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Inflammatory Bowel Disease

more about Inflammatory Bowel Disease

  • Crohn's disease is also known as regional enteritis, regional ileitis, and granulomatous colitis.
  • Ulcerative colitis is also known as idiopathic proctocolitis

  • This is a chronic intestinal disease where there is inflammation in the bowel.
  • It usually occurs during adolescence and young adulthood.
  • This is classified into ulcerative Colitis and Crohn's disease.
  • Crohn's disease occurs anywhere in the gastrointestinal tract, including the mouth, esophagus, stomach, small intestine, colon, rectum, or anus.  However, the most common areas are the ileum (part of the small intestine), other parts of the small intestine, and the colon.  The inflammation involves the whole wall of what it affects (i.e., it affects the full thickness of the ileum).  It is thought to be an autoimmune disease, i.e., the body attacks itself; but this is not entirely certain.
  • Ulcerative Colitis begins in the rectum and is localized to the colon.

  • Crohn's disease
    1. Fever
    2. Abdominal pain
    3. Diarrhea
    4. Bloody stools
    5. Liquid bowel movements
    6. Weight loss
    7. Loss of energy
    8. Abdominal bloating
    9. Anal pain
    10. Anal bleeding
    11. Anal/rectal discharge
    12. Mouth ulcers
    13. Rashes
    14. Arthritis of the back
    15. Joint arthritis/pain
    1. Bloody Diarrhea
    2. The constant feeling of the need to empty the bowels
    3. Urgency and crampy abdominal pain with bowel movements
    4. Fever
    5. Stool frequency
    6. Weight loss
    7. Loss of appetitive
    8. Nausea, vomiting
    9. Joint pain
    10. Growth failure

  • The exact cause is unknown.
  • It may be associated with genetic and environmental factors.

  • Based on clinical findings
  • Examination:
    1. Abdominal tenderness
    2. Mass in right lower abdomen in Crohn's disease
    3. Rectal exam may show blood
  • Laboratory findings:
    1. Anemia
    2. Vitamin B12 deficiency in Crohn's disease
    3. Elevated white blood cell count
    4. Low albumin (protein) because body is not absorbing nutrients properly
    5. Elevated sedimentation rate
  • Imaging:
    1. X-rays may show ulcers, strictures (bowel narrowing), or fistulas (abnormal tracts) in Crohn's disease; and loss of haustral markings in an air-filled colon or marked dilatation in toxic megacolon.
    2. Small bowel follow through (barium is swallowed and X-rays taken) may show inflamed ileum in Crohn's disease
    3. CT scan may show inflamed involved areas
    4. Barium enema microulceration, granularity, or a smooth-appearing surface of mucosa in ulcerative Colitis
    5. Colonoscopy with biopsy

  • Diet -- specific low-fiber or high-fiber may be prescribed depending on the symptoms and locations where the Crohn's disease is found in the gastrointestinal tract.
  • Anti-Diarrheal medications as needed, e.g., Lomotil
  • Antispasmodic medications as needed, e.g., hyoscyamine
  • Medications:
    1. Sulfasalazine 
    2. Corticosteroids, e.g., prednisone
    3. Immune therapy drugs such as azathioprine or mercaptopurine
  • Surgery may be needed for fistulas, abscesses (infections with pus), bowel obstructions, intractable or fulminant Colitis

  • Anemia
  • Perforation of colon
  • Inflammation of the joints
  • Eye lesions
  • Liver disease
  • Scelerosing cholangitis
  • Anklyosing spondylitis
  • Growth failure and impaired sexual development
  • Pyoderma gangrenosum
  • Colon cancer

more about Inflammatory Bowel Disease

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