IBD is very important topic even though the disease is prevalent in western countries. This PPT covers both the diseases side by side for comparing at same time and having an idea about them all together.
2. LEARNING OUTCOMES
Describe the disease process of Crohn’s versus Ulcerative Colitis.Describe the disease process of Crohn’s versus Ulcerative Colitis.
Identify the clinical presentation of a patient with Crohn’s DiseaseIdentify the clinical presentation of a patient with Crohn’s Disease
and Ulcerative Colitis.and Ulcerative Colitis.
Discuss the various diagnostic workups and how they mayDiscuss the various diagnostic workups and how they may
differentiate Crohn’s & U.C. from other GI ailments.differentiate Crohn’s & U.C. from other GI ailments.
Select appropriate treatments for a patient with Crohn’s DiseaseSelect appropriate treatments for a patient with Crohn’s Disease
and Ulcerative Colitis.and Ulcerative Colitis.
3. DEFINITION
It includes a group ofIt includes a group of
chronic disorders thatchronic disorders that
cause inflammation orcause inflammation or
ulceration in large andulceration in large and
small intestines.small intestines.
8. ULCERATIVE COLITIS
UC is an non granulomatous inflammatoryUC is an non granulomatous inflammatory
disorder that affects the rectum and extendsdisorder that affects the rectum and extends
proximally to affect variable extent of the colon.proximally to affect variable extent of the colon.
It strictly affects the colon and has mucosalIt strictly affects the colon and has mucosal
involvementinvolvement
15-40 years (Young adults)15-40 years (Young adults)
No variation between sexesNo variation between sexes
High incidence areas: USA and northern-High incidence areas: USA and northern-
western Europewestern Europe
More common in non-smokersMore common in non-smokers
CD is a condition of chronic granulomatousCD is a condition of chronic granulomatous
inflammation potentially involving any locationinflammation potentially involving any location
of the GIT from mouth to anus.of the GIT from mouth to anus.
Crohn’s Disease - affects mouth to anus andCrohn’s Disease - affects mouth to anus and
has transmural involvementhas transmural involvement
1st peak 15-30 years of age, 2nd peak around1st peak 15-30 years of age, 2nd peak around
60 y60 y
Marginally more common in femalesMarginally more common in females
High incidence areas: North America, UK,High incidence areas: North America, UK,
northern Europenorthern Europe
More common in smokersMore common in smokers
CROHN’S DISEASE
19. DIFFERENTIAL DIAGNOSIS
Chronic infectious colitisChronic infectious colitis
Ischemic colitisIschemic colitis
DiverticulitisDiverticulitis
Irritable Bowel SyndromeIrritable Bowel Syndrome
Amoebic colitisAmoebic colitis
Intestinal tuberculosisIntestinal tuberculosis
D / D – R I F – MassD / D – R I F – Mass
Colon CancerColon Cancer
20. GENERAL MEASURES
Correction of anemia.Correction of anemia.
Fluid & electrolyteFluid & electrolyte
supplementation.supplementation.
Nutrition ( high protein,Nutrition ( high protein,
carbohydrate ,vitamin, but low fatcarbohydrate ,vitamin, but low fat
diet ) ,TPNdiet ) ,TPN
Sedatives and tranquilizers.Sedatives and tranquilizers.
Psychological counselingPsychological counseling
22. ACUTE THERAPY
IV +/- PO Hydrocortisone orIV +/- PO Hydrocortisone or
MethylprednisoloneMethylprednisolone
Rectal +/- Oral 5-ASA;Rectal +/- Oral 5-ASA;
SulfasalazinesSulfasalazines
BSA +/- MetronidazoleBSA +/- Metronidazole
IV Cyclosporine 2-4 mg/kgIV Cyclosporine 2-4 mg/kg
Bowel RestBowel Rest
23. CHRONIC THERAPY
Goals:Goals:
Remission of bowel inflammationRemission of bowel inflammation
1-4 BM/day with mucosal healing1-4 BM/day with mucosal healing
Prevention of strictures, fistulas,Prevention of strictures, fistulas,
other complicationsother complications
Prevention of need for surgeryPrevention of need for surgery
24. CROHN’S DISEASE
Failure of medical therapyFailure of medical therapy
Recurrent obstructionRecurrent obstruction
PerforationPerforation
Fistula / Abscess / StrictureFistula / Abscess / Stricture
HemorrhageHemorrhage
Steroid dependency diseaseSteroid dependency disease
Growth retardation (children)Growth retardation (children)
Malignant changeMalignant change
INDICATIONS - SURGERY