Gastro: Crohn's Disease: Free MSRA Podcast

 ⚕️FREE MSRA PODCAST –Crohn’s Disease🎧 This deep dive breaks down Crohn’s Disease foryour MSRA revision – from pathophysiology and diagnosis to management andcomplications. Clear. Concise. High-yield. 🧠Key Learning Points📌Definition• Crohn’s is a chronic inflammatory bowel disease (IBD)affecting any part of the GI tract (mouthto anus), most commonly the terminal ileum andcolon.• It causes transmural (full-thickness) inflammation and skip lesions (patchy distribution). 📌Memory Aids🌀“Crohn skips townsand burns deep.”→ Skip lesions +transmural inflammation🧠“Crowns to gowns”→ Can affect GItract from mouth to anus 📌Causes & RiskFactors• Multifactorial: Genetic predisposition (e.g. NOD2/CARD15),environmental triggers, and immunedysregulation• 🚬 Smoking is a major risk factor and worsens prognosis• 🧬 Family history, Ashkenazi Jewish heritage, high-fat diet, and pastgut infections may also contribute 📌Pathophysiology• Immune system attacks the bowel wall, causingchronic transmural inflammation• Leads to ulceration, strictures,fistulas, and malabsorption• Extraintestinalinvolvement: eyes, skin, joints, liver 📌DifferentialDiagnosis• Ulcerative colitis(UC): continuous inflammation vs. Crohn’s skip lesions• IBS, coeliacdisease, infectious colitis• Malignancy, TB,ischaemic colitis, radiation-induced injury, Bechet’s disease 📌Epidemiology• Prevalence: ~1 in 650 in the UK• Two peaks: 15–30 years & 50–70 years• Equal male:femaleratio• Rising in childrenand globally• Standardised mortality ratio ≈ 1.38 📌Clinical Features• Abdominal pain(esp. right iliac fossa), diarrhoea,weight loss, fatigue, fever• Perianal disease: abscesses, fistulas, skintags• Extraintestinal:uveitis, arthritis, erythema nodosum, pyoderma gangrenosum, PSC, delayed growthin children• Signs: mouthulcers, clubbing, tender RIF, pallor, tachycardia 📌Investigations🔬Bloods: CRP, ESR, FBC, iron/B12/folate, LFTs, albumin💩Stool tests: Fecal calprotectin (↑ = inflammation), excludeinfection📸Imaging:• CT/MRI abdomen forlocation, extent, abscesses• MRI pelvis forperianal disease• Ileocolonoscopy with biopsy: diagnostic goldstandard – shows skip lesions + transmural inflammation• Non-caseatinggranulomas on histology (not always present) 📌Management🎯Two goals: Induce remission → Maintain remission🛑Lifestyle• 🚭 Stop smoking – critical• Avoid NSAIDs ifpossible💊Induction therapy• Corticosteroids(e.g. prednisolone)• Enteral nutrition(children)• Biologics (e.g.infliximab) for severe/refractory disease• Antibiotics (e.g.metronidazole) for perianal disease🛡️Maintenance therapy• Immunomodulators: azathioprine, mercaptopurine• Check TPMT beforestarting• Alternatives:methotrexate• Biologics if immunomodulators fail🔪Surgery• Common: ~50–80%require surgery• Indications:strictures, obstruction, perforation, abscesses, refractory disease 📌Complications🚨GI:• Strictures →obstruction• Fistulas,perforation• Perianal abscesses• Colorectal cancer(↑ risk with colonic involvement)🦴Extraintestinal:• Osteoporosis (esp.with steroids), malnutrition• Kidney/gallstones(esp. post-ileal resection)• Growth failure& delayed puberty in children• Pregnancycomplications• Rare: amyloidosis,PSC 📎More MSRA Resourcesfor Crohn’s Disease📝 Revision Notes:https://www.passthemsra.com/topic/crohns-disease-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/crohns-disease-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/crohns-disease-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/crohns-disease-rapid-quiz/🎓 Full Course:https://www.passthemsra.com/courses/gastroenterology-for-the-msra/ Hashtags#MSRA#MSRARevisionNotes #MSRAFlashcards #MSRAAccordions #MSRAQuestionBank #MSRAQuiz#CrohnsDisease #GastroenterologyMSRA #IBDRevision #FecalCalprotectin#TransmuralInflammation