Inflammatory Bowel Disease: Types, Symptoms, Pathology

INFLAMMATORY BOWEL DISEASE

There are 2 types of inflammatory bowel disease (IBD)

CROHN'S DISEASE: Any area of the GIT mc site is the ileum, transmural (all layers)

ULCERATIVE COLITIS: It occurred in the colon, Rectum submucosal

EPIDEMIOLOGY :

• It is Bimodal seen in 15-20 years and elderly.
• it is mostly seen in developed countries.
• Female is more prone than male.

PATHOGENESIS OF IBD:

• Because of intake of food rich in preservatives, packed food causing defective development of mucosal immune response.
• If we see of genetic for IBD
• NOD-2 gene polymorphisms started the disease and activate the NF-Kbeta pathway which increases cell proliferation and leads to inflammatory bowel disease.
• another gene affected is ATG16LI, IRGM

HLA association in IBD :

• In Crohn's Disease HLA DR1 effect 
• In Ulcerative Colitis HLA DR2 effect

EARLY-ONSET OF INFLAMMATORY BOWEL DISEASE :

• Usually seen in infants and children
• it occurs due to a defect in the gene for epithelial transport.
• Also associated with ILI beta and IL 10 receptor defect.

Inflammatory Bowel Disease Treatment:

therapy against IL 10 Receptor: patient responds well.

1) CROHN'S DISEASE::

The common site for Crohn's Disease is the ileum.

Gross features :

• skip lesions seen on effective site and it is characterized feature for identifying Crohn's disease.
• Aphthous ulcers are the earliest lesion and it is a deep knife-like and serpentine ulcer.
• Rubbery thick Intestinal wall is seen on site of lesions.
• on the affected area cobblestone appearance of mucosa seen.
• creeping fat seen like mesenteric fat oozes out of the serosal surface.

HISTOPATHOLOGY FEATURES :

• transmural involvement seen
• non-caseating granuloma
• cryptitis
• crypt abscess 

NOTE: Cryptitis and crypt abscess is most common in Ulcerative Colitis.

2) ULCERATIVE COLITIS::

The most common site for UC is the rectum, Colin, terminal ileum.

GROSS FEATURES :

• continuous involvement 
• Ulcer seen on lesions it is superficial,broad-based.
• In islands of Regenerating mucosa  PSEUDOPOLYPS Seen.

which is most common in Ulcerative Colitis and seen as diffuse distribution.

it is seen as patchy distribution in Crohn's Disease.

• The mucosal bridge is seen on the affected area
• Toxic megacolon is present

HISTOPATHOLOGY :

• Submucosal involvement seen
• the ulcer is more prominent than Crohn's disease
• No granuloma seen
• Cryptitis has seen which is most common in Crohn's disease.
• Crypt abscess seen

NOTE :

Cryptitis is also seen in infective colitis,

radiation colitis, diverticular disease.

CLINICAL PRESENTATION/SIGN AND SYMPTOMS | Inflammatory Bowel Disease SYMPTOMS:

Fever, abdominal pain, Diarrhea

extraintestinal manifestation :

Crohn's disease: Uveitis, Ankylosis Spondylitis, migratory Polyarthritis, primary sclerosis, cholangitis

Ulcerative Colitis: Primary Sclerosis, Cholangitis

* Colitis associated neoplasia ( CAN ) seen in both condition but it is more seen in Ulcerative Colitis than Crohn's disease.

*undetermined colitis: 10% of the case where the type of IBD was can't identify.

NOTICE: This blog Only for knowledge 

Brief Knowledge about other GIT disease :

1) Malabsorption syndrome :

• Celiac Disease
• Whipple's Disease
• Tropical sprue

2) ULCER

-There is 3 types of ulcer

a) Typhoid ulcer

• site: ileocecal junction
• it is longitudinal in shape
• less stricture
• erythrophagocytosis has seen in microscopic.

b) TB ulcer

• site: ileocecal junction
• it transverse In shape
• more chances of stricture
• Tb bacilli and granuloma is seen in the microscope.

c) Amoebiasis Ulcer

• Site: Caecum (mc), liver 
• It is a flask-shaped ulcer
• vesicles caused by entamoeba histolytica seen in the microscope.
• Comment below which topic you want.