So this video we’re going to look at ibd which is inflammatory bowel disease a chronic inflammatory bowel disease which pursue a protracted relapsing and remitting course there are two types of ibd s and let us look at them now so ibd typically involve involve the colon but of course one of the types of ibd involve the whole gi t now the two types of ibd are
Ulcerative colitis and crohn’s disease when talking about ulcerative colitis it mainly presents with inflammation of the rectal and sigmoid colon about 40 to 50 percent and this is referred to as proctitis now comparing that to crohn’s disease in crohn’s disease the main area affected is the cecum and the ileum the ileocecal area 40% of crohn’s cases involve the
Ileal and ilio colonic area the second-most common area affecting crohn’s is the small intestine about 30 to 40 percent of cases and in the small intestine we see the inflammation in segments this is termed skip lesions because you have inflammation and then you have no inflammation and then your inflammation again in the no inflammation etc some people who have
Crohn’s can have skip lesions in the colon the large intestine 20% of crohn’s disease cases have this and this is referred to as crohn’s colitis and finally a small majority of cases have perry anal inflammation so those were the four most common areas of affected in crohn’s disease and as we’ve learned a typical characteristic of crohn’s disease are the skip
Lesion going back to all sort of colitis the main areas affected as we talked about is the rectal sigmoid area and this is termed proctitis well a characteristic of ulcerative colitis is that the inflammation can spread and it spreads approximately so from the rectal sigmoid area up the descending colon 30 to 40 percent of ulcerative colitis cases have this and
This is termed left-sided colitis if the inflammation spread far enough that it reaches the transverse colon this is known as extensive colitis so we just saw the common areas affected and in all sort of colitis and crohn’s disease and we saw that they had some differences in that all sort of colitis spreads distal to proximal and crohn’s disease have skip lesions
And mainly affects the ileocecal area but there are a lot more differences which we will go over later on but first let us look at the signs and symptoms associated with the inflammatory bowel disease so signs and symptoms of inflammatory bowel disease can include but not always diarrhea rectal bleeding abdominal pain tenesmus fever weight loss vomiting cramps and
Muscle spasms let us look more at the differences now and similarities between the two types of inflammatory bowel disease so we will look at the differences in gender incidence smoking association the onset location pathology histological differences as well as complications so in ulcerative colitis both genders are affected in the same ratio whereas in crohn’s
They affect more female than male incidence of ulcerative colitis and crohn’s disease are similar except there are more cases of crohn’s disease no spur year two point one to twenty per 100,000 smoking is very interesting for inflammatory bowel disease because for ulcerative colitis smoking is actually a protective factor whereas if you smoke in crohn’s this
Actually aggravates the condition the onset of ulcerative colitis and crohn’s are roughly the same the location which we talked about earlier for ulcerative colitis is mainly the distal colon the rectum and sigmoid area remember and for crohn’s it’s the distal ileum and cecum but it can also affect other areas along the gi t now let’s talk about the pathology the
Differences so for all sort of colitis it is a continuous inflammatory lesion that progresses that it basically progresses from the distal colon to the proximal colon now whereas in crohn’s it is typically discontinuous patchy gut inflammation with skip lesions histologically ulcerative colitis is a superficial inflammation whereas crohn’s disease is a transmural
Inflammation which means that it actually goes through all the layers of the colon complications of ulcerative colitis include severe bleeding toxic megacolon rupture of bowel as well as colon cancer for crohn’s disease complications is a more severe because histologically it affects all the layers of the gi t transmural inflammation so therefore complications
Include stenosis abscess formation fistula colon cancer as well as perforation okay now let’s put all this into drawing let us first zoom into the ulcerative colitis effected colon here so here is the inflammation of the large intestine the superficial inflammation remember all sort of colitis it changes as in relapsing and remitting when the disease is active it
Causes ulceration and information when inactive the cells are basically dying you get atrophy of cells following the in from the inflammatory reaction in ulcerative colitis you can get complications such as severe bleeding toxic megacolon rupture of the bowel and colon cancer now if we were to take a section of the large intestine we have the histological layers
Of course the muscularis the submucosa the mucosa and you can also have these things called pseudo polyps which is a characteristic feature of ulcerative colitis pseudo polyps arise because the cells of the colon are trying to regenerate but they regenerate weirdly causing these polyps as a result now let us compare all sort of colitis to crohn’s disease in crohn’s
Disease it can affect the large intestine or the small intestine let us zoom into the small intestine there here within the small intestine you see transmural inflammation with skip lesions complications of crohn’s disease include stenosis abscess formation fistula colon cancer as well as granulomas if we were to take a cross-section of the small intestine here
Is the mesentery the muscularis the submucosa and the mucosa we can see in crohn’s disease under all the layers are affected it is a transmural inflammation and so complications of crohn’s disease can be quite serious in that it can lead to perforation fistula etc um and in the next video we will look more actually at the pathophysiology of inflammatory bowel
Disease as well as look at the complications the local as well as systemic and the investigations and management that can be that is performed for inflammatory bowel disease thank you
Transcribed from video
Inflammatory Bowel Disease – Crohns and Ulcerative Colitits By Armando Hasudungan