Inflammatory Bowel Disease Clinical essentials - Dr. Kiran Peddi MRCP(UK), FRCP(London), CCT(Gastro)
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Inflammatory Bowel Disease Clinical essentials - Dr. Kiran Peddi MRCP(UK), FRCP(London), CCT(Gastro)
Inflammatory bowel disease (IBD) is an idiopathic chronic relapsing inflammation of the bowel that presents with recurrent episodes of abdominal pain and diarrhea. There are two sub-types of IBD: Crohn's disease and ulcerative colitis.
Interestingly, while smoking is associated with an increased risk of Crohn's disease, it is protective for the development of ulcerative colitis.
IBD subtypes can be differentiated based on the pattern of inflammation:
• Crohn's disease is associated with transmural inflammation. Histopathology reveals lymphoid aggregates with noncaseating granulomas.
• Ulcerative colitis is associated with mucosal inflammation (superficial submucosa may also be affected). Histopathology reveals crypt abscesses with neutrophils, but no granulomas.
IBD subtypes can be differentiated based on the affected location within the GI tract:
• Crohn's disease begins anywhere from the mouth to anus with "skip lesions".The terminal ileum is most commonly involved while the rectum is rarely involved.
• Ulcerative colitis begins in the rectum (always involved) and can extend up to the cecum, with continuous involvement (and sparing of the remainder of the GI tract).
IBD subtypes can be differentiated based on gross morphological appearance:
• In Crohn disease there is "cobblestone" mucosa, strictures, and creeping fat
• In ulcerative colitis, there are pseudopolyps
IBD subtypes can be differentiated based on imaging with barium contrast:
• Crohn disease may present with "string sign" (due to narrowing of the lumen)
• Ulcerative colitis may present with "lead pipe sign" (loss of haustra)
IBD subtypes can be differentiated based on associations with certain extraintestinal disorders:
• Crohn disease is associated with calcium oxalate kidney stones and gallstones
• Ulcerative colitis is associated with primary sclerosing cholangitis (p-ANCA positive)
Both subtypes are associated (to varying degrees) with the following disorders:
• Pyoderma gangrenosum
• Erythema nodosum
• Ankylosing spondylitis
• Uveitis
• Aphthous ulcers
• Arthritis
Serologic studies for the presence of anti-Saccharomyces cerevisiae antibodies (ASCA) and perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) can contribute to the differentiation of IBD subtypes. Helpful patterns are:
• Crohn disease: ASCA-positive, p-ANCA negative
• Ulcerative colitis: ASCA-negative, p-ANCA positive
Systemic complications of both IBD subtypes include:
• Malnutrition due to intestinal inflammation. This is particularly common in patients with Crohn's disease (which most commonly involves the terminal ileum) since the absorption of both vitamin B12 and bile salts occurs in the terminal ileum.
• Adenocarcinoma of the large colon due to persistent inflammation. This can be seen in both inflammatory bowel diseases but is more common in ulcerative colitis since ulcerative colitis always involves the colon.
The risk of developing inflammatory bowel disease-associated adenocarcinoma is proportional to:
• Disease duration (increased risk at 8-10 years)
• Extent of colonic involvement (increased risk with pancolitis)
• Frequency and intensity of inflammation (increased risk with more intense and frequent relapses)
There are several important GI complications more closely associated with Crohn disease, most notably the following:
• Obstruction caused by stricture formation
• Fistula formation
• Perianal disease
• Cholelithiasis
There are several important GI complications more closely associated with ulcerative colitis, most notably:
• Toxic megacolon
• Sclerosing cholangitis
Cutaneous pathologies that are associated with inflammatory bowel diseases include erythema nodosum and pyoderma gangrenosum.
Pyoderma gangrenosum is a neutrophilic dermatosis that appears as a purulent ulcer with a violaceous edge. The majority of patients with pyoderma gangrenosum have an associated systemic disease, most commonly inflammatory bowel disease.
Treatments for ulcerative colitis include:
• 5-aminosalicylic acid formulations (e.g. sulfasalazine, mesalamine)
• 6-mercaptopurine (purine synthesis inhibitor)
• Infliximab (anti-TNFα antibody)
• Colectomy
Treatments for Crohn disease include:
• Corticosteroids
• Azathioprine (purine synthesis inhibitor)
• Infliximab (anti-TNFα antibody)
• Adalimumab (anti-TNFα antibody)
• Antibiotics (ciprofloxacin, metronidazole)
#inflammatoryboweldisease #clinicalessentials #gastroentrology #pathology #internalmedicine #Crohndisease #Crohnsdisease #ulcerativecolitis
I much prefer Dr. Eric Berg's suggestions. Most people with IBD who've experienced the waves of pain are willing to change their diet and heal the gut microbiome.
