48,528
edits
Difference between revisions of "Inflammatory bowel disease"
Jump to navigation
Jump to search
tweak
(tweak) |
|||
| Line 7: | Line 7: | ||
Both are associated with an increased risk of [[colorectal carcinoma]].<ref name=pmid20485256>{{cite journal |author=Schmidt C, Bielecki C, Felber J, Stallmach A |title=Surveillance strategies in inflammatory bowel disease |journal=Minerva Gastroenterol Dietol |volume=56 |issue=2 |pages=189–201 |year=2010 |month=June |pmid=20485256 |doi= |url=}}</ref> | Both are associated with an increased risk of [[colorectal carcinoma]].<ref name=pmid20485256>{{cite journal |author=Schmidt C, Bielecki C, Felber J, Stallmach A |title=Surveillance strategies in inflammatory bowel disease |journal=Minerva Gastroenterol Dietol |volume=56 |issue=2 |pages=189–201 |year=2010 |month=June |pmid=20485256 |doi= |url=}}</ref> | ||
=Clinical= | |||
*It is important to differentiate UC and CD as the management is different. | *It is important to differentiate UC and CD as the management is different. | ||
*UC patients get pouches... CD patients do not. | *UC patients get pouches... CD patients do not. | ||
| Line 39: | Line 39: | ||
*[[Irritable bowel syndrome]]. | *[[Irritable bowel syndrome]]. | ||
=Specimens= | |||
*Biopsies for diagnosis. | *Biopsies for diagnosis. | ||
*Surveillance biopsies - to rule-out dysplasia. | *Surveillance biopsies - to rule-out dysplasia. | ||
| Line 77: | Line 77: | ||
</pre> | </pre> | ||
=Microscopic= | |||
Features helpful for the diagnosis of IBD - as based on a study:<ref name=pmid10048734>{{cite journal |author=Tanaka M, Riddell RH, Saito H, Soma Y, Hidaka H, Kudo H |title=Morphologic criteria applicable to biopsy specimens for effective distinction of inflammatory bowel disease from other forms of colitis and of Crohn's disease from ulcerative colitis |journal=Scand. J. Gastroenterol. |volume=34 |issue=1 |pages=55–67 |year=1999 |month=January |pmid=10048734 |doi= |url=}}</ref> | Features helpful for the diagnosis of IBD - as based on a study:<ref name=pmid10048734>{{cite journal |author=Tanaka M, Riddell RH, Saito H, Soma Y, Hidaka H, Kudo H |title=Morphologic criteria applicable to biopsy specimens for effective distinction of inflammatory bowel disease from other forms of colitis and of Crohn's disease from ulcerative colitis |journal=Scand. J. Gastroenterol. |volume=34 |issue=1 |pages=55–67 |year=1999 |month=January |pmid=10048734 |doi= |url=}}</ref> | ||
#Basal inflammation, i.e. crypt base, plasmacytosis with severe chronic inflammation. | #Basal inflammation, i.e. crypt base, plasmacytosis with severe chronic inflammation. | ||
| Line 212: | Line 212: | ||
|} | |} | ||
=Specific diagnoses= | |||
==Ulcerative colitis== | ==Ulcerative colitis== | ||
*Often abbreviated as ''UC''. | *Often abbreviated as ''UC''. | ||
| Line 487: | Line 488: | ||
=="Indeterminate colitis"== | =="Indeterminate colitis"== | ||
*"Indeterminate colitis" is a confusing term and should be avoided.<ref>{{cite journal |author=Geboes K, Colombel JF, Greenstein A, ''et al.'' |title=Indeterminate colitis: a review of the concept--what's in a name? |journal=Inflamm. Bowel Dis. |volume=14 |issue=6 |pages=850–7 |year=2008 |month=June |pmid=18213696 |doi=10.1002/ibd.20361 |url=}}</ref> | *"Indeterminate colitis" is a confusing term and should be avoided.<ref name=pmid18213696>{{cite journal |author=Geboes K, Colombel JF, Greenstein A, ''et al.'' |title=Indeterminate colitis: a review of the concept--what's in a name? |journal=Inflamm. Bowel Dis. |volume=14 |issue=6 |pages=850–7 |year=2008 |month=June |pmid=18213696 |doi=10.1002/ibd.20361 |url=}}</ref> | ||
=== | ===Suggested terminology=== | ||
#IBDU = IBD unclassified. | #IBDU = IBD unclassified. | ||
