Inflammatory Bowel Disease

( IBD )

Department of GI in the first

affiliated hospital of university zheng zhou

Dr. Niu zhengxian

Definition:
Inflammatory bowel disease (IBD), in cluding
ulcerative colitis (UC) and Crohn’s disease (CD) are
chronic inflammatory disease of the gastrointestinal tract
and unknown etiology . They are diagnosed by a set
clinical, endoscopic, and histologic characteristics, but no
single finding is absolutety diagnostic for one disease or
the other.
The inflammatory response in U C is largely confined
to the mucosa and submucosa of colon , but in C D the
inflammatory extends through the intestinal wall from
mucosa to serosa, U C is confined to the colon, or rectum.
CD can involve any part of the gastrointestinal tract.
Epidemiology:
The incidence and prevalence of C D and U C
very with geographic location.
The highest rates are fur white population in
northern Europe and north America, where the in —
cidence is about 50 per 100,000 and the prevalence in
about 50 per 1000,000 rates in southem Europe south
America, Asia, Africa are lower. The incidence is
equal in men and women. The peak age at onset is
between 15~25years of age. Both diseases occur in
childhood.
Etiology:

The cause of U C an at C D remains unknown

Some causes
• Genetic susceptibility:
• Infections; Bacterial, vinus:
• Immunologic:
• Enviromental factors :
• Psychological factors :
• Smoking :
Pathogenesis:
The disruption of the mucosal barrier
allows exogenous antigen’s to enter the
submucosa and stimulate the gut immune
system. A defect of shutting off the activation
of gut immune system resulting in a persistent
inflammatory response. Proinflammatory
cytokins (TNF α .γ IL……) are relased leading
to inflammatory process.
Pathology:

U C and C D each have a characteristic pathologic

appearance.
• In general:
• Anemia
• Nutrional deficiencies (iron, vitB12)
• ESR↑(acyive stag )
• Hypoalbuminemia
 UC

• Colon appears ulcerated (multiple)

• Hemorrhagic
• Rectum involved very common
• If recurrent, the Colon appears fibrosin longitudinal
result in colon shorting
• Polyps.
C D:

• Small bowel involed very common (ileum)

• Involving the regional lymph nodos
• The bowel appears thickened and lumen narrowed.
• These ulcerations may penetrate into the submucosa
and muscular is.
Clinical features: UC
CD
Dr Burrill B.Crohn (1884-1983)
Prognosis:

• UC :1.Exteusive ulcerative co1itis and over age 60

poor prognosis.
• 2. Left-sides colitis have a favorable prognosis .

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