inflammatory%20bowel%20disease
INFLAMMATORY BOWEL DISEASE
Inflammatory bowel disease consists of ulcerative colitis and Crohn's disease.
Ulcerative colitis is a diffuse mucosal inflammation limited to the colon while Crohn's disease is a patchy, transmural inflammation that occurs in any part of the gastrointestinal tract.
The ileum and colon are the most frequently affected sites.

Introduction

  • Consists of ulcerative colitis (UC) and Crohn’s disease (CD)
    • UC: Diffuse mucosal inflammation limited to the colon
    • CD: Patchy, transmural inflammation that can occur in any part of the gastrointestinal (GI) tract
      • Ileum and colon are the most frequently affected sites

Signs and Symptoms

General Symptoms

Depend on the segment of the intestinal tract involved

  • Chronic diarrhea or constipation
  • Abdominal pain and cramps
  • Blood in stool
  • Pain with bowel movement
  • Urgency in bowel movement
  • Tenesmus
  • Reduced appetite
  • Weight loss
  • Fever
  • Fatigue
  • Growth retardation
  • Primary amenorrhea
  • Night sweats

Clinical Features

Ulcerative Colitis (UC)

  • Cardinal symptoms: Bloody diarrhea, frequent, small volume
  • Associated symptoms: Colicky abdominal pain, tenesmus, urgency
  • Characterized by a relapsing and remitting course

Crohn's Disease (CD)

  • Chronic diarrhea, abdominal pain, weight loss
  • Abdominal mass, perianal lesions, stomatitis, fissures and fistulas
  • Malaise, fever, anorexia are more common with CD than UC

Risk Factors

Risk Factors

  • Smoking is a risk factor for CD but has a protective factor for UC through unknown mechanism
  • Age - most people are diagnosed between 15 and 35 years
    • Early-onset (occurring <40 years) disease is more aggressive and has a less favorable course, requiring more immunomodulators and surgical intervention compared with late-onset disease
  • UC affects men and women equally, while CD is more frequent in women
  • Family history
  • Recent episodes of infectious gastroenteritis
  • Use of non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate UC
  • Appendectomy for proven appendicitis during childhood or adolescence is associated with reduced risk of UC in adulthood
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