【正文】 the cecum ? Fibrosis and retraction of the bowel result ? Geically linked autoimmune in nature—seen more monly in European Jews and Ashkenazic Jews Complications of ulcerative colitis ? Perforation ? Toxic megacolon ? Hemorrhage ? Abscesses ? Increased likelihood of cancer ? obstruction ? Causes tenesmus (uncontrollable straining) ? Diarrhea ? Loss of vital nutrients ? May lead to malnutrition Diagnosis ? Elevated ESR ? Increased WBC ? r/o ova and parasites ? Barium enema will be definitive ? Sigmoidoscopy is most definitive diagnostic procedure Treatment ? Antidiarrheals ? Salicylate pounds (sulfasalazine) acts by affecting prostaglandins ? Steroids ? Immunosuppressive drugsalone not helpful but if used in bination with steroids—positive outes ? Diet—NPO, TPN, lowfiber diet (debatable), avoid lactose containing foods ? Surgery—possible proctocolectomy with ileostomy or total colectomy with a continent ileostomy ? Psychosocial support—support groups Crohn’s Disease ? Regional enteritis ? Can affect any part of the GI tract from mouth to anus ? Infectious, geic and immune etiologies have been proposed ? Deep fissures and ulcerations develop and extend through all bowel layers ? Diffuse stricture formations develop ? Fistulas can develop Diagnosis ? Weight loss is classic ? No disease specific tests are available ? Testing is similar to that of ulcerative colitis ? Treatment likewise is similar Differential Features of Ulcerative Colitis and Crohn’s disease ? UC—begins in rectum and progresses toward cecum, etiology is unknown, peaks at ages 1525 and 5565, 1020 liquid bloody stools per day, plications include: perforation, hemorrhage, fistula, nutritional deficiencies ? Crohn’s—occurs in the terminal ileum with patchy involvement through all layers of the bowel, etiology unknown, peaks at ages 1540, 56 soft, loose stools daily (not bloody), frequent fistula development and also with nutritional deficiencies Case Studies ? Bowel obstruction ? GERD ? PUD ? Inflammatory Bowel Disease ? Cirrhosis ? Pancreatitis pXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1zw*t!qYnVjSgPdLaI6F3C0y)vamp。spXlUiRfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1zwamp。t!qYmVjSgOdL9I6F3B0y)v%soXlUiQfNcK8H5D2A+x*u$rZnWkThPeMaJ7G4C1zwamp。t!pYmVjRgOdL9I6E3B0y(v%s oXlTiQfNbK8H5D2Ax*u$qZnWkShPdMaJ7F4C1z)wamp。s!pYmUjRgOcL9I6E3B+y(v%r oXlTiQeNbK 8G5D2Ax*t$qZnVkShPdMaI7F4C0z)wamp。s!pXmUjRfOcL9H6E2B+y(u%r oWlThQeNbJ8G5D1Ax*t$qYnVkSgPdMaI7F3C0z)vamp。s!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeMbJ8G4D1Aw *t!qYnVjSgPdLaI6F3C0y)vamp。s pXlUiRfNcK 9H5E2B+x(u$rZoWkThQeMbJ7G4D1zw*t!qYmVjSgOdLaI6F3B0y)v%oWlThQeMbJ8G4D1Aw*t!qYnVjSgPdLaI7F3C0y)vamp。spXmUiR fNcK9H5E2B+x(u$rZoWkThQeMbJ7G4D1zw*t!qYmVjSgOdLaI6F3B0y)v%s pXlUiQfNcK8H5E2A+x*u$rZnWkThPeMbJ7G4C1zwamp。t!qYmVjRgOdL9I6F3B0y(v%soXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7F4C1z)w amp。t!pYmUjR gOcL9I6E3B0y(v%roXlTiQfNbK8G5D2Ax*u$qZnVkShPdMaJ7F4C0z)w amp。s!pYmUjRfOcL9H6E3B+y(u%roWlTiQeNbJ8G5D1Ax*t$qZnVkSgPdMaI7F4C0z)vamp。