Thanks doctor
To give good suggestion.
VERY NICE SUGESSIONS
Sir please make a video on this topic ( IBD ) in hindi .
Very nice sir
Thanks and welcome
I am from India, Kerala
Crohn's victim, with ilium sticture
Diagnosed in 2016 and under treatment not struggling with sticture and pain
Where are you taking the treatments? I am also a patient of crohns disease. Please suggest.
@@juibhattacharya7283heyy what was your symptom.bfore diagnosis?
Where are you taking treatment ? Didn’t dr suggested to get it operated ?
@@juibhattacharya7283mujhe bhi chrohns h plz help kre kya trtmnt lu ?
superb 🌷🌷🌷✌
Thanks for liking
Awesome explanation sir
Thanks for liking
जानकारी हिंदी में देते तो शायद अच्छा रहता
आपका विडियो 100 लोग देखते पर 1 या 2 ही समझ पाये होंगे
Sir i got ileal erosion and on report it's written lymphoma hyperplasia what this is , i never had any idea about all this..
I get irregular bowel movement & that irritation of not having complete bowel always make me anxious, lethargic & weight loss and hair thinning
if a informative video on this topic can be made and what can happen,causes & treatment for this?
It means some kind of bacterial overgrowth
How r u?
Doctor tld me i av uc but i don av diarrhea than what it means?
Ash guard juice will be helpful? Pls let me know
What about soluble fiber?
Hlo sir I’m a patient of alsar and some other disease Im suffering for this for 5 years plese help me
I’m consulting with u
Sir ibd can be cured by ayurveda and probiotics
Can you please suggest to me any reliable ayurvedic Dr if you are confident...my friend is suffering from IBD
Are biologics recommended?
Alupathy and alupathy doctors never recover of stamach problems only they are giving tritment on it
I safring stamach problems last 16 years back every alupathy treatment i done but not recovered.but i done the fruit diet now and yoga I totally recover now .
I want to talk to u
Can u give yr no plz I need help
Allopathy मे जितने प्रकार की बीमारी उतने प्रकार के डॉक्टर्स होते हैं। जबकि ज्यादातर बीमारी का मूल कारण पेट से संबंधित है। allopathy के डॉक्टर्स कभी भी exercise, योगा, प्राणयाम, सेहतमंद भोजन, sunlight, उपवास, detoxification इत्यादि के बारे मे कभी नहीं बताते .
Hi sir, can u please explain my biopsy brow report
Impression
Ileum and Colon biopsies:
(A) Colon: The Histology Features Consistent with Chronic Non-specific Inflammation. (B) Ileum: The Histology Features Consistent with Chronic Non-Specific Inflammation.
The report is as same as mine. It is not proved actually. ileal inflammation may cause Chrons. But in case of non specific it can't be said properly.
@@ibnemasudkhan1899 can I have ur contact number, I have colonoscopy again with ultrasound
@@ibnemasudkhan1899 do u have abdominal pain, bleeding or what kind of issue ?
@@ibnemasudkhan1899 hi . I too have same brother..
I'm also diagnosed 2 month back.. How r now..
Your video is very good. I was also the patient of Ulcerative colitis which were not treated even after taking many medicines of allopathy. After that my friend recommended my Ayurvedic medicines of Planet Ayurveda which treated my Ulcerative Colitis in just 3 months. Now i am completely fine.
Medicine name send kren
Send
Send me doctor name
@@amritpal7018 Dr Vikram Chauhan
its paid advertisement comment
Sir i have edematous ascending colon means its ulcerative colitis?
Ibd me gas and digestive problems. And long time 5years kaun se medicine le sir
Ash gourd juice..jeera water..wood apple juice..with rice and murmura
Apple doesn't suit few people, are you checking your crp frequently?
सर हिंदी मध्ये माहिती द्या
Kuthun ahes bhava
My CT report is chance to Crohns disease but colonoscopy is extremely normal..🙄i have abdominal pain and diarrhea sometimes
Hi does CT report give accurate results?
