8/9/2019 Inflammatory Disturbances

1/63

8/9/2019 Inflammatory Disturbances

2/63

8/9/2019 Inflammatory Disturbances

3/63

Ulcerative Colitis:!igh incidence areas: U", U#, northern $urope

%oung adults, commoner in females

Crohn&s 'isease:1 st pea( 1)*+ -ears of age, 2 nd pea( around -

/0C/'$0C$ /" 0 !$ R/"$ /0 A"/A0 3/0'/A45 5U6A / 0

Epidemiology

8/9/2019 Inflammatory Disturbances

4/63

8/9/2019 Inflammatory Disturbances

5/63

Ulcerative Colitis

A mucosal diseaseusuall- involves

rectum and e

8/9/2019 Inflammatory Disturbances

6/63

Ulcerative Colitis

=hen the whole colon is involved, in ammation e *) ? + *> ?

2 ?

8/9/2019 Inflammatory Disturbances

7/63

ULCERATIVE COLITIS CLINICALPRESENTATION

he ma@or s-mptoms of UC are:

* 'iarrhea* Rectal 8leeding* enesmus* 5assage of mucus

* Cramp- a8dominal pain* 6oss of weight

8/9/2019 Inflammatory Disturbances

8/63

UC DISEASEPRESENTATION

MILD MODERATE SEVERE BOWELMOVEMENTS < 4 per day 4-6 per

day>6 per day

BLOOD INSTOOL small moderate SevereFEVER none 37,5CTACHYCARDIA none 90 meanpulse

ANEMIA mild >75%

8/9/2019 Inflammatory Disturbances

9/63

8/9/2019 Inflammatory Disturbances

10/63

'iagnosis of / ' 3UC vs. C'4 Allows visualiBation of large intestine

and ileum Allows 8iopsies to e

8/9/2019 Inflammatory Disturbances

11/63

COLONSCOP" # UC

8/9/2019 Inflammatory Disturbances

12/63

Nor!al UC

8/9/2019 Inflammatory Disturbances

13/63

SUPER$ICIAL ULCERATIONAND LOSS O$ %UCOSALARCHITECTURE

8/9/2019 Inflammatory Disturbances

14/63

8/9/2019 Inflammatory Disturbances

15/63

8/9/2019 Inflammatory Disturbances

16/63

Colonic pseudopol-ps

8/9/2019 Inflammatory Disturbances

17/63

%icroscopic $i&di&gs i& UC

8/9/2019 Inflammatory Disturbances

18/63

DI$$ERENT CLINICAL $EATURES

U. Colitis Croh !s"is#$s#

Bloo" i stool es !""asionallyM%&%s es !""asionallyS'st#(i&s'()to(s

!""asionally #re$uently

P$i !""asionally #re$uently

A*"o(i $l($ss

arely es

P#ri #$l

"is#$s#

&o #re$uently

8/9/2019 Inflammatory Disturbances

19/63

$EATURES

U. Colitis Croh !s"is#$s#

Fist%l$s &o esS($ll

i t#sti #o*str%&tio

&o #re$uently

Colo i&o*str%&tio

arely #re$uently

R#s)o s# to$ ti*ioti&

&o es

R#&%rr# $+t#r s%r,#r'

&o es

8/9/2019 Inflammatory Disturbances

20/63

DI$$ERENT ENDOSCOPIC$EATURES

U. Colitis Croh !s"is#$s#

R#&t$l s)$ri , arely #re$uentlyCo ti %o%s"is#$s#

es !""asionally

-Co**l#sto i ,

&o es

/r$ %lo($ o*io)s'

&o !""asionally

8/9/2019 Inflammatory Disturbances

21/63

"erpiginous ulcer, a classic 9nding in Crohn&s disease

8/9/2019 Inflammatory Disturbances

22/63

8/9/2019 Inflammatory Disturbances

23/63

8/9/2019 Inflammatory Disturbances

24/63

Pat'ologic (eat)res o( Cro'&*sDisease a&d Ulcerative ColitisFeature Crohn's

DiseaseUlcerative

Colitis

Tra&sm)rali&+ammatio&

Yes Uncommon

!ra&)lomas 50-75% No

$iss)res Common Rare

$i,rosis Common No

S),m)cosali&+ammatio&

Common Uncommon

8/9/2019 Inflammatory Disturbances

25/63

8/9/2019 Inflammatory Disturbances

26/63

5t with suspected : $ndoscop- with multiple deep 8iopsies!istopatholog- A7 smear , A7 Culture

5ositive for "tart A 8 ?4

Complicatio&s o( UC S)rgery

8/9/2019 Inflammatory Disturbances

61/63

8/9/2019 Inflammatory Disturbances

62/63

!er8al 7ood "upplements

!olarhenaAntid-sentrica

ro

8/9/2019 Inflammatory Disturbances

63/63

IBD concl#sion

/t is a chronic disorder0eed to e