IBD is
ulcerative collitis + chrons disease
what are the characterisations of IBD
inflammation, swelling and ulceration os intestinal tissue. This is chronic with periods of remission,
Symptoms of IBD
stomach pain, weight loss, diarrhoea, tiredness
joint pain, inflamed eyes and rashes (less common)
Ulcerative collitis ( where it effects, and symptoms)
only effects the large bowel ( colon and rectum) and the inflammation is on the inner lining so its limited to the bowel mucosa and can include oedema, ulceration and haemmorhage: usually present with blood and mucus in the stools and abdominal pain
Chrons disease ( where it effects, and symptoms)
can effect any area of the GI system from mouth to anus, areas of the gut are interspersed with areas of disease and all layers of tissue can be inflamed, clinical features are more varied than in UC- including vomiting, diarrhoea, weight loss and abdominal pain
IBD diagnosis
presenting symptoms, blood tests done for anaemia, vit deficiency and inflammatory markers, xrays , sigmoidoscopy/colonoscopy,
for crohns - small bowel enema and capsule endoscopy
causes of IBD
unknown, but it can be a result of a weakened immune system - possible causes include: incorrect response to environmental triggers eg virus/bacteria or genetic links
IBD prevalence
most common in : late teens/early 20s, white ethnic groups, women
effects 1/350
what are the aims of treatment of IBD
induce/ maintain remission , improve quality of life, reduce inflammation and autoimmune response
which drugs reduce inflammation
steroids, aminosalicylates, cytokine modulators
which drugs reduce autoimmune response
imunosuppressant drugs
corticosteroids eg
hydrocortisone, beclomathasone, budenoside, prednisolone (oral/rectal)
cautions/side effects/interactions with corticosteroids
ct: congestive heart failure, hypothyroidism, osteoporosis, untreated infection
se: insomnia, dyspepsia, cushings, adrenal suppression , mood change, increased infection riskm weight gain
interactions: grapefruit juice ( increases plasma conc of oral budesonide) , antagonise diuretic effects
aminosalicylates eg
balsalazide, mesalazine, olsalazine, sulfasalazine ( oral/rectal) - these are taken regularly
5-ASA ( aminosalicylate) commonly used in
colitis - as initial trwatment for flare ups and to maintain a period of recovery
NOT commonly used in crohns but can be used if your symptoms are mild and you dont have steroids
aminosalicylates side effects
salicylate sensitivity, nausea, headaches
rare: blood disorders, bleeding, bruising, purpura, sore throat, fever , kidney effects
(check renal function regularly)
sulfazanine side effects
colours urine and contact lenses organse and degreses conc of digoxin and absorption of folates
cytokine modulators
monoclonal antibodies which inhivit pro-inflammatory cytokine, tumour necrosis factor alpha
administered subcutaneous eg infliximab, adalimumab, golimumab, vedolizumab
stops the epansion of activated t cells by interupting a cascade
immunosuppressants eg
azathioprine, ciclosporin, mercaptopurine, methotrexate
( oral or injection )
what are immunosuppressants
anticancer drugs with blood and liver toxicity - T cell effects
what happens if your on methotrexate
( dosing etc)
weekly dosage, with one dose of folic acid per week to reduce side effects, FBC , renal and liver testing
mild disease in rectum and recto-sigmoid is treated with
local steroid or aminosalicylate
diffuse/unresponsive IBD treated
orally with steroid or amiinosalicylate ( alone or combination)
severe IBD cases treatment
parenteral administration of steroid, immunosuppression and antibody therapy)
-
lecture 112
-
lecture 249
-
lecture 325
-
lecture 422
-
lecture 527
-
lecture 616
-
lecture 726
-
lecture 813
-
lecture 935
-
lecture 1021
-
lecture 1114
-
lecture 124
-
lecture 1332
-
lecture 1429
-
lecture 1641
-
lecture 174
-
lecture 1836
-
lecture 1923
-
lecture 2015
-
lecture 2118
-
lecture 221
-
lecture 2342
-
lecture 2439
-
lecture 250
-
random1
