75 In f_l ammatory bowel disease

A C U T E C O L I T I S Approximately 5% of patients present with acute severe (fulminant) coli...

Acute severe colitis Patients with a mild attack usually respond to a course of oral prednisolon...

Aetiology The aetiology of CD remains incompletely understood but is thought to involve a complex...

Bacteriology A stool specimen should be sent for microbiological analysis when UC is suspected in...

CANCER RISK IN COLITIS The risk of cancer in ulcerative colitis increases with duration of dise...

CLASSIFICATION OF SEVERITY The assessment of the severity of colitis is determined by the - fre...

CLINICAL MANIFESTATIONS The clinical manifestations of IBD primarily depend on the diagnosis (ei...

CROHN’S DISEASE (REGIONAL ENTERITIS) Chronic inflammatory disease of the ileum, possibly first rec...

Clinical features The clinical presentation depends on the pattern of disease. Occasionally , CD...

Colonic Crohn’s disease Colonic involvement is found in 30% of patients with CD, frequently in a...

Duodenal Crohn’s disease The duodenum is an uncommon site for CD and involvement is more commonly...

EXTRAINTESTINAL MANIFESTATIONS Arthritis occurs in around 15% of patients and is typically an as...

Endoscopic dilatation in Crohn’s disease Although penetrating disease will often require surgical...

Endoscopy Colonoscopic examination may be normal or show patchy eal inflammation. Characteristical...

FURTHER READING Baumgart DC, LeBerre C. Newer biologic and small-molecule therapies for inflammato...

I N V E S T I G A T I O N S Endoscopy and biopsy Rigid/flexible sigmoidoscopy can detect proctitis...

INDETERMINATE COLITIS Approximately one in 10 patients with colitis presents with histological fe...

INFLAMMATORY BOWEL DISEASE

Ileal pouch–vaginal fistula Ileal pouch–vaginal fistula is most commonly due to an anastomotic comp...

Indications for surgery Surgery has a significant role in managing complications of IBD and in im...

INTRODUCTION The term inflammatory bowel disease (IBD) is reserved for conditions characterised by...

Investigations Laboratory A full blood count should be performed as anaemia is common, resulting ...

Learning objectives To understand: The aetiology and pathology underlying in /f_l ammatory • bowe...

Medical treatment Improved understanding of the complex cell signalling path ways that underlie ...

Nutritional support It is essential that nutritional status is evaluated in all patients with IBD...

Operative treatment Emergency In the emergency situation (or for a patient who is malnour - ished...

Pathology The terminal ileum is the most commonly a ff ected segment of bowel in patients with CD...

Perianal Crohn’s disease Perianal CD is distressing and often debilitating for patients. The most...

Radiology A plain abdominal film may indicate the severity of disease in the acute setting and is...

SURGERY Many general surgeons have relatively little experience in managing patients with IBD. Hi...

TREATMENT E ff ective treatment of UC requires a multidisciplinary approach to management. Member...