The Curbsiders Internal Medicine Podcast #138 Inflammatory Bowel Disease: Crohn’s and Ulcerative Colitis
Feb 4, 2019
Learn expert tips for the diagnosis and management of inflammatory bowel disease (IBD) from Dr. Adam Ehrlich. Topics include initial work-up, general principles of management, primary care considerations, ulcerative colitis, Crohn's disease, fecal transplants, documentary RBG, career advice, the underrated sci-fi film Edge of Tomorrow, extra intestinal manifestations of UC, diagnosis and differential of crampy abdominal pain, and the risk of colorectal cancer in IBD patients.
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Initial Approach to Suspected IBD
- Look for bloody diarrhea, urgency, and tenesmus, especially in young, healthy individuals.
- These symptoms, especially with a family history of bowel problems, raise suspicion for IBD.
Nocturnal Bowel Movements and IBD
- Waking up in the middle of the night to defecate suggests an organic GI problem.
- This can be a helpful clue when distinguishing between IBS and IBD.
Smoking History in IBD
- Inquire about smoking history, especially recent cessation, in patients with suspected IBD.
- Ulcerative colitis onset is linked to stopping smoking, while Crohn's is worsened by it.