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inflammatory bowel disease (Ulcerative colitis , crohn's disease)
Inflammatory bowel disease (IBD) includes two major types: Crohn's disease and ulcerative colitis. Crohn's disease can affect any part of the gastrointestinal tract and often involves the full thickness of the intestinal wall. Ulcerative colitis only involves the innermost layers of the colon and rectum. Both conditions result from an interaction between genetic, immune, environmental, and bacterial factors. Symptoms include diarrhea, abdominal pain, and weight loss. Treatment focuses on inducing remission through medications like aminosalicylates or surgery to remove the colon. Crohn's disease is characterized by "skip lesions" and strictures while ulcerative colitis causes inflammation and ulcers confined to the colon.
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inflammatory bowel disease (Ulcerative colitis , crohn's disease)
- 1. BY : KHALEDHANI. NAJI. ALKHODARI SADI YEHIA EL-NAKHALA SUPERVISOR : DR. OMAR SALEH FERWANA Inflammatory Bowel disease IBD Crohn’s disease Ulcerative colitis
- 2. General introduction : Inflammatory bowel disease (IBD) is a chronic condition that includes two major entities : 1- Crohn’s disease 2- ulcerative colitis The distinction between ulcerative colitis and Crohn disease is based, in large part, on: 1. the distribution of affected sites 2. the morphologic expression of disease at those sites 2
- 3. General introduction : Ulcerative colitis is limited to the colon and rectum and extends only into the mucosa and submucosa. Crohn’s disease may involve any area of the gastrointestinal tract and frequently is transmural 3
- 4. Causes The exactcause 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 ) 4
- 5. Genetic factors Riskof disease is increased when there is an affected family member. In Crohn disease, the concordance rate for monozygotic twins is approximately 50%. In ulcerative colitis concordance rate for monozygotic twins is only 16%. 5
- 6. 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 immunoregulation contribute to the development of both ulcerative colitis and Crohn disease 6
- 7. Epithelial defects Varietyof epithelial defects have been described in Crohn disease & ulcerative colitis. 7
- 8. Ulcerative colitis By :Khaled H. Alkhodari
- 9. Introduction Is adisease in which extensive areas of the walls of the large intestine become inflamed and ulcerated. The motility of the ulcerated colon is often so great that mass movements occur much of the day. The colon’s secretions are greatly enhanced the patient has repeated diarrheal bowel movements. 9
- 10. Introduction Begins graduallyand 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. 10
- 11. 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. 11
- 12. Complications Rectal bleeding. Dehydration and malabsorbtion. Changes in bones. Inflammation in other areas of the body. Megacolon 12
- 13.
- 14. 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. 14
- 15. 15 Removal ofthe entire colon "cures" ulcerative colitis. A surgeon can do that by two different types of surgery : Proctocolectomy and ileostomy. Proctocolectomy and ileoanal reservoir. Full recovery from both operations may take 4 to 6 weeks. Treatment – Surgery IleostomyIleoanal reservoir
- 16. CROHN DISEASE BY :SADI NAKHALA
- 17. Crohn’s disease: also knownas regional enteritis, may occur in any area of the gastrointestinal tract !! 17
- 18.
- 19. The mostcommon sites involved by Crohn’s disease at presentation are: 1-terminal ileum. 2-ileocecal valve. 3-cecum. 19
- 20. 1-skip lesion: 20 The characteristic of crohn's disease
- 21. The characteristic ofcrohn's disease 2- Strictures (stenosis ) 21
- 22. 3-loss ofnormal mucosal folds ( linear mucosa ) in addition to ( cobblestone –shaped mucosa ) 22 The characteristic of crohn's disease
- 23. 4- (creepingfat) 23 The characteristic of crohn's disease
- 24. 5- Themicroscopic features of active Crohn disease include abundant neutrophils that infiltrate and damage crypt epithelium ,, Clusters of neutrophils within a crypt are referred to as a crypt abscess and often are associated with crypt destruction. 24 The characteristic of crohn's disease
- 25. Clinical features : 1-In most patients, disease begins with: -mild diarrhea -fever and abdominal pain 2- Iron deficiency anemia may develop in persons with colonic disease 3- extensive small bowel disease may result in : -serum protein loss -generalized nutrient malabsorption (VB12 and bile salts ) 25
- 26. Treatment : 1- Anti-inflammatorydrugs ( reduces inflammation ) 2- Immune system suppressors ( suppress immune system that increases inflammation ) 3- Antibiotics (reduce harmful intestinal bacteria ) 4- Surgery 26
- 27.
- 28. References Robbins-basic pathology,9th editiom The National Institute of Diabetes and Digestive and 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, 12th edition. Pathoma. 28
- 29.
Editor's Notes
- #5 The exact cause of ulcerative colitis is unknown Autoimmune disease. Genetic factors. Environment. Bacteria.
- #7 but overall, it is likely that some combination of derangements that activate mucosal immunity and suppress immunoregulation contribute to the development of both ulcerative colitis and Crohn disease.
- #10 1- the large intestine become inflamed 2 The motility of the ulcerated colon is often so great 3-secretions are greatly enhanced has repeated diarrheal bowel movements gradually
- #12 are diarrhea with blood or pus and abdominal discomfort An urgent need to have a bowel movement. Feeling tired. Nausea or loss of appetite. Weight loss. Fever. Anemia.
- #13 Rectal bleeding. Dehydration and malabsorbtion. Changes in bones. Inflammation in other areas of the body. Megacolon 3- bcs corticosteroid megacolon Megacolon is a rare complication of ulcerative colitis.
- #15 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. Immunomodulators reduce immune system activity, resulting in less inflammation in the colon.
- #16 Proctocolectomy and ileostomy. A proctocolectomy is surgery to remove a patient's entire colon and rectum. An ileostomy The surgeon brings the end of the ileum through an opening in the skin. The stoma most often is located in the lower part of the patient's abdomen, just below the beltline. A removable external collection pouch, connects to the stoma and collects intestinal contents outside the patient's body. The stoma has no muscle, so it cannot control the flow of intestinal contents, and the flow occurs whenever peristalsis occurs. Peristalsis is the movement of the organ walls that propels food and liquid through the GI tract. ***************************** Proctocolectomy and ileoanal reservoir. An ileoanal reservior is an internal pouch made from the patient's ileum. The ileoanal reservior connects the ileum to the anus. The surgeon preserves the outer muscles of the patient's rectum during the proctocolectomy. Next, the surgeon creates the ileal pouch and attaches it to the end of the rectum. Waste is stored in the pouch and passes through the anus. After surgery, bowel movements may be more frequent and watery than before the procedure.