Crohn's disease
 |
| Colitis |
Crohn's disease :-
Non specific localized granulomatous inflammation of bowel.
Anywhere from mouth to anus.
Non specific localized granulomatous inflammation of bowel.
Anywhere from mouth to anus.
Pathology -
-Entire wall of bowel thickened and edematous
-cobblestone appearance of terminal ileum
-deep ulcer may penetrate through wall initiates abscess and fistula.
-skip lesions pattern observed.
-mesentric lymph nodes enlarged.
-non necrotizing granuloma characteristic of crohn's disease.
-Entire wall of bowel thickened and edematous
-cobblestone appearance of terminal ileum
-deep ulcer may penetrate through wall initiates abscess and fistula.
-skip lesions pattern observed.
-mesentric lymph nodes enlarged.
-non necrotizing granuloma characteristic of crohn's disease.
C/f
Depend upon where affected.
Ileal disease
Obstructive features
Narrowing of bowel due to spasm, fibrotic stenosis, inflammation causes bloating of abd. And pain.
Pain- common symptom
At rt. Iliac fossa and rt side colon.
Colicky type
Diarrhoea -not severe as uc. Watery not bloody.
Inflammatory features
Fever, malaise, abd. Pain, wt. Loss
Steatorrhoea and mal-absorption
Depend upon where affected.
Ileal disease
Obstructive features
Narrowing of bowel due to spasm, fibrotic stenosis, inflammation causes bloating of abd. And pain.
Pain- common symptom
At rt. Iliac fossa and rt side colon.
Colicky type
Diarrhoea -not severe as uc. Watery not bloody.
Inflammatory features
Fever, malaise, abd. Pain, wt. Loss
Steatorrhoea and mal-absorption
Crohn's colitis
Bloody diarrhoea
Symptoms like wt. Loss, malaise , anorexia
No involvement of rectum and perianal diseases.
Clinical examination
Wt .loss, mouth ulcer, rt. Iliac fossa tenderness, palpable mass in rectal exam
Perianal disease -edematous anal tag, anal fissures , perianal abscess.
Bloody diarrhoea
Symptoms like wt. Loss, malaise , anorexia
No involvement of rectum and perianal diseases.
Clinical examination
Wt .loss, mouth ulcer, rt. Iliac fossa tenderness, palpable mass in rectal exam
Perianal disease -edematous anal tag, anal fissures , perianal abscess.
Complication
Abscess
Fistula
Intestinal obstruction
Intestinal perforation
Increased risk of CA
Abscess
Fistula
Intestinal obstruction
Intestinal perforation
Increased risk of CA
Ix
Blood cp(ceruloplasmin)
Anaemia
Esr -raised
Serum albumin-hypoalbuminaemia
Stool analysis
Barium enema
Sigmoidoscopy ,colonoscopy
Biopsy
Blood cp(ceruloplasmin)
Anaemia
Esr -raised
Serum albumin-hypoalbuminaemia
Stool analysis
Barium enema
Sigmoidoscopy ,colonoscopy
Biopsy
Imp investigation -
PANCA, or MPO-ANCA, or perinuclear anti-neutrophil cytoplasmic antibodies, are antibodies that stain the material around the nucleus of a neutrophil.
More in u. Colitis.
PANCA, or MPO-ANCA, or perinuclear anti-neutrophil cytoplasmic antibodies, are antibodies that stain the material around the nucleus of a neutrophil.
More in u. Colitis.
The test for anti-Saccharomyces cerevisiae antibodies( asca)
More common for c. Colitis.
More common for c. Colitis.
Management -
Balanced diet
Symptomatic treatment.
Cholestyramin -2-4 gm for 2-3 times. Ac
Loperamide 2-4mg three times daily.
Steroids prednisone 40-60 mg/d for tapering for 2-3week and continue for 4-5 week.
Immunosupressive therapy
Azathioprime and mercaptopurine
Infiximabe if chronic steroids required
Remission may be maintained by help of mesalamine (800 mg 3 times daily).
My YouTube channel -🔗
https://www.youtube.com/channel/UCdm1ayoWPlk-ByN6dnHp-Gg
Balanced diet
Symptomatic treatment.
Cholestyramin -2-4 gm for 2-3 times. Ac
Loperamide 2-4mg three times daily.
Steroids prednisone 40-60 mg/d for tapering for 2-3week and continue for 4-5 week.
Immunosupressive therapy
Azathioprime and mercaptopurine
Infiximabe if chronic steroids required
Remission may be maintained by help of mesalamine (800 mg 3 times daily).
My YouTube channel -🔗
https://www.youtube.com/channel/UCdm1ayoWPlk-ByN6dnHp-Gg
Hi. I’m Designer of Blog Magic. I’m CEO/Founder of ThemeXpose. I’m Creative Art Director, Web Designer, UI/UX Designer, Interaction Designer, Industrial Designer, Web Developer, Business Enthusiast, StartUp Enthusiast, Speaker, Writer and Photographer. Inspired to make things looks better.
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