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Crohn's Disease Notes

This is a sample of our (approximately) 3 page long Crohn's Disease notes, which we sell as part of the Gastrointestinal (GI) System Notes collection, a 1st (70-80%) package written at Bristol University in 2012 that contains (approximately) 57 pages of notes across 19 different documents.

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Crohn's Disease Revision

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Lecture 24 Crohn's Disease

What is Crohn's disease?
o Chronic inflammatory disease, effects anywhere from mouth-anus (UC is only colon) o Characterised by patchy inflammation with ulceration (unlike UC, which is confluent) o Symptoms determined by site of disease and severity of inflammation & the complications of inflammation Symptoms o Pain: Constant or in waves (inflammatory stricture of bowel) o Diarrhoea: Loose/severe, may be bloody o Weight loss: Due to disease, poor absorption & loss of appetite o Fatigue: Partly anaemia, but hard to treat Who gets it?
o Getting more common o Bimodal=young adults & middle aged o 1 in 500 o Can run in families; Developed nations o More common in smokers (opposite of UC) Site of disease o Enterocolitis (small & large bowel) 50%
o Enteritis (small bowel) 29%
o Colitis (large bowel) 19%
o Other sites (e.g. cutaneous) 2%
What causes Crohn's disease?
o BACTERIA (abnormal)
 Bacterial flora change (is it because of CD or does it cause CD?)
 In general, reduced diversity of Firmicutes & Bacterioides
 Increased mucosa-associated E. coli in Crohn's disease

• Adherent Invasive E. Coli (AIEC)- able to penetrate gut wall, difficult to kill once there and sit in macs causing inflammation
 Abnormalities

• Loss of some Firmicutes & Bacterioides

• Role of (AIEC)

• BUT- Crohn's disease not transmittable, & what about familial risk?
o Mucus (defective)
 Too much mucin (opposite of UC)
 Mutation of MUC 19 gene in CD o Bowel wall (leaky)
 Abnormal permeability

• In CD patients and relatives

• Tight junction defects

• May be secondary to inflammation BUT o MYO9B gene mutation associated with UC o Gene in CD disputed
 Abnormal defence

• Defective mucus layer and epithelial barrier MAY permit invasion of gut wall by bacteria

o

Recognition (abnormal); Inflammation (dysregulated); Enhanced recruitment of inflammatory cells
 Macrophages

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