| Crohn's Disease |
- Can affect any part of the gastrointestinal tract (mouth to anus).
- Patchy inflammation with "skip lesions."
- Transmural (full-thickness) inflammation.
- Symptoms: Diarrhoea, abdominal pain, weight loss, fatigue, and perianal disease.
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- Blood tests: Full blood count (FBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) for inflammation.
- Stool tests: Fecal calprotectin to assess intestinal inflammation.
- Endoscopy: Colonoscopy with biopsy to confirm diagnosis, showing granulomas and transmural inflammation.
- Imaging: MRI or CT enterography to assess small bowel involvement.
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- Acute management: Corticosteroids (e.g., Prednisone) for flare-ups.
- Maintenance therapy: Immunosuppressants (e.g., Azathioprine), biologics (e.g., Infliximab), or methotrexate to prevent relapses.
- Dietary management: Nutritional support (e.g., enteral feeding) in severe cases.
- Surgical management: Resection of affected bowel in case of complications (e.g., strictures, fistulas).
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| Ulcerative Colitis |
- Limited to the colon and rectum.
- Continuous inflammation starting from the rectum and extending proximally.
- Inflammation limited to the mucosal layer.
- Symptoms: Bloody diarrhoea, urgency, tenesmus, and abdominal cramping.
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- Blood tests: CBC, CRP, and ESR to assess for anaemia and systemic inflammation.
- Stool tests: Fecal calprotectin or lactoferrin to gauge intestinal inflammation.
- Endoscopy: Sigmoidoscopy or colonoscopy with biopsy, showing continuous mucosal inflammation and crypt abscesses.
- Imaging: Abdominal X-ray or CT to assess for complications (e.g., toxic megacolon).
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- Acute management: Corticosteroids for acute flares.
- Maintenance therapy: Aminosalicylates (e.g., Mesalamine), immunosuppressants (e.g., Azathioprine), and biologics (e.g., Adalimumab).
- Topical therapy: Rectal suppositories or enemas (e.g., Mesalamine) for proctitis or distal colitis.
- Surgical management: Total colectomy is curative for refractory or complicated cases.
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| Indeterminate Colitis |
- Overlap of features between Crohn's disease and ulcerative colitis.
- Diagnosis made when clinical, endoscopic, and histologic features are inconclusive.
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- Blood tests and stool tests as described for Crohn's disease and ulcerative colitis.
- Endoscopic and histologic evaluation may show mixed features of both diseases.
- Imaging studies (e.g., MRI enterography) to assess for small bowel involvement.
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- Management depends on the predominant clinical presentation (treat as Crohn's or ulcerative colitis).
- Immunosuppressive therapy (e.g., Azathioprine) and biologics (e.g., infliximab) can be used.
- Monitor disease progression and adjust treatment based on response.
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