Inflammatory

Bowel disease
IBD
Crohn’s Ulcerativ
e
disease colitis
BY : KHALED HANI. NAJI. ALKHODARI
SADI YEHIA EL-NAKHALA
SUPERVISOR : DR. OMAR SALEH
FERWANA
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General
introduction :

 Inflammatory bowel disease (IBD) is a chronic

condition that includes two major entities :
1 Crohn’s disease
2 ulcerative colitis

 The distinction between ulcerative colitis

and Crohn disease is based, in large part, on:
1. the distribution of affected sites
2. the morphologic expression of disease at those sites
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General
introduction :

 Ulcerative colitis is limited to the colon and

rectum and extends only into the mucosa
and submucosa.

 Crohn’s disease may involve any area of

the gastrointestinal tract and frequently is
transmural
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Causes

 The exact cause of IBD is unknown, However,

most investigators believe that IBD results from
a combination of :
 Genetic factors.
 Mucosal immune responses.
 Environmental factors
 Bacteria( epithelial defect )
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Genetic
factors

 Risk of disease is increased when there is

an affected family member.
 In Crohn disease, the concordance rate for
monozygotic twins is approximately 50%.

 In ulcerative colitis concordance rate for

monozygotic twins is only 16%.
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Mucosal immune
responses

 Although the mechanisms by which mucosal

immunity contributes to the pathogenesis of
Ulcerative colitis and Crohn disease are still
being not completely understood. it is likely that
some combination of derangementsthat
activate mucosal immunity and suppress
immunoregulation contribute to the
development of both ulcerative colitis and
Crohn disease
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Epithelial
defects

 Variety of
epithelial
defects have
been described
in Crohn
disease &
ulcerative
colitis.
Ulcerative
colitis

By : Khaled H.
Alkhodari
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Introduction

 Is a disease in which extensive areas of the walls of

the
large intestine become inflamed and ulcerated.

 The motility of the ulcerated colon is often so great

that
mass movements occur much of the day.

 The colon’s secretions are greatly enhanced 

the
patient has repeated diarrheal bowel movements.
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Introduction 0

 Begins gradually and can become worse over time.

 Is an autoimmune disease characterized by T-cells

infiltrating
the colon.

 Ulcerative colitis usually involves the rectum and is

confined to the colon, with occasional involvement of the
ileum.
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Signs and 1
symptoms

 The most common are diarrhea with blood or

pus and abdominal discomfort. Other signs
and symptoms include:
 An urgent need to have a bowel movement.
 Feeling tired.
 Nausea or loss of appetite.
 Weight loss.
 Fever.
 Anemia.
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Complication 2
s

 Rectal bleeding.
 Dehydration and malabsorbtion.
 Changes in bones.
 Inflammation in other areas of the
body.
 Megacolon
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3
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Treatment - 4
Medications
 No medication cures ulcerative colitis, many
can reduce symptoms. The goals of
medication therapy are:
 Inducing and maintaining remission.
 Improving the person's quality of life.
 Medications that best treat symptoms:
 Aminosalicylates (Aspirin and Ibuprofen.).
 Corticosteroids (prednisone).
 Immunomodulators.
 Other medications.
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Treatment – 5
Surgery
 Removal of the entire colon "cures" ulcerative colitis.
A surgeon can do that by two different types
of surgery :
 Proctocolectomy and ileostomy.
 Proctocolectomy and ileoanal reservoir.
 Full recovery from both operations may take 4
to weeks.
6 Ileoanal reservoir Ileostomy
CROHN
DISEASE
BY : SADI
NAKHALA
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Crohn’s 7
disease:

also known as regional

enteritis, may occur in any
area of the gastrointestinal
tract !!
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American Gastroenterologist: 8
Burrill Bernard Crohn
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9

 The most common sites involved by

Crohn’s disease at presentation
are:
1-terminal ileum.
2-ileocecal valve.
3-cecum.
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0
The characteristic of crohn's
disease
 1-skip lesion :
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1
The characteristic of crohn's
disease
 2- Strictures (stenosis )
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2
The characteristic of crohn's
disease
 3-loss of normal mucosal folds ( linear mucosa )
in addition to ( cobblestone –shaped mucosa )
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3
The characteristic of crohn's
disease
 4- (creeping fat)
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4
The characteristic of crohn's
disease
 5- The microscopic features of active
Crohn disease include abundant
neutrophils that infiltrate and damage
crypt epithelium ,, Clusters of
neutrophils within a crypt are referred
to as a crypt abscess and often are
associated with crypt destruction.
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Clinical 5
features :

1- In most patients, disease begins with:

-mild diarrhea
-fever and abdominal pain
2- Iron deficiency anemia may develop in persons with
colonic disease

3- extensive small bowel disease may result in :

-serum protein loss
-generalized nutrient malabsorption
(VB12 and bile salts )
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Treatment 6
:

1 Anti-inflammatory drugs ( reduces inflammation )

2 Immune system suppressors ( suppress immune

system that increases inflammation )

3 Antibiotics (reduce harmful intestinal bacteria )

4 Surgery
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COMPARISON 7
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References 8

 Robbins-basic pathology ,9th editiom

 The National Institute of Diabetes and Digestive and
Kidney Diseases:

http://www.niddk.nih.gov/health-information/health-
topics/digestive-diseases/ulcerative-colitis/Pages/facts.aspx#
what
 Guyton and Hall Textbook of Medical Physiology, 12th
edition.
 Pathoma.
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9

Thank you
