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16 Cards in this Set
- Front
- Back
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What is ulcerative colitis? |
- Inflammation of the superficial mucosa -Mainly affects the rectum and distal colon but can extend down the whole colon - The inflammation tends to be CONTINUOUS not patchy -rectum is often involved
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What are the signs and symptoms of UC?
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The main symptoms are: Bloody diarrhea rectal bleeding dehydration urgency/tenamus Other symptoms can include: Abdominal pain (variable), fever, anemia and weight loss |
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How is mild UC diagnosed? |
Site: distal colon and rectum Diarrhoea: intermittent, 3-5/day without cramping pain Fever: absent Anorexia/weight loss: absent Systemic Sx: absent |
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How is moderate UC diagnosed? |
Site: 1/3 to 1/2 of the colon Diarrhoea: >5/day with blood and cramping pain Fever: intermittent up to 38C Anorexia/weight loss: Intermittent Systemic Sx: Intermittent, fatigue |
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How is sever UC diagnosed? |
Site: usually involves the whole colon Diarrhoea: Profuse with blood Fever: present 38-40C Anorexia/weight loss: sever and persistent Systemic Sx: extreme fatigue and weakness |
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What is the treatment of mild UC? |
1. Rectal 5-ASA + oral 5-ASA E.g Oral Sulfsalazine 2-4g daily in 3-4 divided doses + Mesalazine suppository 1g d or bd IF INEFFECTIVE ADD rectal corticosteroid E.g Prednisolone suppository 5mg d or bd IF STILL INEFFECTIVE ADD oral corticosteroid E.g Prednisolone 40-60mg d until response then taper down
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What is the treatment of moderately sever/extensive UC? |
Oral 5-ASA +/- oral corticosteoid (depending on severity) E.g Sulfsalazine 2-4g daily in 3-4 devided doses +/- Oral Prednisolone 40-60mg daily, then taper down |
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What is the treatment for extensive/sever UC? |
Admission into hospital IV hydrocortisone 100mg q6h for 3-5 days Fluid/blood replacment may be required IF UNRESPONSIVE IV ciclosporin or IV infliximab |
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What is the treatment for UC if the patient is unresponsive to corticosteroids and/or frequently relapsing? |
Azathioprin 2-2.5mg/kg daily OR Mercaptopurine 1-1.5mg/kg daily IF UNFRSPONSIVE AFTER 3 MONTHS Infliximab IV OR Methotrexate oral + Folic acid 5-10 mg daily
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What is the therapy for the maintenance of UC? |
Rectal or Oral 5-ASA e.g Sulfasalazine 500mg tds OR Mesalazine suppository 1g 2-3 times weekly IF INEFFECTIVE Azathioprine OR mercaptopurine OR methotrexate + folic acid weekly OR infliximab IV every 8 weeks |
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What is Chron's Disease? |
- Chronic inflammation that can affect any part of the GI (mouth to anus) - The inflammation may extend to all layers of the GI - The pattern of the inflammation is more patchy/non-continuous and can have a cobble stone appearance |
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What are the main signs and symptoms of Chron's disease? |
-Diarrhoea -Abdominal pain -Weight loss (30% of people) -but no blood in the stool
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What is the treatment for mild to moderate CD? |
Oral prednisolone 40-60mg daily then taper after clinical response IF ILEOCAECAL DISEASE Budesonide controlled release daily for 8 weeks the taper down |
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What is the treatment for sever CD? |
Admission into hospital IV hydrocortisone 100mg q6h for 3-5 days Fluid/blood replacment may be required IF UNRESPONSIVE IV ciclosporin or IV infliximab
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What is the treatment of CD if corticosteroid refractory or dependent? |
Azathioprin 2-2.5mg/kg daily OR Mercaptopurine 1-1.5mg/kg daily IF UNFRSPONSIVE AFTER 3 MONTHS Infliximab IV OR Methotrexate oral + Folic acid 5-10 mg daily |
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What is the treatment plan for the maintenance of CD? |
Azathioprine OR mercaptopurine OR methotrexate + folic acid weekly Stopping Smoking is paramount |
