Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about inflammatory bowel disease.

And you can find written notes on this topic at zero to finals.com or in the gastroenterology section

of the second edition of the zero to finals medicine book.

So let's get straight into it.

Inflammatory bowel disease involves recurrent episodes of inflammation in the gastrointestinal tract.

The two main types are ulcerative colitis and Crohn's disease. They're associated with periods

of exacerbation and remission where the symptoms are worse and resolve over time.

Inflammatory bowel disease is thought to be caused by a combination of factors related to genetics,

environment and the gut microbiome.

The typical patient presents in their 20s.

Let's talk about the features.

The general presenting features of inflammatory bowel disease are diarrhea,

abdominal pain, rectal bleeding, fatigue and weight loss. There are features that can help you

differentiate between ulcerative colitis and Crohn's disease.

Differentiating features of Crohn's can be remembered with the crow's nests pneumonic,

with nests being the pneumonic.

N for no blood or mucus, referring to the fact that PR bleeding is less common in Crohn's than ulcerative colitis, E for entire gastrointestinal tract affected from the mouth to the anus,

S for skip lesions on endoscopy, T for terminal ileum most affected and transmural, meaning full thickness of

the bowel wall inflammation, and S for smoking as a risk factor for Crohn's.

And you don't want to set the nest on fire, which is how I remember

that smoking relates to Crohn's disease. Crones is also associated with strictures and fistulas.

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