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IBD Ulcerative Colitis Crohn’s Disease
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IBD Pathogenesis – genetics +environment (smoking,infection,drugs) UC –bloody diarrhoea. Exacerbation & remission-50%/yr CD- more heterogenous – abdo pain,diarrhoea,wt loss,malaise,fever. 80% require surgery
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Diagnosis Colonoscopy – unless presenting with severe disease. Terminal ileoscopy + BaFT CT/MR/US/WBC scanning
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Management 5ASAs + steroids – local/systemic Azathioprine- good. TPMT assay UC – consider CyA/infliximab CD – Mtx/infliximab The future – newer biological therapies
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