this show discusses inflammatory bowel disease+ ulcerative colitis + crohn's disease

1. BY : KHALED HANI. 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
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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’s disease may involve any area of the
gastrointestinal tract and frequently is
transmural
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4. 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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5. Genetic factors
 Risk of 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%.
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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
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7. Epithelial defects
 Variety of
epithelial
defects have
been described
in Crohn disease
& ulcerative
colitis.
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8. Ulcerative colitis
By : Khaled H. Alkhodari

9. Introduction
 Is a disease 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.
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10. 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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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.
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12. Complications
 Rectal bleeding.
 Dehydration and malabsorbtion.
 Changes in bones.
 Inflammation in other areas of the body.
 Megacolon
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13. 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.
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15. 15
 Removal of the 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 known as regional
enteritis, may occur in any
area of the gastrointestinal
tract !!
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18. American Gastroenterologist:
Burrill Bernard Crohn
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19.  The most common sites involved by
Crohn’s disease at presentation are:
1-terminal ileum.
2-ileocecal valve.
3-cecum.
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20.  1-skip lesion :
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The characteristic of crohn's disease

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

23.  4- (creeping fat)
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The characteristic of crohn's disease

24.  5- The microscopic 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.
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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 )
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26. 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
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27. COMPARISON
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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.
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29. Thank you 
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