IBD

• What is Crohn's Disease (CD)?

  A chronic inflammatory disease of the digestive tract
• What characterizes Crohn's Disease?

  Transmural inflammation and granulomas
• What are the main types of Crohn's Disease and their usual age of diagnosis?

  • Main Types:
  • Terminal ileum (30%)
  • Ileocolonic (>50%)
  • Entire GI tract
  • Age of Diagnosis:
  • Most common in ages 14-25 and 55-65
• What genetic mutations are associated with Crohn's Disease?

  NOD2/CARD15 mutations lead to barrier defects
• What causes segmental damage in Crohn's Disease?

  Transmural inflammation and granuloma formation
• What are the digestive manifestations of Crohn's Disease?

  • Chronic diarrhea (often without blood)
  • Abdominal pain
  • Malabsorption
  • Perianal lesions (fistulas, abscesses)
  • Malnutrition and weight loss
• What are the extradigestive manifestations of Crohn's Disease?

  • Fever
  • Asthenia
  • Arthritis
  • Erythema nodosum
  • Uveitis
• What are the imagistic findings in Crohn's Disease?

  • Endoscopy: Aphthoid lesions, deep ulcerations, cobblestoning, fistulas
  • Entero-MRI: Stenoses, fistulas, pseudodiverticula
• What biological data is relevant for Crohn's Disease?

  • Inflammatory markers: ESR, CRP, fecal calprotectin
  • Anemia, hypoalbuminemia
  • Positive ASCA antibodies
• How does Crohn's Disease differ from Ulcerative Colitis (UC) in terms of diagnosis?

  Distinct endoscopic and histological features
• What are the local complications of Crohn's Disease?

  • Fistulas
  • Abscesses
  • Strictures
  • Perianal disease
  • Intestinal occlusions (medical emergency)
• What are the treatment options for Crohn's Disease?

  1. Nutritional: Correct deficiencies, exclusive enteral nutrition
  2. Pharmacological:

  • Mild/Moderate: Enteral nutrition, Budesonide
  • Severe: Systemic steroids, biologics (Infliximab, Adalimumab)

  1. Maintenance Therapy: Mesalazine, Azathioprine, Methotrexate, biologics
  2. Surgical: For complications like strictures or fistulas
• What is the prognosis for Crohn's Disease?

  Chronic disease with potential severe complications
• What does endoscopy reveal in Crohn's Disease?

  • Segmental lesions with deep ulcerations
  • Cobblestoning
• What does histopathology show in Crohn's Disease?

  • Granulomas
  • Transmural inflammation
• What is Ulcerative Colitis (UC)?

  A chronic inflammatory disease of the colon
• What characterizes Ulcerative Colitis?

  Recurrent diarrhea with blood, mucus, and pus
• What are the main types of Ulcerative Colitis and their usual age of diagnosis?

  • Main Types:
  • Classified by severity (mild, moderate, severe)
  • Location (proctitis, rectosigmoiditis, left colitis, pancolitis)
  • Age of Diagnosis:
  • Most common in ages 14-25 and 55-65
  • Increasing diagnosis in children aged 10-12
• What leads to chronic lesions in Ulcerative Colitis?

  Disruption of the intestinal mucosal barrier
• What are the digestive manifestations of Ulcerative Colitis?

  • Diarrhea (3-10 stools/day)
  • Severe forms include blood, mucus, and pus
  • Abdominal pain, tenesmus, cramps, tenderness
• What are the extradigestive manifestations of Ulcerative Colitis?

  • Fever
  • Weight loss
  • Anemia
  • Arthritis, ankylosing spondylitis
  • Uveitis, erythema nodosum, pyoderma gangrenosum
  • Sclerosing cholangitis, amyloidosis
• What are the clinical forms of Ulcerative Colitis?

  • Mild: <4 stools/day, mild anemia, no fever
  • Moderate: 5-8 stools/day, low-grade fever, anemia
  • Severe: >8 stools/day, fever >38°C, hypoalbuminemia, poor general condition
• What are the imagistic findings in Ulcerative Colitis?

  • Endoscopy: Continuous mucosal lesions from rectum
  • Active phases: “Bleeding mucosa,” erythema, superficial ulcerations
  • Radiology: Loss of haustration, granular mucosa, pseudopolyps
• What biological data is relevant for Ulcerative Colitis?

  • Elevated ESR, CRP, leukocytosis, fecal calprotectin
  • Anemia, hypoalbuminemia
  • Positive ANCA antibodies
• What are the differential diagnoses for Ulcerative Colitis?

  Includes Crohn’s disease and intestinal infections
• What are the local complications of Ulcerative Colitis?

  • Toxic megacolon
  • Massive bleeding
  • Colorectal cancer after 8-10 years
• What are the systemic complications of Ulcerative Colitis?

  • Arthritis
  • Ankylosing spondylitis
  • Sclerosing cholangitis
  • Skin and eye conditions
• What are the treatment options for Ulcerative Colitis?

  1. General Measures: Avoid dairy, raw fruits, saturated fats
  2. Pharmacological:

  • Mild: Mesalazine (oral or rectal)
  • Moderate: Oral steroids + Mesalazine
  • Severe: IV steroids, nutritional support, antibiotics

  1. Maintenance Therapy: Mesalazine, Azathioprine, biologics (Infliximab)
  2. Surgical: Toxic megacolon, neoplasia
• What is the prognosis for Ulcerative Colitis?

  Chronic disease with cycles of remission and relapse
• What does endoscopy reveal in Ulcerative Colitis?

  • Friable mucosa
  • Pseudopolyps
  • Loss of vascular patterns
• What does histopathology show in Ulcerative Colitis?

  • Crypt abscesses
  • Mucosal inflammation
  • Edema