1- Defines inflammatory bowel disease. 2-Recall pathological changes associated with ulcerative colitis and Crohn's disease Inflammatory bowel disease (IBD) is an idiopathic disease caused by a dysregulated immune response to host intestinal microflora. The two major types of inflammatory bowel disease are: ulcerative colitis (UC), which is limited to the colon. Crohn disease (CD), which can affect any segment of the gastrointestinal tract from the mouth to the anus, involves skip lesions Med_students0 Follow us: Instagram slideshare

1. Inflammatory bowel disease
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2. 1- Defines inflammatory bowel disease.
2-Recall pathological changes
associated with ulcerative colitis and
Crohn's disease
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3. 1- Defines inflammatory bowel disease:
Inflammatory bowel disease (IBD) is an idiopathic disease
caused by a dysregulated immune response to host intestinal
microflora.
The two major types of inflammatory bowel disease are:
ulcerative colitis (UC), which is limited to the colon.
Crohn disease (CD), which can affect any segment of the
gastrointestinal tract from the mouth to the anus, involves skip
lesions

4. •
There are: three additional forms of inflammatory bowel disease
are
also recognized, namely:
• microscopic ulcerative,
• microscopic lymphocytic
•microscopic collagenous colitis
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5. • is unknown.
• it is becoming clear that IBD represents the outcome of three essential
interactive co-factors:
•Genetic susceptibility:
•Familial. A positive family history is the largest independent risk factor for the
disease.
•Jewish families
•The environment
Good domestic hygiene has been shown to be a risk factor for CD but not for UC.
Helminth infections
•Host immune response
The aetiology of IBD:
Breast feeding may provide protection against inflammatory bowel disease
developing in offspring
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6. •
•psychological factors such as chronic stress and depression seem to increase
relapses
•smoking has been shown to exacerbate CD.
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7. •
2-Recall pathological changes associated with
ulcerative colitis and Crohn's disease:
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8. •
Crohn's disease (CD):
•a chronic inflammatory condition.
•may affect any part of the gastrointestinal tract from the mouth to the
anus.
•has a particular tendency to affect the terminal ileum and ascending
colon
(ileocolonic disease).
The disease can involve one small area of the gut such as the
terminal ileum, or multiple areas with relatively normal bowel in
between
(skip lesions).
•It may also involve the whole of the colon (total colitis) sometimes
without small bowel involvement.

9. Macroscopic and Microscopic changes
•
•Crohn’s disease the involved small bowel is usually thickened and
narrowed.
•There are deep ulcers and fissures in the mucosa, producing a
cobblestone appearance.
•The inflammation extends through all layers (transmural) of the
Bowel.
•50% cases show non-caseating granulomas.
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10. 10
Thickened Bowel wall
Thickened Bowel wallNarrowing of the lumen

11. 11
Cobblestone appearance
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12. •Radiographic feature:
String sign in the terminal ileum from luminal narrowing by inflammation and fibrosis
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13. Creeping fat:
mesentric fat wraps around the serosa of bowel
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Ulcerative colitis(UC):
.
•In continuous fashion.
•Primarily involves the rectum and left colon
• (can affect the rectum alone (proctitis))
•Mucosal and submucosal (unlike CD)
•No skip lesions (unlike CD)
•Does not involve other areas of GIT (unlike CD)
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15. Macroscopic and Microscopic changes
.
•Primarily involves the rectum and left colon
•Limited to mucosa and submucosa:
•Non-granulomatous.
mucosa looks reddened, inflamed and bleeds
easily.
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16. Ulcerations in continuity
No skip lesions
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17. Elevated sessile reddish nodules:
known as pseudopolyps (from regenerating mucosa)
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18. Lead pipe appearance
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19. The differentiation between these two diseases can
usually be made not only on the basis of clinical and radiological
data but also on the histological differences seen in the rectal
and colonic mucosa obtained by biopsy
•There is overlap between these two conditions in their
clinical features, histological and radiological abnormalities.
•in 10% of cases of colitis a definitive diagnosis of either UC
or CD is not possible.
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20. Med_students0

21. Robbins basic pathology

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