Inflammatory bowel disease (summary)
Updates to Article Attributes
Inflammatory bowel disease is a generic term used to describe diseases of the GI tract that have an inflammatory cause. Crohns disease (CD) and ulcerative colitis (UC) are the commonest causes of inflammatory bowel disease.
Reference article
This is a summary article for inflammatory bowel disease. However, we do have a; read more in-depth reference our article on inflammatory bowel disease.
Summary
-
epidemiology
- young adults
- CD: 15-25, M=F
- UC: 15-40, M>F
- young adults
-
presentation
- chronic diarrhoea (may be bloody)
- abdominal pain
- Crohns may present with extra-intestinal features
-
pathophysiology
- CD: any part of the bowel may be affected
- skip lesions, fistulation
- US: only the colon is affected
- CD: any part of the bowel may be affected
-
investigation
- blood tests: raised inflammatory markers, e.g. CRP, ESR
- colonoscopy: visualise abnormal areas and allow biopsy
- ultrasound: thickened bowel wall
- CT: used in the acutely unwell patient to identify complications
- MRI: assessment of small bowel or perianal fistula (Crohns)
-
treatment
- disease modifying drugs
- steroids
- immunomodulation, e.g. azathioprine, cyclosporine, methotrexate
- biological agents, e.g. infliximab
- surgical treatment
- strictures, fistulae, abscess, perforation
- non-responding bowel disease, e.g. colectomy
- disease modifying drugs
Role of imaging
Radiology can be useful for diagnosis and follow-up.
- identify abnormal bowel
- determine response to therapy
- identify complications
Radiographic features
Ultrasound
Bowel ultrasound allows assessment of the whole bowel. It is a relatively simple technique but requires a practitioner who has appropriate experience. It requires patient preparation and cooperation and may take up to 30 minutes.
- bowel wall thickening
- loss of normal bowel wall architecture
- increased vascularity
Ultrasound may also detect complications:
- localised perforation
- interloop abscess
- fistulation
Ultrasound is used in the assessment of rectal disease (endorectal ultrasound) and of liver disease (abdominal ultrasound).
CT
CT with both IV and luminal contrast can be used to assess small and large bowel.
- bowel wall thickening
- ulceration
- strictures
- fistulae (CD)
- abscess formation and perforation
MRI
MRI is particularly useful in Crohns disease:
- assessment of small bowel disease
- assessment of perianal fistulae
-<p><strong>Inflammatory bowel disease</strong> is a generic term used to describe diseases of the GI tract that have an inflammatory cause. Crohns disease (CD) and ulcerative colitis (UC) are the commonest causes of inflammatory bowel disease.</p><h4>Reference article</h4><p>This is a <a href="/articles/summary-article">summary article</a> for inflammatory bowel disease. However, we do have a more in-depth reference article: <a href="/articles/inflammatory-bowel-disease">inflammatory bowel disease</a>.</p><h4>Summary</h4><ul>- +<p><strong>Inflammatory bowel disease</strong> is a generic term used to describe diseases of the GI tract that have an inflammatory cause. Crohns disease (CD) and ulcerative colitis (UC) are the commonest causes of inflammatory bowel disease.</p><h4>Reference article</h4><p>This is a <a href="/articles/summary-article">summary article</a>; read more in our article on <a title="Inflammatory bowel disease" href="/articles/inflammatory-bowel-disease">i</a><a title="Inflammatory bowel disease" href="/articles/inflammatory-bowel-disease">nflammatory</a><a title="Inflammatory bowel disease" href="/articles/inflammatory-bowel-disease"> bowel disease</a>.</p><h4>Summary</h4><ul>