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CHRONIC INFLAMMATORY BOWEL DISEASE
Inflammation and/or ulceration of bowel; exacerbations and remissions
ULCERATIVE COLITIS CROHN’S DISEASE (Regional
Enteritis)
ETIOLOGY - Ages 15 – 30 & >60 M>F
- Risk factors: family hx; Caucasian;
Ashkenazi Jewish background; northern
climate; non-smokers
-Etiology: environmental triggers +
predisposition?
- Ages 20-30 F>M
- Risk factors: family hx; Caucasian;
Ashkenazi Jewish background; northern
climate; smokers
-Etiology: environmental triggers +
predisposition?
PATHOPHYSIOLOGY – LOCATION &
DEPTH OF INVOLVEMENT
- Begins in rectum and large intestine,
retrograde to cecum
- Mucosa & submucosa
- Terminal ileum, patchy involvement
through all bowel layers
- Transmural, all layers
- “Cobblestone appearance” to bowel
- Steatorrhea
CLINICAL MANIFESTATIONS -10-20 liquid stools/day; may be bloody
- Tenesmus
- LLQ abd. pain
Extraintestinal symptoms: arthritis;
osteoporosis; skin disorders; vision
problems
- 5-6 loose stools/day, rarely bloody
- RLQ abd. pain
Steatorrhea
DIAGNOSTIC/LAB EVALUATION Barium enema; *colonoscopy w/biopsy;
sigmoidoscopy; CT/MRI (show abscesses);
Magnetic resonance enterography (MRE)
Labs: + Stool OB; WBC; H&H;
albumin; electrolyte imbalances: K, Mg,
Ca..
* CT/MRI; Barium enema; Colonoscopy;
sigmoidoscopy; Abd. x-rays; ultrasound;
Magnetic resonance enterography (MRE)
Labs: WBC; H&H; albumin; electrolyte
imbalances: K, Mg, Ca.
Folic acid and VitB12
