{ VERY IMPORTANT for PLAB }
◙ Points towards [Crohn’s disease]
- Endoscopy → Skip lesions, Transmural (deep Ulcers), Cobblestone appearance
- Histology → Granuloma. ↑ Goblet cells.
- Examination → Abdominal Pain or Mass on the RIGHT iliac fossa.
- Diarrhea “Usually Non-bloody”.
- Weight loss is more common.
- Fistulae, perianal fistulas.
◙ Points towards [Ulcerative Colitis]
- Barium enema → Loss of haustration, drain pipe appearance.
- Histology → Crypt Abscesses. (↓) Goblet Cells.
- Abdominal pain on LEFT lower quadrant.
- Bloody Diarrhea is more common.
- Primary Sclerosing Cholangitis is more common.
Aphthous oral ulcers occur in both CD and UC, however, more common in UC.
◙ For Treatment:
• In CD → Pick Oral Prednisolone. (1st line to induce remission)
• In UC → Pick 5-ASA (Mesalazine). (1st line to induce remission)
• In severe UC exacerbation → Pick IV Hydrocortisone.