Inflammatory Bowel Disease ( Ibd )

Inflammatory Bowel Disease ( IBD ) Department of GI in the first affiliated hospital of university zheng zhou

Dr. Niu zhengxian

Definition: Inflammatory bowel disease (IBD), in cluding ulcerative colitis (UC) and Crohn’s disease (CD) are chronic inflammatory disease of the gastrointestinal tract and unknown etiology . They are diagnosed by a set clinical, endoscopic, and histologic characteristics, but no single finding is absolutety diagnostic for one disease or the other. The inflammatory response in U C is largely confined to the mucosa and submucosa of colon , but in C D the inflammatory extends through the intestinal wall from mucosa to serosa, U C is confined to the colon, or rectum. CD can involve any part of the gastrointestinal tract.

Epidemiology: The incidence and prevalence of C D and U C very with geographic location. The highest rates are fur white population in northern Europe and north America, where the in — cidence is about 50 per 100,000 and the prevalence in about 50 per 1000,000 rates in southem Europe south America, Asia, Africa are lower. The incidence is equal in men and women. The peak age at onset is between 15~25years of age. Both diseases occur in childhood.

Etiology: The cause of U C an at C D remains unknown Some causes • Genetic susceptibility: • Infections; Bacterial, vinus: • Immunologic: • Enviromental factors : • Psychological factors : • Smoking :

Pathogenesis: The disruption of the mucosal barrier allows exogenous antigen’s to enter the submucosa and stimulate the gut immune system. A defect of shutting off the activation of gut immune system resulting in a persistent inflammatory response. Proinflammatory cytokins (TNF α .γ IL……) are relased leading to inflammatory process.

Pathology:

• • • • •

U C and C D each have a characteristic pathologic appearance. In general: Anemia Nutrional deficiencies (iron, vitB12) ESR↑(acyive stag ) Hypoalbuminemia

UC • • • • •

Colon appears ulcerated (multiple) Hemorrhagic Rectum involved very common If recurrent, the Colon appears fibrosin longitudinal result in colon shorting Polyps.

C D: • • • •

Small bowel involed very common (ileum) Involving the regional lymph nodos The bowel appears thickened and lumen narrowed. These ulcerations may penetrate into the submucosa and muscular is.

Clinical features: UC

CD

Dr Burrill B.Crohn (1884-1983)

Prognosis: • UC :1.Exteusive ulcerative co1itis and over age 60 •

poor prognosis. 2. Left-sides colitis have a favorable prognosis .

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