Eric M Osgard MD, FACG Gastroenterology Consultants Reno, Nevada.
IBD • Definition – – Ulcerative Colitis – Relapsing and remitting episodes of inflam. Of the mucosal layer of the colon – rectum invariably involved – Crohn’s Disease – Transmural inflammatory changes of any portion of the GI tract – usually term ileum involved
Ulcerative Colitis
Crohns Disease
History • Burrill B. Crohn – Published first account of chronic disease in JAMA – 1932
• Johne’s disease – Similar disease in cattle – M. Paratuberculosis
– Involves mucosa only – More predictable presentation
– Whole GI tract can be involved • Most often Terminal ileum • Anal, colonic
– Transmural • Strictures, fistulae
– Varied Symptomatology
Indeterminate Colitis
Epidemiology
Epidemiology • Men + Women affected equally* • Higher socioeconomic groups • Northern latitudes • Caucasians > other races • Bimodal distribution of age of onset. – 2nd to 3rd decade of life – 5th to 7th decade of life Ileal Crohn’s Disease
Pathophysiology Genetics
Autoimmune Reaction
Environment
Pathophysiology
Diet • Surprisingly little data • Western style diet – High in refined sugars, processed foods, and fried foods • High in animal fat, mild protein • Low in vegetables
• Overall minimal dietary interventions have proven to be effective
