Inflammatory Bowel Disease

Chronic relapsing inflammation of the GIT with unknown origins

2 Types

• Crohn's
• UC

Crohn's

Granulomatous disease

Can affect any part of GI tract

*smI & colon

Ulcerative Colitis

Nongranulomatous disease

Limited to colon

Both have extra intestinal inflammatory sites

Eyes
(uveitis/episcleritis/conjunctivitis)
Joints
(Monoarticular arthritis/Ank Spond/Sacroileitis)
Skin
(Erythema nodosum/vasculitis/pyoderma gangrenosum)
Liver
(fatty change/sclerosing cholangitis/hepatitis/cirrhosis)
Calculi
(higher incidence of calculi - urinary tract & GB)

Aetiology
?cause
Suggested mechanisms:
1) Inflammatory reactions
Mycobacterium
Measles
Viruses
2) Autoimmune
3) Multifocal infarction of GIT

Comparison of the Crohn's and UC

Crohn's

Mouth 2 anus

Skip lesions

Thickened bowel wall

Transmural inflammation

Granulomas

Deep fissuring ulcers

Fistula form

Cancer rare
Non-surveillance

Ulcerative Colitis

Colon only

Continuous lesion

Normal BW thickness

Mucosal inflammation

x Granulomas

Pseudopolyps

x Fistula formation

Cancer common
Surveillance