Inflammatory Bowel Diseases

Patricia Kozuch, M.D.
Disclosures		The author has no relationships with commercial interests related to the content of the presentation.

Anthony Infantolino, M.D., F.A.C.P.
Disclosures		Relationship: Yes Consultant: TAP, Astra Zeneca, Wyeth, Exzav

The Planners of this activity have no relationships to disclose.

Dr. Kozuch is an Assistant Professor of medicine at Jefferson Medical College and is an attending physician in the Division of gastroenterology and Heptology. She is board certified in Internal Medicine and Gastroenterology and specializes in the treatment of Ulcerative Colitis and Crohn's Disease.

This lecture and the post-test is worth 1.5 credit hours.

In this lecture, Dr. Infantolino defines and classifies inflammatory bowel disease (IBD) noting that the main subcategories are Crohn's disease and ulcerative colitis; other types include microscopic colitis, diversion colitis, diverticular colitis, and pouchitis.

After differentiating between Crohn's disease and ulcerative colitis, the author discusses the characteristics, manifestations – such as serpiginous ulcers in Crohn's disease – and the symptoms of each. The anatomic distribution of Crohn's disease is well illustrated, and is followed by descriptions of clinical patterns, such as obstruction, borborygmi in Crohn's disease and fistualization. The classic endoscopic feature of aphthoid ulcer in Crohn's disease is demonstrated. There is further detailing of the incidence, and age and sex distribution in Crohn's, followed by a discussion of conventional drug therapies whose main goal is to induce clinical remission and improve quality of life. Maintenance therapy in Crohn's disease is the subject of six sections of the lecture, each accompanied by informative graphics. Supportive measures include the important factor of maintaining proper nutrition, and the often-overlooked antidiarrheal agents such as loperamide in Crohn's disease.

The author concludes with a discussion of the risks of colorectal cancer in inflammatory bowel disease and how these might be modified, including by colonoscopic surveillance for dysplasia in inflammatory bowel disease.