Pathogenesis
Risk Factors for Inflammatory Bowel Disease
- Family history of inflammatory bowel disease
- Western diet - high fat, high sugar
- Medications - NSAIDs, oral contraceptives
- Not being breastfed
- Psychological stress
Manifestations
Manifestations of Inflammatory Bowel Disease
- Bloody diarrhoea
- Toxic megacolon
- Fulminant colitis
- Stricturing
- Colorectal cancer
Extra-Intestinal
- Dermatologic - erythema nodosum, pyoderma gangrenosum
- Musculoskeletal - enteropathic arthritis, osteoporosis
- Hepatic - primary sclerosing cholangitis, non-alcoholic fatty liver disease, cirrhosis, cholelithiasis (Crohn's)
- Renal - nephrolithiasis (calcium oxalate)
- Ocular - uveitis, episcleritis, conjunctivitis
Management
Management Options for Ulcerative Colitis
Non-Pharmacologic
- Nutritional optimisation
- Psychologic supports
- Cancer surveillance
Pharmacologic
- Steroids
- 5-Aminosalicylates - sulfasalazine, mesalazine
- Thiopurines - azathioprine, 6-mercaptopurine
- Calcineurin inhibitors - cyclosporin, tacrolimus
- TNF blockers - infliximab, adalimumab
- Other biologics - vedolizumab, ustekinumab
Surgical
- Colectomy + ileoanal pouch
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