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Lect 6-inf bowel dis

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Mohanad Mohanad
Mohanad Mohanad

inflammatory bowel disease

Health & Medicine
1 of 55
INFLAMMATORY BOWEL DISEASE SMS 2044
INFLAMMATORY BOWEL DISEASE IBD is a group of inflammatory conditions of large intestine ,in some cases small intestine.
Intestines - Pathology Idiopathic Inflammatory Bowel Diseases ,[object Object],Crohn’s disease Ulcerative Colitis
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Idiopathic Inflammatory Bowel Diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Different Clinical, Endoscopic, and Radiographic Features of Crohn’s & Ulcerative Colitis Ulcerative Colitis Crohn's Disease   CLINICAL Gross blood in stool Yes Occasionally   Mucus Yes Occasionally   Systemic symptoms Occasionally Frequently   Pain Occasionally Frequently   Abdominal mass Rarely Yes   Significant perineal disease No Frequently   Fistulas No Yes   Small intestinal obstruction No Frequently   Colonic obstruction Rarely Frequently   Response to antibiotics No Yes   Recurrence after surgery No Yes   ANCA-positive Frequently Rarely  
Ulcerative Colitis Crohn's Disease ENDOSCOPIC Rectal sparing Rarely Frequently Continuous disease Yes Occasionally "Cobblestoning" No Yes Granuloma on biopsy No Occasionally RADIOGRAPHIC Small bowel significantly abnormal No Yes Abnormal terminal ileum Occasionally Yes Segmental colitis No Yes Asymmetrical colitis No Yes Stricture Occasionally Frequently
Intestines - Pathology Idiopathic Inflammatory Bowel Diseases (CD) (UC) Fissuring Ulcer noncaseating granulomas
Pathogenesis ,[object Object],[object Object],[object Object],[object Object]
ULCERATIVE COLITIS ,[object Object],[object Object],[object Object],[object Object]
 
AETILOGY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Genetic factors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Autoimmune disease ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Pathological Feature
[object Object],[object Object],[object Object],[object Object]
 
Patients with ulcerative colitis can occasionally have aphthous ulcers involving the tongue, lips , palate and pharynx   Endoscopic image of ulcerative colitis showing loss of vascular pattern of the sigmoid colon, granularity and some friability of the mucosa.
Clinical presentation ,[object Object],[object Object],[object Object],[object Object]
CLASSIFICATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],Severity of disease
Extraintestinal features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
H&E stain of a colonic biopsy showing a crypt abscess:a classic finding in ulcerative colitis [ edit ] General
Crohn's Disease
Contents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definition: ,[object Object],[object Object],[object Object],[object Object]
Introduction to Crohn’s disease: ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object]
Classification: ,[object Object]
Classification contd..
Classification ,[object Object],[object Object],[object Object],[object Object]
Cause ,[object Object],[object Object],[object Object]
Cause contd.. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathology: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
www.freelivedoctor.com
Clinical Features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
f) chronic course may lead to: i) fibrosing strictures - terminal ileum - fistulas other areas ii) protein loss iii) Vit B 12 loss iv) bile salt loss - steatorrhea v) linear serpentine ulcers www.freelivedoctor.com
Complications: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Differential Diagnosis ,[object Object]
Investigations: ,[object Object]
Contd….. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contd.. ,[object Object]
Crohn’s Disease at Glance: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Contd.. ,[object Object],[object Object],[object Object],[object Object]
Comparison of UC and CD ULCERATIVE COLITIS CROHN’S Age Any Any Sex m=f M=f Anatomical distribution Colon only Any part of G.I Presentation Bloody diarrhoea Variable; pain diarrhoea, Weight loss Risk factors more common in non smokers More common in smokers
Treatment of Inflammatory Bowel Disease
TREATMENT ,[object Object],DIETARY CHANGES LIFESTYLE CHANGES DRUG THERAPY SURGERY
Dietary Changes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LIFESTYLE CHANGES ,[object Object],Taking rest nonsmoking Stress reduction Doing exercise
Drug Therapies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Aminosalicylates ,[object Object],[object Object],[object Object],[object Object],[object Object]
 

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6@gas exchange and transport
 
4@neaural control of respiration
4@neaural control of respiration4@neaural control of respiration
4@neaural control of respiration
 
3@lung and pleura
3@lung and pleura 3@lung and pleura
3@lung and pleura
 
2@trachea and larynx
2@trachea and larynx2@trachea and larynx
2@trachea and larynx
 
1@nose and nasal cavity
1@nose and nasal cavity1@nose and nasal cavity
1@nose and nasal cavity
 
Lect 6-wound healing
Lect 6-wound healingLect 6-wound healing
Lect 6-wound healing
 
