BY : KHALED HANI. NAJI. ALKHODARI

SADI YEHIA EL-NAKHALA

SUPERVISOR : DR. OMAR SALEH FERWANA

Inflammatory Bowel disease IBD

Crohn’s disease

Ulcerative colitis

General introduction :

Inflammatory bowel disease (IBD) is a chronic condition

that includes two major entities :

1- Crohn’s disease

2- ulcerative colitis

The distinction between ulcerative colitis

and Crohn disease is based, in large part, on:

1. the distribution of affected sites

2. the morphologic expression of disease at those sites

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General introduction :

Ulcerative colitis is limited to the colon and

rectum and extends only into the mucosa and

submucosa.

Crohn’s disease may involve any area of the

gastrointestinal tract and frequently is transmural

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Causes

The exact cause of IBD is unknown, However,

most investigators believe that IBD results from a

combination of :

Genetic factors.

Mucosal immune responses.

Environmental factors

Bacteria( epithelial defect )

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Genetic factors

Risk of disease is increased when there is an

affected family member.

In Crohn disease, the concordance rate for

monozygotic twins is approximately 50%.

In ulcerative colitis concordance rate for monozygotic

twins is only 16%.

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Mucosal immune responses

Although the mechanisms by which mucosal

immunity contributes to the pathogenesis of

Ulcerative colitis and Crohn disease are still

being not completely understood. it is likely that

some combination of derangements that

activate mucosal immunity and suppress

immunoregulation contribute to the

development of both ulcerative colitis and

Crohn disease

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Epithelial defects

Variety of

epithelial

defects have

been described

in Crohn disease

& ulcerative

colitis.

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Ulcerative colitis

By : Khaled H. Alkhodari

Introduction

Is a disease in which extensive areas of the walls of the

large intestine become inflamed and ulcerated.

The motility of the ulcerated colon is often so great that mass movements occur much of the day.

The colon’s secretions are greatly enhanced the

patient has repeated diarrheal bowel movements.

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Introduction

Begins gradually and can become worse over time.

Is an autoimmune disease characterized by T-cells infiltrating

the colon.

Ulcerative colitis usually involves the rectum and is confined

to the colon, with occasional involvement of the ileum.

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Signs and symptoms

The most common are diarrhea with blood or

pus and abdominal discomfort. Other signs and

symptoms include:

An urgent need to have a bowel movement.

Feeling tired.

Nausea or loss of appetite.

Weight loss.

Fever.

Anemia.

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Complications

Rectal bleeding.

Dehydration and malabsorbtion.

Changes in bones.

Inflammation in other areas of the body.

Megacolon

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Treatment - Medications

No medication cures ulcerative colitis, many

can reduce symptoms. The goals of medication

therapy are:

Inducing and maintaining remission.

Improving the person's quality of life.

Medications that best treat symptoms:

Aminosalicylates (Aspirin and Ibuprofen.).

Corticosteroids (prednisone).

Immunomodulators.

Other medications.

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Removal of the entire colon "cures" ulcerative colitis.

A surgeon can do that by two different types of

surgery :

Proctocolectomy and ileostomy.

Proctocolectomy and ileoanal reservoir.

Full recovery from both operations may take 4 to 6

weeks.

Treatment – Surgery

IleostomyIleoanal reservoir

CROHN DISEASE

BY : SADI NAKHALA

Crohn’s disease:

also known as regional enteritis, may occur in any area of the gastrointestinal

tract !!

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American Gastroenterologist: Burrill Bernard Crohn

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The most common sites involved by

Crohn’s disease at presentation are:

1-terminal ileum.2-ileocecal valve.

3-cecum.

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1-skip lesion :

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The characteristic of crohn's disease

The characteristic of crohn's disease

2- Strictures (stenosis )

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3-loss of normal mucosal folds ( linear mucosa )

in addition to ( cobblestone –shaped mucosa )

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The characteristic of crohn's disease

4- (creeping fat)

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The characteristic of crohn's disease

5- The microscopic features of active

Crohn disease include abundant

neutrophils that infiltrate and damage

crypt epithelium ,, Clusters of

neutrophils within a crypt are referred

to as a crypt abscess and often are associated with crypt destruction.

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The characteristic of crohn's disease

Clinical features :

1- In most patients, disease begins with:

-mild diarrhea

-fever and abdominal pain

2- Iron deficiency anemia may develop in persons with colonic disease

3- extensive small bowel disease may result in :

-serum protein loss -generalized nutrient malabsorption

(VB12 and bile salts )

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Treatment :

1- Anti-inflammatory drugs ( reduces inflammation )

2- Immune system suppressors ( suppress immune

system that increases inflammation )

3- Antibiotics (reduce harmful intestinal bacteria )

4- Surgery

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COMPARISON

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References

Robbins-basic pathology ,9th editiom

The National Institute of Diabetes and Digestive and

Kidney Diseases:

http://www.niddk.nih.gov/health-information/health-

topics/digestive-diseases/ulcerative-colitis/Pages/facts.aspx#what

Guyton and Hall Textbook of Medical Physiology, 12th edition.

Pathoma.

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Thank you

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