Mam abi apko je problem suru ho gya hai isme apko letring me mucus ana suru ho jaye ga g jis se wait kam ho jayega and weakness rhegi or v kyi symptoms chlte hai me khud iska pasent reh chuka hu sabse pehle apna khan paan sahi kre baki allopathic homeopathy me iska koi permanent ilaaz nahi hai paise khraab na kre g mera je last me desi medicine se thek hua tha ap v koi achi desi medicine use kre pure parhej ke sath thek ho jaoge g bs sath me parhej ka pura dyaan rkhe g
@@bshah7686 hlo bhai
@@ankitnarwal5262 hanji btaye
@@bshah7686 bhai reply to kro
I take 1 masacol od
1 tinib 5mg
1 azoran 5mg
I don't go to doctor any more just taking these medicines one time a day is that okay if I keep taking these
Bro aapko uc h ya chrohns plz reply
Which MRI test should be done for large intestine By which to know what is the infection in the large intestine Doctor sir please write the name of that test
Do colonoscopy
I have anal fissure since 3 months I got a lot done but it's not getting better yes tell me some medicine who can fix my anal fissure I've seen three doctors surgeon But they give medicines but it is not working for me you tell me some medicine that can be found in pakistan and my anal fissure be fine can someone tell me such a doctor who know you in pakistan Specialist for Anal Fisher's please doctor sir please tell me I am very upset because of this disease plz replay me as soon as possible sir
@@ranashoaib6757 u r not d
Feeling better after treatment
@@makhanlovemom6938 no difference in my health i can't relax please tell me any such medicine who can heal my anal fisher and ease my pain
@@makhanlovemom6938 Or can you recommend me a doctor or you me Tell me some such medicine who can cure my anal.fissure I'm tired of this pain and from may life
Sir I am going India for medical treatment
Kya beemari hy apko ?
Come in mumbai meet Dr.philip abraham at hinduja hospital
Inflammation me sitz bath ya heat therapy sahi hti h?
Hookworms put both my celiac disease and ulcerative colitis into full remission.
What r u saying
CT scan of Gut, colonoscopy and Cal protectin. All these are for IBD and digestive related ailments, nothing to do with tuberculosis. CRP and ESr are common for all diesesse which create inflammation.
Can you tell me about your dicize in hindi then i will help you definetli
U r right
Correct! So I had negative calprotecin but 5cm inflammation on my terminal ileium an he called it ileitis. Said I have a 6% chance of getting crohns. But I have all the symptoms, mouth ulcers, fevers every 3 months for over a week etc. Do you think could be TB?
@@braydenkeith6187 do u hVe colonscopu report? And what value was calprotectin
@@rambo6150 yes I do. I have the results. They just told me it was negative the stool test. So it's weird. But I have multiple symptoms in seeing another specialist for a 2nd opinion to see what he thinks
I am suffering from ibd what can I do?
Change your diet, cut out sugar and all processed foods, carnivore diet has helped me greatly,
Sir ibs me sar ka top portion bhari rehta hai kya pls reply
han mera b aisa hi hravy rahta hai all the time😢😢😢
Can Vizalac tablet be used along with mucosalmine?
I have eosinophilic ileitis problem.
Why is he wearing his scrubs? Strange.
Sir hind me boliye
Aap india me ho ok
Send me procuger iam from Pakistan
Right iliac fossa shows mild inflamned mesentery and bowel loops..........what should i di sir?
Sir reply me as soon as possible
My father also go from same problem
@@Man-Tantra bhai colonscopy karvao
Sir what to do at home if large intestine is injured
Super explanation sir thank you so much
So nice of you
Vit b12 shot
Thank you sir .
VERY GOOD👌👍👏
Good
How to diagnosis Crohn's disease sir??
Colonoscopy followed by biopsy to confirm crohns
Thank u sir 😊💖
Videsh jao india me q ho angrage ki
If I want to connect with you how can I contact with you sir kindly resolve my problems which is completely out of situation
Lamina propria chronic inflammation cell
How to differentiate IBS & IBD
Ibs is a functional bowel issue but ibd is chronic inflammatory condition
Dr sab es ka parmenent ilaj hy uc
Sir what medical treatment
Sir ' thank you for guidence
Always welcome
Sir please talk to hindi
Sir muje nabhi k andar hypoechoic 2mm to 3mm hai kya operation jaruri hai konse doctor ko bataye
Need help form you ..
Sir wt is Aphthous ulcers in colon?does it need life long treatment?
What does biopsy report say? If apthous ulcers are non specific, then no need of any treatment
@@rahulkrishna2766 seriously
I've apthous ulcers.. In biopsy : non specific..
