What is inflammatory bowel disease?
Chronic, relapsing, remitting inflammation of the GI tract
What are examples of inflammatory bowel disease?
What do Crohn's disease and ulcerative colitis differ in?
Location and inflammation
When does inflammatory bowel disease commonly present?
In the teens and twenties
What can IBD be due to?
Is IBD medelian inherited?
No, but has genetic susceptibility
What kind of genetic variation makes people genetically susceptible to IBD?
SNPs (single nucleotide polymorphisms)
What percentage of someones offspring who has IBD will also develop IBD?
What do genes that cause inflammatory bowel disease regulate?
What is the pathogenesis of IBD?
Pathogenic gut causes altered microbiota
Damaged epithelial barrier increases bacterial adhesion and translocation
Chronic inflammation occurs
What is the ratio of microbial cells in the gut lumen to eukaryotic cells in the human body?
How many different species of bacteria are present in the gut?
At least 500 different species
What is the metabolic activity of all gut bacteria equivalent to?
That of the liver
What part of the gut contains the most bacteria?
What is different in the microbiota of people with IBD compared to those without?
In IBD there is a dysbosia in microbial communities
What kind of bacteria is massively more present in people with IBD than those who do not have it?
What is ulcerative colitis?
Chronic condition where the colon and rectum become inflammed
How does ulcerative colitis affect males compared to females?
Both affected the same
What are symptoms of ulcerative colitis?
What investigations are done for ulcerative colitis?
Bloods for markers of inflammation
Stool culture to rule out infection
Colonoscopy and colon mucosal biopsies
What are examples of markers of inflammation checked for in ulcerative colitis?
What is considered normal faecal calprotectin?
<50ug/g of stool
What is considered elevated faecal calprotectin?
>200ug/g of stool
What is faecal calprotectin?
Substance that is released into the intestines when inflammation is present
Where in the GI tract is inflammation due to ulcerative colitis present?
Only in the colon, starting at the rectum and working proximally
What percentage of people with ulcerative colitis require a colectomy within 10 years of diagnosis?
What are the different levels of severity of ulcerative colities?
What are characteristics of mild ulcerative colitis?
With or without blood
No signs of toxicity
What are characteristics of moderate ulcerative colitis?
Minimal signs of toxicity
CRP less than or equal to 30mg/L
What are characteristics of severe ulcerative colitis?
More than or equal to 6 blood stools/day
AND any of:
temperature > 37.8
tachycardia > 90bpm
anaemia (Hb < 105g/L)
ESR > 30mm/h, CRP > 30mg/L