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INFLAMMATORY BOWEL DISEASEUlcerative Colitis

Crohns DiseaseDr. Quintin Babaran

Inflammatory bowel disease (IBD)

An idiopathic and chronic intestinal inflammation

2 major types:

Ulcerative colitis (MC: young 15-30)

Crohns disease (old 60-80)

Differential dx: TB of intestinesEpidemiology and Incidence

US: 11/100,000 UC 7/100,000 CD

ASIA: rare .5/100,000 UC

.08/100,000 CD

PEAK AGE:

15 30

60 80

Effect of Smoking:

40% increased risk UC

2x increased risk CD

1.7 increased risk former smokers

Contraceptive use:

1.9 increased risk

*appendectomy confers protection

Etiology and Pathogenesis

In genetically predisposed individuals:

Exogenous factors (e.g. infectious agents, normal luminal flora)

Host factors (e.g. intestinal epithelial cell barrier, function, vascular supply, neuronal activity)

Result in:

State of dysregulated mucosal immune function that is further modified by specific environmental factors (e.g. smoking)

Pathogenesis

IBD

Infectious

agents

Exogenous

Interstitial

Epithelial cell

Barrier, vascular supply

Host Factors

Environment

smoking

Chronic stte of dysregulated mucosal immune function