My symptoms are less..plz tell my brother
@@450-saikiran8 non specific means no disease. Dont worry
Me too have same issue.. How r u now?
@@rahulkrishna2766 could you plz text me in fb.. Plz provide ur Facebook id my brother
Pranayam..diet ..
Biopsy report-chrohnic iletis , moderate activity with follicular lymphoid hyperplasia.... What is this please say something dr,!
Aapki bimari shi ho gyi?
Bas Diherrhea h.... Aur koi symptoms nhi h... Aap ko hua h kya
Aap ka contact number mil sakta h?
@@Om-lx8nt ji
@@Om-lx8nt hellow
Sir treatment kya h
Sir , my sister struggling from colitis from one month. The report said that there is mild wall thickening of colon suggest colotis.
She get stomoch ramps and sounds . What might be the cause sir...no one is giving proper treatment sir
Bro did she got cured?
I am tensed bro I also have digestion problem
@@akashg7 not yet
And she diagnosed with autoimmune disease
Easy nd nice explanation sir...
Tysm
Sir please help me fluffy stool ata hai no blood or anus me stool pass krte samay or 3-4 ghanto tak dard hota rahta hai or pet bhi dang se saaf nhi hota. m faisla nhi kar pa rha ki ye kya h fissure proctitis IBD or anything else
Same with me
Did you find any solution
Hloo
Well done ✅👍
Thank you 👍
Mera ultrasound report ma ya Aya hai batao ya Kiya problem hai sir
mild dilated with thickened bowls loop ?????
Usg(ultrasound) abdomen men ?
Ab kesa feel kr rhy ho?
Gastroenterologist ko dikhaye?
@@khandaniali5515 nhi es report ma Kiya dikkat bata Raha hai bhai
Bro men doc nhin hun so I can't tell Kisi doc ko dikhen
My CRP is 27 is it dangerous
Hello sir what CRP 27
CRP 27 is consistent with an acute inflammatory process which is not normal consult your gi
Mera ultrasound report ma ya Aya hai batao ya Kiya problem hai sir
mild dilated with thickened bowls loop ?????
kaise ho bhai ab
@@meliodas2690 bhai iska matlab kiya hai
mujhe bhi nhi bata apko doctor ki kya bataya hai
@@meliodas2690 apko Kiya problem hai report ma Kiya aya hai
@@unknownevil2506BHAI APNI INSTAGRAM ID DO
Why he is wearing operation theatre cap🤣
Hey doc, my sigmoidoscopy found small ulcers. Biopsy says non specific and blood says no inflammation.
Why do you say Crohn's and TB are difficult to diagnose? My husband might be getting diagnosed in the US currently, and TB is not a very well known disease here. Most doctors can't diagnose TB here and his symptoms don't look like Crohn's. Any pointers will be useful so that we can ask the doctors here to perform the tests to check
Chest CT and blood test is available for TB. And Colonoscopy for IBDs and Abdominal TB
Actually many doctors could not differentiate between Crohns/Ulcerative colities/non benign temporary ulcer etc. The symptoms may vary from patient to patient, some may have constipation/some may have diaheria and some alternative/some no symptoms at all. They only do colonoscope/ct scan which indicates some ulcer formation and give either of the name. To be honest there is no treatment in allopathy, and it is one of the disease where it can be treated very easily just by diet modification.
can IBD patients have sever stomach pain such as burning sensation, bloating or floating sensation , sever pain all over stomach more in lower right side ???
q2: And sever vomiting can be symptoms of IBD ? food not digesting and instant vomiting ?? even liquid food too not digesting
plz answer
Yes. Bcz i have
Sahi ho gaya bhai
@@thestarboy__ bhai kaise sahi hua??
@@thestarboy__ plz help..
The first part sounds a lot like my son before his diagnosis! The second part, he didn’t have a lot of vomiting itself, but definitely nausea.
Sir I affected the IBD
I am from Ayodhya
Sir my doctor give me
Pd.
Mesalamine prolonged resalas
The tab neme
UC gut of
1200 mg
Per day I take 3600 mg
My doctor treet me 5month
But he couldn't less the dose of
Medisin
Please suggested me
What I can do
Please sir
And
What this problem come back my
Genetics
Mins my child
IBD uc r crohn's
Bro
𝓗𝓲𝓷𝓭𝓲 𝓶𝓮 𝓫𝓪𝓽 𝓴𝓪𝓻𝓮