1. Inflammatory Bowel Disease
Dr Omar Mansour
Consultant Colorectal & Laparoscopic
General Surgeon
Assistant Professor of General Surgery
Al-Balqa Applied University
FRCS FRCSI FEBC MSc MRCSI

2. What IS IBD?
Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine.
Crohn's disease and ulcerative colitis are the principal types of inflammatory bowel disease. Crohn's disease affects the small intestine and large intestine, as well as the mouth, esophagus, stomach and the anus, whereas ulcerative colitis primarily affects the colon and the rectum

3. Demographics
Differential diagnosis Gastroenteritis, irritable bowel syndrome, celiac disease
Frequency 11.2 millions worldwide (2015)[1]
Deaths 47,400 worldwide (2015)[2]

4. Risk Factors
Diet
Microbial
Genetics

5. Classification
The chief types of inflammatory bowel disease are Crohn's disease and ulcerative colitis (UC).
Inflammatory bowel diseases fall into the class of autoimmune diseases, in which the body's own immune system attacks elements of the digestive system.[33]
Accounting for fewer cases are other forms of IBD, which are not always classified as typical IBD:
Microscopic colitis subdivided into collagenous colitis and lymphocytic colitis
Diversion colitis
Behçet's disease
Indeterminate colitis

6. How to Diagnose IBD

7. How to Diagnose IBD
Histroy Exam Labs Radiology Endoscopy

8. Colonoscopy Video

15. What is this?

16. Erythema Nodosum

19. Pyoderma gangrenosum
is a condition that causes tissue to become necrotic, causing deep ulcers that usually occur on the legs.
When they occur, they can lead to chronic wounds. Ulcers usually initially look like small bug bites or papules, and they progress to larger ulcers.
Though the wounds rarely lead to death, they can cause pain and scarring.

20. Treatment of IBD

21. Crohn’s
The disease was identified in It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s.[1]

23. Aminosalicylates
Aminosalicylates represent first-line therapy for mild-to-moderate CD.
These 5-aminosalicylic acid (5-ASA) compounds act on epithelial cells, moderating the release of lipid mediators, cytokines, and reactive oxygen species.19
 Examples include sulfasalazine, mesalamine, olsalazine, and balsalazide. Studies of sulfasalazine 3 g to 5 g/day demonstrated an elevated rate of remission (40%-50%) at 16 weeks.2

24. 1Sulfasalazine contains a sulfa moiety that is responsible for most allergic reactions (e.g., Stevens-Johnson syndrome). Adverse effects include anorexia, headache, nausea, GI distress, and oligospermia. Other possible reactions include pancreatitis, agranulocytosis, and alveolitis.8
Mesalamine, a newer 5-ASA compound, does not contain a sulfa moiety and causes fewer allergic reactions

25. Biological Treatment Infliximab:
 Infliximab, a chimeric mouse/human mAb, was FDA-approved in 2003 for reducing signs and symptoms and maintaining remission in moderate-to-severe CD.
It also is useful in the treatment of fistulizing CD. Infliximab neutralizes the biological activity of TNF-alpha by binding to the cytokine and preventing it from binding to its receptors.
Infliximab is immunogenic and may be associated with infusion reactions and decreased efficacy