Clubbing Pallor Eyes Legs Abdominal tenderness PR
Signs – Crohn’s
Clubbing Pallor Eyes Mouth Legs Abdominal tenderness Mass in RIF PR – skin tags, abscesses, fistulas
Faecal calprotectin Protein common in neutrophil cytoplasm Bacteriostatic and resistant to enzyme degredation NICE guideline: 1) To differentiate IBD from IBS in pts where cancer is NOT suspected Also: can also be used to evaluate IBD Rx and predict flares
A-E approach NBM, IVI, transfusion depending on Hb IV hydrocortisone +/- rectal steroids If getting better – transfer to oral pred and 5-ASA If getting worse – consider ciclo/infliximab/surgery
Long term management
Aminosalicylates Azathioprine or mercaptopurine
Comparing Crohn’s and UC Clinical presentation Histological findings? Smoking?
Recap Scoring system for UC severity? Extra-intestional manifestations of IBD?
Explanation station Please explain a colonoscopy to the patient
Explanation station Check patient’s understanding Think about patient’s experience Why we do it and risks No jargon Any questions Leaflet
Always remember for IBD Ask about eyes, joints and skin Only ever do flexi sig in an acute flare If in doubt over diagnosis, say IBD Know difference between ileostomy and colostomy Test for TB before starting infliximab Any questions?