li></ul></ul><ul><ul><li>Extraintestinal </li></ul></ul>
  13. 13. Ulcerative Colitis Complications <ul><li>Intestinal complications: </li></ul><ul><ul><li>Haemorrhage </li></ul></ul><ul><ul><li>Strictures </li></ul></ul><ul><ul><li>Perforation </li></ul></ul><ul><ul><li>Toxic megacolon </li></ul></ul><ul><ul><li>Colonic dilation </li></ul></ul>
  14. 14. Ulcerative Colitis Complications <ul><li>Toxic megacolon </li></ul><ul><ul><li>Dilation and paralysis of the colon </li></ul></ul><ul><ul><li>Occurs in 5% of patients </li></ul></ul><ul><ul><li>Associated with perforation </li></ul></ul>
  15. 15. Ulcerative Colitis Complications <ul><li>Extraintestinal complications: </li></ul><ul><ul><li>May be directly related to the colitis </li></ul></ul><ul><ul><li>May be nonspecific complications mediated by a disturbance in the immune system </li></ul></ul>
  16. 16. Crohn's Disease Description <ul><li>A chronic, nonspecific inflammatory bowel disorder of unknown origin that can affect any part of the GI tract from the mouth to the anus </li></ul>
  17. 17. Crohn's Disease Description <ul><li>Can occur at any age </li></ul><ul><li>Most often between ages 15 and 30 years </li></ul><ul><li>Both genders are affected </li></ul><ul><li>Similar to ulcerative colitis </li></ul>
  18. 18. Crohn's Disease Etiology and Pathophysiology <ul><li>Characterized by inflammation of segments of the GI tract </li></ul><ul><li>Can affect any part of the GI tract but is most often seen in the terminal ileum, jejunum, and colon </li></ul>
  19. 19. Crohn's Disease Etiology and Pathophysiology <ul><li>Inflammation involves all layers of the bowel wall </li></ul><ul><li>Ulcerations are deep and longitudinal and penetrate between islands of inflamed oedematous mucosa, causing the classic cobblestone appearance </li></ul>
  20. 20. Crohn's Disease Etiology and Pathophysiology <ul><li>Thickening of the bowel wall </li></ul><ul><li>Narrowing of the lumen with stricture development </li></ul>
  21. 21. Crohn's Disease Etiology and Pathophysiology <ul><li>Abscesses or fistula tracts that communicate with other loops of bowel, skin, bladder, rectum, or vagina may develop </li></ul>
  22. 22. Crohn's Disease Clinical Manifestations <ul><li>Manifestations depend on the anatomic site of involvement, extent of the disease process, and presence or absence of complications </li></ul>
  23. 23. Crohn's Disease Clinical Manifestations <ul><li>Onset is usually insidious </li></ul><ul><li>Nonspecific complaints: </li></ul><ul><ul><li>Diarrhoea </li></ul></ul><ul><ul><li>Fatigue </li></ul></ul><ul><ul><li>Abdominal pain </li></ul></ul><ul><ul><li>Weight loss </li></ul></ul><ul><ul><li>Fever </li></ul></ul>
  24. 24. Crohn's Disease Clinical Manifestations <ul><li>Principal manifestations: </li></ul><ul><ul><li>Diarrhoea (non-bloody) </li></ul></ul><ul><ul><li>Abdominal pain </li></ul></ul>
  25. 25. Crohn's Disease Clinical Manifestations <ul><li>Pain (severe and intermittent) </li></ul><ul><li>Abdominal cramping and tenderness </li></ul><ul><li>Abdominal distension </li></ul><ul><li>Arthritis </li></ul><ul><li>Finger clubbing </li></ul>
  26. 26. Crohn's Disease Complications <ul><li>Strictures and obstruction from scar tissue </li></ul><ul><li>Fistulas </li></ul><ul><li>Peritonitis </li></ul><ul><li>Fat intolerance </li></ul><ul><li>Gluten intolerance </li></ul>

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