Colyn Polyp, diverticulosis, IBD, LI, UC, Crohns

1. remission/relapse
2. ab pain = predefecatory
3. diarrhea = early, frequent
4. fever = rare
5. bright red blood

1. dull, achy pain
2. ab pain = colicy
3. diarrhea = present but less likely
4. fever
5. steatorrhea

1. sigmoidoscopy
2. ab mass - none
3. roentgen study - see pseudopolyps
4. circumfrential and ocntinuous ulcerations of mucosa
5. angiography - no help
6. biopsy - non specific inflammation of mucosa
7. L colon

1. apthoid ulcers - deep, ulcers with raised margins
2. right colon
3. cobblestone appearance
4. fissures, fistulas
5. microgranulomas made of langerhan's giant cells

1. initial attack
2. toxic megacolon - can cause death
3. abcess formation
4. in remission get fibroblasts laying down collagen
5. strictures, stenosis
6. pseudopolyps
7. high carcinoma risk

1. acute attacks rare
2. fistula
3. abcess
4. strictures
5. carcinoma rare

lesions causes inflammed mucosa with small ulcer. collagen laid down. starts healing. contraction and mucosa comes together, get puckering of mucosa = pseudopolyp

TPN

-normally bile salts com down and circulate 2x with each meal
- in crohns..bacteria act against conjugated bile salts and decongugate them. thus not absorbed and get diarrhea

- with UC get 5 to 10x greater carcinoma
-usually seen in transverse and r colon

1. pseudopolyp
2. stricture
3. perianal inflam
4. massive hemorrhage
5. carcinoma
6. perforation
7. toxic megacolon

1. arthritis
2. skip lesions
3. hepatic lesions
4. ocular lesions - uveitis
5. thromboembolism
6. renal lesions
7 associated disease - SLE, scleroderma, chronic active hepatitis, thymoma with hypogammaglobulinemia

1. colon rest
2. bed rest
3. sedatives
4. psychotherapy
5. antidiarrheas
6. antispasmodics
7. fluid replacement
8. diet
9. vit
10. hematinics
11. ab
12. steroids
13. immunosuppressive therapy

1. gonorrheal proctitis
2. histoplasmosis
3. lymphogranuloma venerum
4. amebiasis
5. radiation proctitis
6. diverticulitis
7. ischemic colitis
8. pseudomembranous colitis
9. behcets syndrome

1. Idiopathic IBD - UC, crohns, colitis
2. Inflam caused by infectious agents - viruses, chlamydia, bact, fungi, parasite
3. Inflam associated with motor disorders - diverticultis, solitary rectal ulcer syndrome
4. Inflam secondary to vascular hypoperfusion - Ischemic colitis

-UC
-proctitis
-crohns
-ileojejunitis colitis

-shigella, salmonella, yersinia, campylobacter, pseudomonoas, gonococcal, syphilitis, tb

-lymphogranuloma venereum, cmb, behcet, hsv

- E. histolytica
-histoplasmosis
-blastomycosis

- ischemic colitis
-collagenous colitis
-metabolic
-hemolytic

1. dig rectal exam proctosigmoiddoscopy
2. barium enema
3. colonoscopy
4. cytology/biopsy

1. size
2. number
3. villous component
4. dysplasia
5. location

1.annual fecal occult blood tests
2. flexible sigmoidoscopy every 5 years - 50
or
1. colonoscopy 10 yrs
or
1. double barium enema every 5-10 yr

1.annual fecal occult blood tests
2. flexible sigmoidoscopy every 5 years - 40
or
1. colonoscopy 10 yrs
or
1. double barium enema every 5-10 yr

1. colonoscopy every 3 yr- 40

1. colonoscopy every 1 to 3 yrs starting at 21
2. genetic counseling
3. genetic testing

1. colorectal cancer
2. few colon polyps
3. right colon
4. other associated cancers - uterine, ovarian, gastric, si, panc, ureteric