Difference between revisions of "Inflammatory bowel disease"

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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===
==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.


Epidemiology:
==Epidemiology==
*NOD2/CARD15 variants are assoc. with stricturing CD, early need for surgery and recurrence.<ref name=pmid16244543 >{{cite journal |author=Alvarez-Lobos M, Arostegui JI, Sans M, ''et al.'' |title=Crohn's disease patients carrying Nod2/CARD15 gene variants have an increased and early need for first surgery due to stricturing disease and higher rate of surgical recurrence |journal=Ann. Surg. |volume=242 |issue=5 |pages=693–700 |year=2005 |month=November |pmid=16244543 |pmc=1409853 |doi= |url=}}</ref>
*NOD2/CARD15 variants are assoc. with stricturing CD, early need for surgery and recurrence.<ref name=pmid16244543 >{{cite journal |author=Alvarez-Lobos M, Arostegui JI, Sans M, ''et al.'' |title=Crohn's disease patients carrying Nod2/CARD15 gene variants have an increased and early need for first surgery due to stricturing disease and higher rate of surgical recurrence |journal=Ann. Surg. |volume=242 |issue=5 |pages=693–700 |year=2005 |month=November |pmid=16244543 |pmc=1409853 |doi= |url=}}</ref>


===Microscopic===
==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, i.e. crypt base, plasmacytosis with severe chronic inflammation,
*Basal, i.e. crypt base, plasmacytosis with severe chronic inflammation,
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# The hepatic flexure is considered the divider for normal paneth cells and abnormal paneth cells, i.e. paneth cells proximal to the hepatic flexure are normal; paneth cells distal to the hepatic flexure are abnormal.<ref>STC. 14 December 2009.</ref>
# The hepatic flexure is considered the divider for normal paneth cells and abnormal paneth cells, i.e. paneth cells proximal to the hepatic flexure are normal; paneth cells distal to the hepatic flexure are abnormal.<ref>STC. 14 December 2009.</ref>


===Crohn's disease vs. ulcerative colitis===
==Crohn's disease vs. ulcerative colitis==
UC features:<ref name=Ref_PBoD850>{{Ref PBoD|850}}</ref>
UC features:<ref name=Ref_PBoD850>{{Ref PBoD|850}}</ref>
*Mucosal involvement --sometimes submucosa.  
*Mucosal involvement --sometimes submucosa.  
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