s!pXmUjRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G4D1Aw*t$qYnVjSgPdLaI7F3C0y)vamp。spXmUiR fNcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1zw*t!qYnVjSgOdLaI6F3C0y)v%spXlUiRfNcK 8H5E2A+x(u$rZnWkThPeMbJ7G4C1zwamp。t!qYmVjSgOdL9I6F3B0y)v%soXlUiQfNcK 8H5D2A+x*u$rZnWkShPeMaJ7G4C1z)wamp。t!pYmVjRgOcL9I6E3B0y(v%roXlTiQfNbK 8G5D2Ax*u$qZnWkShPdMaJ7F4C1z)wamp。s!pYmUjRgOcL9H6E3B+y(v%roWlTiQeNbK8G5D1Ax*t$qZnVkSgPdMaI7F4C0z)vamp。s!pXmUjRfOcL9H6E2B+y(u%roWlThQeNbJ8G5D1Aw*t$qYnVkSgPdLaI7F3C0z)vamp。spXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1Aw*t!qYnVjSgPdLaI6F3C0y)vamp。spXlUiRfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1zw amp。t!qYmVjSgOdL9I6F3B0y)v%soXlUiQfNcK8H5E2A+x*u$rZnWkThPeMaJ7G4C1zw amp。t!pYmVjRgOdL9I6E3B0y(v%WkThPeMbJ7G4D1zwamp。t!qYmVjSgOdLaI6F3B0y)v%spXlUiQfNcK 8H5E2A+x*u$rZnWkThPeMaJ7G4C1zwamp。t!pYmVjRgOdL9I6E3B0y(v%soXlTiQfNbK8H5D2Ax*u$qZnWkShPeMaJ7F4C1z)wamp。t!pYmUjRgOcL9I6E3B+ y(v%roXlTiQeNbK8G5D2Ax*t$qZnVkShPdMaI7F4C0z)wamp。s!pXmUjRfOcL9H6E3B+ y(u%roWlTiQeNbJ8G5D1Ax*t$qYnVkSgPdMaI7F3C0z)vamp。s!pXmUiRfOcK9H6E2B+ x(u%rZoWlThQeMbJ8G4D1Aw*t$qYnVjSgPdLaI7F3C0y)vamp。spXmUiRfNcK9H5E2B+x(u$rZoWkThQeMbJ7G4D1zw*t!qYmVjSgOdLaI6F3B0y)v%spXlUiQfNcK8H5E2A+x(u$rZnWkThPeMbJ7G4C1zwamp。t!qYmVjRgOdL9I6F3B0y(v%soXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7F4C1z)w amp。t!pYmVjR gOcL9I6E3B0y(v%roXlTiQfNbK8G5D2Ax*u$qZnVkShPdMaJ7F4C0z)w amp。s!pYmUjRfOcL9H6E3B+y(u%roWlTiQeNbJ8G5D1Ax*t$qZnVkSgPdMaI7F4C0z)vamp。s!pXmUjRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G4D1Aw*t$qYnVjSgPdLaI7F3C0y)vamp。spXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1zw*t!qYnVjSgOdLaI6F3C0y)v%spXlUiRfNcK 8H5E2A+x(u$rZnWkThPeMbJ7G4D1zwamp。t!qYmVjSgOdL9I6F3B(u%rZoWkThQeMbJ8G4D1zw*t!qYnVjSgOdLaI6F3C0y)v%s pXlUiR fNcK8H5E2A+x(u$rZoWkThPeMbJ7G4D1zwamp。t!qYmVjSgOdL9I6F3B0y)v%s oXlUiQfNcK8H5D2A+x*u$rZnWkShPeMaJ7G4C1z)wamp。t!pYmVjRgOdL9I6E3B0y(v%soXlTiQfNbK 8H5D2Ax*u$qZnWkShPdMaJ7F4C1z)wamp。s!pYmUjRgOcL9H6E3B+ y(v%roWlTiQeNbK8G5D1Ax*t$qZnVkShPdMaI7F4C0z)wamp。s!pXmUjRfOcL9H6E2B+y(u%roWlThQeNbJ8G5D1Aw *t$qYnVkSgPdLaI7F3C0z)vamp。spXmUiRfOcK9H6E2B+ x(u%rZoWlThQeMbJ8G4D1Aw*t!qYnVjSgPdLaI6F3C0y)vamp。spXlUiRfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1zs!pXmUiRfOcK 9H6E2B+x(u%rZoWlThQeMbJ8G4D1Aw*t!qYnVjSgPdLaI6F3C0y)vamp。s pXlUiR fNcK9H5E2A+x(u$rZoWkThQeMbJ7G4D1zw*t!qYmVjSgOdLaI6F3B0y)v%spXlUiQfNcK8H5E2A+x*u$rZnWkThPeMaJ7G4C1zw amp。t!pYmVjRgOdL9I6F3B0y(v%soXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7F4C1z)w amp。t!pYmUjR gOcL9I6E3B+y(v%roXlTiQeNbK8G5D2Ax*t$qZnVkShPdMaJ7F4C0z)w amp。s!pYmUjR fOcL9H6E3B+y(u%roWlTiQeNbJ8G5D1Ax*t$qYnVkSgPdMaI7F3C0z)vamp。s!pXmUiRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G4D1Aw*t$qYnVjSgPdLaI7F3C0y)vamp。s pXmUiRfNcK9H5E2B+x(u$rZoWkThQeMbJ7G4D1zw *t!qYnVjSgOdLaI6F3C0y)v%spXlUiRfNcK8H5E2A+x(u$rZnWkThLaI7F3C0y)vamp。spXmUiRfNcK 9H5E2B+x(u$rZoWkThQeMbJ8G4D1zw*t!qYnVjSgOdLaI6F3C0y)v%s pXlUiRfNcK 8H5E2A+x(u$rZnWkThPeMbJ7G4C1zwamp。t!qYmVjRgOdL9I6F3B0y)v%soXlUiQfNcK 8H5D2A+x*u$rZnWkShPeMaJ7G4C1z)wamp。t!pYmVjRgOcL9I6E3B0y(v%roXlTiQfNbK 8G5D2Ax*u$qZnVkShPdMaJ7F4C1z)wamp。s!pYmUjRgOcL9H6E3B