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13 Cards in this Set
- Front
- Back
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Crohn's disease is an inflammatory disease of the gastrointestinal tract lining, most commonly at the __________ and __________ but __________.
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terminal ileum and ascending colon
but it can involve any part of the gastrointestinal tract from the mouth to the peri-anal area. |
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Crohn's develops as a result of
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excessive instestinal mucosal T-lymphocytes, which cause chronic inflammation.
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Is damage in Crohn's limited or transmural?
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Transmural
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Are skip-lesions present in Crohn's or UC?
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Crohn's
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Complications of Crohn's
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1. Strictures
2. Fistulas 3. Malabsorption 4. Perforation (surgical emergency) |
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Peak incidence age for Crohn's
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two peaks
at 20 (smaller peak) at 50 |
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F:M ratio for Crohn's
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F > M
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Apart from age and gender, two other risk factors for Crohn's
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smoking
european descent |
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Common symptoms of Crohn's
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• Abdominal pain (commonly lower right quadrant),
• Diarrhea, Vomiting • Weight loss • Anorexia • Malaise, Lethargy • Fever • Anemia if bleeding is involved. |
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Examination findings in Crohn's
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Apthous ulcers of the mouth (like pale spots on back of lips)
?mass in RLQ abdo tenderness perianal fistulas anal skin tags anorectal strictures |
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Best way to confirm diagnosis of Crohn's
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Endoscopy with biopsy
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Investigations in suspsected Crohn's
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• Stool samples: to rule out an infectious cause of diarrhoea.
• Blood tests: will often show a raised WCC, ESR,CRP, low albumin and suggest anaemia • Barium swallow x-ray series: used to identify strictures and fistulas in the small intestine. Barium enema may be useful for colonic strictures. • Endoscopy with biopsy is the most accurate way of confirming the diagnosis. • Plain X-Ray: to look for perforation. |
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Management principles for Crohn's (what and how)
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1. Reduce inflammation (steroids, IV or oral if mild)
2. Relieve symptoms (anti-diarrhoetic, abscess drain, stoma formation) 3. Keep inflammation in remission (immunosupressive drugs e.g. 5ASA derivatives) 4. Lifestyle advice (stop smoking, dietary supplements if malabsorption, regular colon Ca screening due to incr risk in Crohn's) |
