Lightning Learning: Inflammatory Bowel Disease
Inflammatory Bowel Disease (IBD) is a chronic condition resulting in inflammation of the gastrointestinal tract.
It is divided into Crohn’s disease (CD), affecting the entire GI tract from mouth to anus, and ulcerative colitis (UC) affecting colon and rectum.
Symptoms of IBD include; bloody diarrhoea, abdominal pain, loss of appetite, fever, weight loss and fecal urgency.
Severity of IBD depends on the number of bowel motions and the Montreal severity index (for UC) or CD activity index (for CD).
Flare ups of IBD can result in toxic megacolon which is a life-threatening complication of IBD.
It presents as severe abdominal pain in systemically unwell patients, and can be accompanied with a fever. An abdominal CT or plain abdominal film can help to identify toxic megacolon.
Features to look for are dilated loops of colon (>6cm), loss of haustra, and thumbprinting (due
to mucosal oedema).
Pneumo-peritoneum can be evident if it has perforated. Less serious flare ups of IBD generally respond to intravenous fluids with high dose steroids with antibiotics if indicated.