Study Guide for GI
Crohn’s Disease (15-40y/o)
Ulcerative Colitis (15-25, 55-65y/o)
Aka: regional enteritis or infal. Bowel dz.
Can occur an
anytime but usually adolescents/young adults. Affects ileum,
ascending colon, and cecum. As lesions heal, scar tissue may
form which prevents food from being absorbed normally.
Stricutes may also occur leading to intestinal obstruction as
well as fistulas b/t segments. Most often in terminal ileum,
with patchy involvement through all layers of the bowel. 7-10
stools/day. Inflammatory dz of small intestine, colon, or both.
Involves all layers of bowel but most commonly involves the
terminal ileum. Slowly progressive and recurrent with
predominant involvement of multiple regions of the intestine
w/ normal sections b/t. Chronic, nonspecific inflammation of
the entire intestinal tract. Eventually deep fissures and
ulcerations develop and extends through all bowel layers.
Begins in rectum and proceeds in a continuous
manner toward cecum. (10-20stools/day).
Ulcerative and inflammatory disease of the
colon and rectum. Affects distal colorectal
area primarily left colon. Affects superficial
mucosa of the colon w/ alternating period of
remission and exacerbation. Ulcerative lesions
are continuous, and eventually spread
throughout the large intestine. Over time, the
bowel will narrow, shorten, and thicken.
RLQ pain, anorexia, weight loss, malnutrition, fever,
leukocytosis, stools may contain mucous, pus, and FAT.
Diarrhea major symptom w/ 7-10 stools/day. Bowel sounds
may be decreased/absent.
Abdominal pain, diarrhea, stools that have
blood, put, and mucous, but NO fat, fecal
bleeding, anemia, fever, bowel obstruction,
hemorrhage, abscess formation,
malabsorption, perforation, increased risk for
Sulfasalazine, glucocorticoids, Flagyl, Imuran,
Immunosuppressive drugs: Methotrexate, Infliximab
Sulfasalazine, Mesalamine, Dipentum,
Colazal.Rowasa enema, coorticosteriods
(prednisone), Hydrocortisone rectal foam,
hydrocortisone enema. Immunosuppressive
drugs: not effective alone but good when in
combo w/ steroids. cyclosporine, Purinethol.
Antidiarrheal drugs: Lomotil, Imodium.
Infliximab (used if no other drug is working.
Barium enema, colonoscopy, stool specimen (+ for
steatorrhea). Decreased H&H w/ bleeding.
Low folic acid
and B12 b/c decreased absorption.
Decreased albumin levels
b/c decreased amino acid absorption. Increased ESR b/c
inflammation. Decreased electrolytes b/c diarrhea.
for bowel rest. Elemental diet using Vivonex to induce
remission. Elemental diets are absorbed in the jejunum. Once
in remission, a low residue diet is used. Supplements such as
ensure can be sued for calories. Avoid caffeine, alcohol.
Surgical management: resection by laparoscopy. Small bowel