Back
ditki Logo
medical & biological sciences
All Access Pass - 1 FREE Month!
Institutional email required, no credit card necessary.

Inflammatory Bowel Disease for the NP Exam

Free One-Month! Institutional (.edu or .org) email required
Log in or start your One-Week Free Trial!
Inflammatory Bowel Disease (IBD)
Overview
  • Inflammatory Bowel Disease (IBD) consists of two chronic inflammatory conditions: Ulcerative Colitis (UC) and Crohn’s Disease (CD).
  • UC is limited to the colon, while CD can affect any part of the gastrointestinal (GI) tract.
Pathophysiology
  • Immune dysregulation: Both UC and CD result from an abnormal immune response to gut microbiota in genetically predisposed individuals.
    • UC: Inflammation is limited to the mucosa.
    • CD: Inflammation is transmural, affecting all layers of the bowel.
  • Genetics: Mutations in the NOD2 gene are associated with CD.
  • Environmental factors: Smoking worsens CD but may have a protective effect in UC.
Ulcerative Colitis (UC)
  • Location: Involves only the colon and always starts in the rectum, extending proximally in a continuous manner.
Ulcerative Colitis
  • Symptoms: Bloody diarrhea is the hallmark, often accompanied by abdominal pain (typically left-sided) and tenesmus.
  • Complications: Increased risk of toxic megacolon and colon cancer.
Crohn’s Disease (CD)
  • Location: Can affect any part of the GI tract, most commonly the terminal ileum and colon. CD is characterized by skip lesions (discontinuous inflammation).
Crohn’s Disease
  • Symptoms: Non-bloody diarrhea, right lower quadrant (RLQ) pain, and perianal disease (e.g., fistulas).
  • Complications: Strictures, fistulas, and malabsorption (leading to deficiencies like vitamin B12).
Diagnosis
  • Endoscopy with biopsy: The gold standard for diagnosis. UC shows continuous inflammation, while CD displays skip lesions and deep ulcers.
  • Lab markers: Elevated C-reactive protein (CRP) and fecal calprotectin indicate active inflammation.
Treatment
  • Corticosteroids: Used for inducing remission during flares.
  • Immunomodulators and biologics: Such as azathioprine or infliximab for long-term management and prevention of relapses.
Key Points
  • Ulcerative Colitis is limited to the colon, with bloody diarrhea as the hallmark symptom, while Crohn’s Disease can affect any part of the GI tract, often presenting with non-bloody diarrhea and RLQ pain.
  • Complications include toxic megacolon and colon cancer in UC, and fistulas, strictures, and malabsorption in CD.
  • Diagnosis is confirmed by endoscopy with biopsy, supported by elevated CRP and fecal calprotectin.
  • Treatment includes corticosteroids for acute flares and immunosuppressants or biologics for maintenance.

Related Tutorials