Lect 5- cell injury
Lect 5- cell injuryLect 5- cell injury
Lect 5- cell injury
 
Lect 4-inflammation-2-
Lect 4-inflammation-2-Lect 4-inflammation-2-
Lect 4-inflammation-2-
 
Lect 3-inflammation
Lect 3-inflammationLect 3-inflammation
Lect 3-inflammation
 
Lect 2- cellular adaptation
Lect 2- cellular adaptationLect 2- cellular adaptation
Lect 2- cellular adaptation
 
Lect 1-pathophysiology basics
Lect 1-pathophysiology basicsLect 1-pathophysiology basics
Lect 1-pathophysiology basics
 
Chapter 4-stomach
Chapter 4-stomachChapter 4-stomach
Chapter 4-stomach
 
Chapter 3-pharynx +esophagus
Chapter 3-pharynx +esophagusChapter 3-pharynx +esophagus
Chapter 3-pharynx +esophagus
 
Chapter 2- salivary glands
Chapter 2- salivary glandsChapter 2- salivary glands
Chapter 2- salivary glands
 
Chapter 1-oral cavity
Chapter 1-oral cavityChapter 1-oral cavity
Chapter 1-oral cavity
 
female reproductive system
female reproductive system female reproductive system
female reproductive system
 
male reproductive system
male reproductive systemmale reproductive system
male reproductive system
 
male reproductive organs
male reproductive organsmale reproductive organs
male reproductive organs
 
Thyroid disorders
Thyroid disordersThyroid disorders
Thyroid disorders
 

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Lect 6-inf bowel dis

  • 2. INFLAMMATORY BOWEL DISEASE IBD is a group of inflammatory conditions of large intestine ,in some cases small intestine.
  • 3.
  • 4.
  • 5.
  • 6. Different Clinical, Endoscopic, and Radiographic Features of Crohn’s & Ulcerative Colitis Ulcerative Colitis Crohn's Disease   CLINICAL Gross blood in stool Yes Occasionally   Mucus Yes Occasionally   Systemic symptoms Occasionally Frequently   Pain Occasionally Frequently   Abdominal mass Rarely Yes   Significant perineal disease No Frequently   Fistulas No Yes   Small intestinal obstruction No Frequently   Colonic obstruction Rarely Frequently   Response to antibiotics No Yes   Recurrence after surgery No Yes   ANCA-positive Frequently Rarely  
  • 7. Ulcerative Colitis Crohn's Disease ENDOSCOPIC Rectal sparing Rarely Frequently Continuous disease Yes Occasionally "Cobblestoning" No Yes Granuloma on biopsy No Occasionally RADIOGRAPHIC Small bowel significantly abnormal No Yes Abnormal terminal ileum Occasionally Yes Segmental colitis No Yes Asymmetrical colitis No Yes Stricture Occasionally Frequently
  • 8. Intestines - Pathology Idiopathic Inflammatory Bowel Diseases (CD) (UC) Fissuring Ulcer noncaseating granulomas
  • 9.
  • 10.
  • 11.  
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.  
  • 18. Patients with ulcerative colitis can occasionally have aphthous ulcers involving the tongue, lips , palate and pharynx   Endoscopic image of ulcerative colitis showing loss of vascular pattern of the sigmoid colon, granularity and some friability of the mucosa.
  • 19.
  • 20.
  • 21.  
  • 22.
  • 23.
  • 24.
  • 25. H&E stain of a colonic biopsy showing a crypt abscess:a classic finding in ulcerative colitis [ edit ] General
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 34.
  • 35.
  • 36.
  • 37.
  • 39.
  • 40. f) chronic course may lead to: i) fibrosing strictures - terminal ileum - fistulas other areas ii) protein loss iii) Vit B 12 loss iv) bile salt loss - steatorrhea v) linear serpentine ulcers www.freelivedoctor.com
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48. Comparison of UC and CD ULCERATIVE COLITIS CROHN’S Age Any Any Sex m=f M=f Anatomical distribution Colon only Any part of G.I Presentation Bloody diarrhoea Variable; pain diarrhoea, Weight loss Risk factors more common in non smokers More common in smokers
  • 49. Treatment of Inflammatory Bowel Disease
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.  

Editor's Notes

  1. Crohn's disease shows a transmural pattern of inflammation , meaning that the inflammation may span the entire depth of the intestinal wall. [1]
  2. Slide 5 Ideally, treatment for active Crohn's disease should rapidly improve symptoms. Non-specific anti-inflammatory drugs are the mainstay of treatment for Crohn's disease. Examples are: glucocorticoids 5-aminosalicylates (5-ASA) immunosuppressants antimetabolites methotrexate.