#CUTE = Colitis of uncertain type or etiology. | #CUTE = Colitis of uncertain type or etiology. | ||
#*Should be reserved for resection specimens only. | #*Should be reserved for resection specimens only. | ||
==Dysplasia-associated lesion or mass== | ==Dysplasia-associated lesion or mass== | ||
| Line 516: | Line 519: | ||
==Pouchitis== | ==Pouchitis== | ||
===General=== | ===General=== | ||
*Inflammation of an ileal pouch | *Inflammation of an ileal pouch; pouches are a treatment for [[ulcerative colitis]]. | ||
**Generally, pouches are ''not'' used in Crohn's disease. | |||
*Chronic pouchitis seen in approximately 15% of patients.<ref name=pmid12617884 >{{Cite journal | last1 = Gionchetti | first1 = P. | last2 = Amadini | first2 = C. | last3 = Rizzello | first3 = F. | last4 = Venturi | first4 = A. | last5 = Poggioli | first5 = G. | last6 = Campieri | first6 = M. | title = Diagnosis and treatment of pouchitis. | journal = Best Pract Res Clin Gastroenterol | volume = 17 | issue = 1 | pages = 75-87 | month = Feb | year = 2003 | doi = | PMID = 12617884 }}</ref> | *Chronic pouchitis seen in approximately 15% of patients.<ref name=pmid12617884 >{{Cite journal | last1 = Gionchetti | first1 = P. | last2 = Amadini | first2 = C. | last3 = Rizzello | first3 = F. | last4 = Venturi | first4 = A. | last5 = Poggioli | first5 = G. | last6 = Campieri | first6 = M. | title = Diagnosis and treatment of pouchitis. | journal = Best Pract Res Clin Gastroenterol | volume = 17 | issue = 1 | pages = 75-87 | month = Feb | year = 2003 | doi = | PMID = 12617884 }}</ref> | ||
*May be assessed by fecal calprotectin.<ref name=pmid18301296>{{Cite journal | last1 = Johnson | first1 = MW. | last2 = Maestranzi | first2 = S. | last3 = Duffy | first3 = AM. | last4 = Dewar | first4 = DH. | last5 = Forbes | first5 = A. | last6 = Bjarnason | first6 = I. | last7 = Sherwood | first7 = RA. | last8 = Ciclitira | first8 = P. | last9 = Nicholls | first9 = JR. | title = Faecal calprotectin: a noninvasive diagnostic tool and marker of severity in pouchitis. | journal = Eur J Gastroenterol Hepatol | volume = 20 | issue = 3 | pages = 174-9 | month = Mar | year = 2008 | doi = 10.1097/MEG.0b013e3282f1c9a7 | PMID = 18301296 }}</ref> | *May be assessed by fecal calprotectin.<ref name=pmid18301296>{{Cite journal | last1 = Johnson | first1 = MW. | last2 = Maestranzi | first2 = S. | last3 = Duffy | first3 = AM. | last4 = Dewar | first4 = DH. | last5 = Forbes | first5 = A. | last6 = Bjarnason | first6 = I. | last7 = Sherwood | first7 = RA. | last8 = Ciclitira | first8 = P. | last9 = Nicholls | first9 = JR. | title = Faecal calprotectin: a noninvasive diagnostic tool and marker of severity in pouchitis. | journal = Eur J Gastroenterol Hepatol | volume = 20 | issue = 3 | pages = 174-9 | month = Mar | year = 2008 | doi = 10.1097/MEG.0b013e3282f1c9a7 | PMID = 18301296 }}</ref> | ||
| Line 544: | Line 548: | ||
**>50. | **>50. | ||
=See also= | |||
*[[Colon]]. | *[[Colon]]. | ||
*[[Colorectal tumours]]. | *[[Colorectal tumours]]. | ||
| Line 551: | Line 555: | ||
*[[Intestinal polyps]]. | *[[Intestinal polyps]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
=External links= | |||
*[http://kathrin.unibas.ch/game/diffdiag01/index.html Crohn's disease vs. ulcerative colitis vs. pseudomembranous colitis puzzle (unibas.ch)] in a collection of [http://kathrin.unibas.ch/game/index.html games] by [http://kathrin.unibas.ch/kathrin/ Katharina Glatz-Krieger]. | *[http://kathrin.unibas.ch/game/diffdiag01/index.html Crohn's disease vs. ulcerative colitis vs. pseudomembranous colitis puzzle (unibas.ch)] in a collection of [http://kathrin.unibas.ch/game/index.html games] by [http://kathrin.unibas.ch/kathrin/ Katharina Glatz-Krieger]. | ||
[[Category:Gastrointestinal pathology]] | [[Category:Gastrointestinal pathology]] | ||