Pre PACES Podcast #28 Inflammatory bowel disease (part 2)
Feb 13, 2022
Join Dr. Ajay Verma, a consultant gastroenterologist, as he dives deep into inflammatory bowel disease with essential insights and management strategies. He breaks down the crucial tests for diagnosing IBD, including bloods and imaging techniques, and reviews treatment options for both Crohn's disease and ulcerative colitis. Dr. Verma also discusses complications, maintenance strategies, and the importance of supportive care. To lighten the mood, he takes on a fun quiz about Premier League top scorers, showcasing his wit and football knowledge!
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Baseline Bloods And Stool Tests First
- Do order baseline blood tests including FBC, CRP, U&E, LFTs, B12, folate and ferritin when working up suspected IBD.
- Use stool cultures and fecal calprotectin to rule out infection and to decide need for further endoscopic assessment.
Pick Endoscopy For UC, Imaging For Crohn’s
- Do sigmoidoscopy for suspected ulcerative colitis because disease is confluent and starts distally.
- For suspected Crohn's, prioritise imaging (MRI small bowel for younger outpatients or CT abdomen/pelvis if acutely unwell).
Induce Remission According To Severity
- Use topical budesonide or oral steroids to induce remission in Crohn's, escalating to IV steroids or biologics for severe disease.
- Use mesalazine for mild UC locally, with oral/IV steroids and infliximab or ciclosporin for severe or acute severe UC.