1. Inflammatory bowel disease (IBD) includes two major types: Crohn's disease and ulcerative colitis. 2. Crohn's disease can affect any part of the gastrointestinal tract and often extends deep into tissues. Ulcerative colitis only involves the colon and rectum in the innermost lining. 3. The causes of IBD are unknown but involve genetic, immune, environmental, and bacterial factors. Both conditions involve severe diarrhea, abdominal pain, and weight loss.

1. BY : KHALED HANI. NAJI.
ALKHODARI
SADIYEHIAEL-NAKHAL
A
SUPERVISOR : DR. OMARSALEH FERWANA
Inflammatory Bowel
disease IBD
Crohn’s
disease
Ulcerative
colitis
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Inflammatory bowel disease (IBD)
BY

2. General introduction :
Inflammatory bowel disease (IBD) is a chronic condition
that includestwo major entities :
1-Crohn’sdisease
2-ulcerative colitis
The distinction between ulcerative colitis
and Crohndisease is based, in large part, on:
1.the distribution of affected sites
2.the morphologic expression of disease at those sites
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3. General introduction :
Ulcerative colitis is limited to the colon and
rectum and extends only into the mucosa and
submucosa.
Crohn’sdisease may involve any area of the
gastrointestinal tract and frequentlyis
transmural
3

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 Ulcerative colitis. This condition causes long-lasting inflammation and
sores (ulcers) in the innermost lining of your large intestine (colon) and
rectum.
 Crohn's disease. This type of IBD is characterized by inflammation of the
lining of the digestive tract, which often spreads deep into affected
tissues.
Note: Both ulcerative colitis and Crohn's disease usually involve severe
diarrhea, abdominal pain, fatigue and weight loss.

5. E
Causes
The exact cause of IBD is unknown, However,
most investigators believe that IBD results from a
combination of :
Genetic factors.
Mucosal immune responses.
Environmental factors
Bacteria( epithelial defect )
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6. Genetic factors
Risk of disease is increased when there is an
affected family member.
In Crohn disease, the concordancerate for
monozygotic twins is approximately 50%.
In ulcerative colitis concordancerate for monozygotic
twins is only 16%.
5

7. Mucosal immune responses
Although the mechanisms by which mucosal
immunity contributes to the pathogenesis of
Ulcerative colitis and Crohn disease are still
being not completely understood.it is likely that
some combination of derangements that
activate mucosal immunity and suppress
immunoregulationcontribute to the
development of bothulcerative colitis and
Crohn disease
6

8. Epithelial defects
Variety of
epithelial
defects have
been described
in Crohn disease
& ulcerative
colitis.
7

9. Ulcerative colitis
By : Khaled H. Alkhodari

10. Introduction
Is a disease in which extensive areas of the walls of the
large intestine become inflamed and ulcerated.
The motilityof the ulcerated colon is often so greatthat
mass movements occur much of the day.
The colon’ssecretionsare greatly enhanced the
patient has repeated diarrheal bowel movements.
9

11. Introduction
Begins gradually and can become worse over time.
Is an autoimmune disease characterized by T-cells infiltrating
the colon.
Ulcerative colitis usually involves the rectum and is confined
to the colon, with occasional involvement of the ileum.
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12. Signs and symptoms
The most common are diarrhea with blood or
pus and abdominal discomfort. Other signs and
symptoms include:
An urgent need to have a bowel movement.
Feeling tired.
Nausea or loss of appetite.
Weight loss.
Fever.
Anemia.
 A sense of the bowels not being empty after a
bowel movement
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13. Complications
Rectal bleeding.
Dehydration and malabsorbtion.
Changes in bones.
Inflammation in other areas of the body.
Megacolon
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14. 13

15. Treatment -Medications
No medication cures ulcerative colitis, many
can reduce symptoms. The goals of medication
therapy are:
Inducing and maintaining remission.
Improving the person's quality of life.
Medications that best treat symptoms:
Aminosalicylates(Aspirin and Ibuprofen.).
Corticosteroids(prednisone).
Immunomodulators.
Other medications.
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16. 15
Removal of the entire colon"cures" ulcerative colitis.
A surgeon can do that by two different types of
surgery :
Proctocolectomyand ileostomy.
Proctocolectomyand ileoanalreservoir.
Full recovery from both operations may take 4 to 6
weeks.
Treatment –Surgery
IleostomyIleoanalreservoir

17. CROHN
DISEASE
BY :SADINAKHALA

18. Crohn’s disease:
also known as regional
enteritis, may occur in any
area of the gastrointestinal
tract !!
17

19. AmericanGastroenterologist:
BurrillBernard Crohn
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20. The most common sites involved by
Crohn’s disease at presentation are:
1-terminal ileum.
2-ileocecal valve.
3-cecum.
19

21. 1-skip lesion :
20
The characteristic of crohn'sdisease

22. The characteristic of crohn'sdisease
2-Strictures (stenosis )
21

23. 3-loss of normal mucosal folds ( linear mucosa )
in addition to ( cobblestone –shaped mucosa )
22
The characteristic of crohn's disease

24. 4-(creepingfat)
23
The characteristic of crohn'sdisease

25. 5-The microscopic features of active
Crohndisease includeabundant
neutrophils that infiltrate and damage
crypt epithelium ,, Clusters of
neutrophils within a crypt are referred
to asa crypt abscess and often are
associated with crypt destruction.
24
The characteristic of crohn's disease

26. Clinical features :
1-In most patients, disease begins with:
-mild diarrhea
-fever and abdominal pain
2-Iron deficiency anemia may develop in persons with
colonicdisease
3-extensive small bowel disease may result in :
-serum protein loss
-generalized nutrient malabsorption
(VB12 and bile salts )
25

27. Treatment :
1-Anti-inflammatory drugs ( reduces inflammation )
2-Immune system suppressors ( suppress immune
system that increases inflammation )
3-Antibiotics (reduce harmful intestinal bacteria)
4-Surgery
26

28. COMPARISON
27

29. References
Robbins-basic pathology ,9theditiom
The National Institute of Diabetes and Digestiveand
Kidney Diseases:
http://www.niddk.nih.gov/health-information/health-
topics/digestive-diseases/ulcerative-colitis/Pages/facts.aspx#what
Guyton and Hall Textbook of Medical Physiology, 12thedition.
Pathoma.
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