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colitis

Transcript: Antibiotic associated colitis Presented by: Shams Aldosari Atheer Altalhi Objectives: -Define antibiotic associated colitis and it nomenclature. -Outline the etiology and risk factors -Describe the pathogenesis and microbiology, signs and symptoms, the appropriate investigations and medical treatment. -List the indications of surgery -Outline the complications of the disease Definition: Antibiotic associated colitis refers to diarrhea that develops in a person who is taking or recently took antibiotics. One of the most serious causes of antibiotic-associated diarrhea is infection with a bacterium, Clostridium difficile. Hence comes it's other nomenclature as Antibiotic associated diarrhea, C.difficile colitis or pseudomembranous colitis. Etiology and risk factors Etiology and risk factors: 1- Antibiotics: - current use or recent use Other drugs: immuno-suppressive therapy proton pump inhibitors Antineoplastic chemotherapy Other risk factors: host factors: - Age > 65 - Underlying pathological conditions: Chronic disease of the digestive tract IBD post gastrointestinal surgery - Prolonged hospitalization - Previous history of AAD Microbiology: C. difficile, an anaerobic, Gram-positive, spore-forming, motile, toxigenic bacillus. Pathogenesis: Clinical presentation: Asymptomatic carrier state sever\fulminant colitis: sever diarrhea associated with pus or blood in stool, Diffuse abdominal pain and distention High grade Fever Nausea Signs and symptoms of hypovolemia Non-sever disease: Watery diarrhea Low grade fever Mild abdominal pain and tenderness Laboratory Investigations: 1- Blood tests: -Leuckocytosis -Increased serum creatinin -Electrolyte imbalance - hypokalemia 2- C. difficile organism detection: -Anaerobic stool culture and antigen testing 3- Toxin A or B detection -Cytotoxin assays -Enzyme immunoassays -Polymerase chain reaction [PCR] Imaging 1- Flexible sigmoidoscopy or colonoscopy: to see the pathognomonic Irregular yellow plaques of necrotic debris and edematous bowel mucosa Histopathology shows: superficial erosion of colonic mucosa with adherent fibrin, mucin and inflammatory debris (pseudomembrane). Other imaging: 2- Abdominal x-rays: May show “thumb printing” suggestive of colonic inflammation 3- CT: Thickening of the colonic wall Complications: - Paralytic ileus Due to loss of colonic muscular tone - Toxic megacolon: characterized by total or segmental non-obstructive colonic dilatation plus systemic toxicity - Perforation & peritonitis - MODS Medical treatment 1- Immediate cessation of the offending microbial agent 2- Treatment of asymptomatic patients is not indicated 3- Mild to moderate disease: treat as outpatients with a 10 days to 2-weeks course of PO metronidazole or PO vancomycin if the patient was allergic to metronidazole 4- Sever c. difficile infection: bowel rest, IV hydration and PO vancomycin OR combination therapy of both PO vancomycin, IV metronidazole +/- vancomycin enema 5- Recurrent colitis: is treated with a longer course of vancomycin (up to 1 month) 1- Refractory progressive C.difficle colitis 2- Toxic megacolon 3- Perforation or impending perforation 4- Fulminant colitis who fail to respond rapidly to medical therapy Indications for surgery Surgical approach A subtotal colectomy with end ileostomy is the procedure of choice. An alternative approach is: - A loop ileostomy is created - Subsequent intra-operative colonic washout was performed with warmed polyethelene glycol solution via the ileostomy. This was associated with less mortality and more than 90% colon preservation References: Thank you

Colitis

Transcript: Colitis What Is It? Colits is the swelling or inflammation of the large intestine. This, is a healthy colon. This, is a colon with colitis What Causes Colitis? Signs and Symptoms Treatment The goals of treatment are to: Control the acute attacks Prevent repeated attacks Help the colon heal DIET AND NUTRITION Certain types of foods may worsen diarrhea and gas symptoms, especially during times of active disease. Diet suggestions include: Eat small amounts of food throughout the day. Drink plenty of water (drink small amounts throughout the day). Avoid high-fiber foods (bran, beans, nuts, seeds, and popcorn). Avoid fatty, greasy or fried foods and sauces (butter, margarine, and heavy cream). Limit milk products if you are lactose intolerant. Dairy products are a good source of protein and calcium. MEDICATIONS Medications that may be used to decrease the number of attacks include: 5-aminosalicylates such as mesalamine or sulfazine, which can help control moderate symptoms Immunomodulators such as azathioprine and 6-mercaptopurine Corticosteroids (prednisone and methylprednisolone) taken by mouth during a flare-up or as a rectal suppository, foam, or enema Infliximab (Remicade) or other biological treatments, if you do not respond to other medications SURGERY Surgery to remove the colon will cure ulcerative colitis and removes the threat of colon cancer. Surgery is usually recommended for patients who have: Colitis that does not respond to complete medical therapy Changes in the lining of the colon that are thought to be precancerous Serious complications such as rupture of the colon, severe bleeding, or toxic megacolon Most of the time, the entire colon, including the rectum, is removed. Afterwards, patients may need a surgical opening in the abdominal wall (ileostomy), or a procedure that connects the small intestine to the anus to help the patient gain more normal bowel function. Prognosis About 10% of people have serious complications (such as perforation or massive bleeding) Approximately 10% of people never have another flare-up after their first one For those who are diagnosed with ulcerative proctitis, where the disease is located only in the rectum, the chance of disease spreading up through the colon is 10% to 30%. Anywhere from 10% to 40% of patients with ulcerative colitis will require surgery to treat their disease. Colon cancer develops in about 5% of people with ulcerative colitis. The risk of colon cancer is increased after 8 to 10 years of active disease and having more extensive disease (pancolitis). Aloe vera juice is accessible in quantity and may simply be integrated into your daily diet. In addition to aloe, other natural items are employed as a natural treatment for ulcerative colitis. These consist of chamomile, turmeric, and boswellia. All can be included into your every day routine and greatly assist to alleviate signs and symptoms and can be identified at most wellness food stores and online. References Gihealth. (n.d.). Preventing Colon Cancer [Web log post]. Retrieved May 15, 2011, from http://www.gihealth.com Harpin, A. (2008). Ulcerative Colitis Practice Guidelines in adults (Rep.). Retrieved May 15, 2011, from AdvancesInMedicine website: www.advances-in-medicine.com Harpin, A. (2010). Colitis. Colitis. Retrieved May 15, 2011, from http://www.ncbi.nlm.nih.gov PubMed. (2009, October 13). Colitis (Canada, A.D.A.M.). Retrieved from http://www.ncbi.nlm.nih.gov PubMed. (2010, October). Ulcerative Colitis (Canada, A.D.A.M., PubMed). Retrieved May 15, 2011. Remedies (2009, October 13). Ulcerative Colitis: Fun Facts (Canada, A.D.A.M.). Retrieved fromhttp://cureremedies.org/ PubMed. (2009, October 13). Colitis (Canada, A.D.A.M.). Retrieved from http://www.ncbi.nlm.nih.gov Ulcerative PubMed. (2010, October). Ulcerative Colitis (Canada, A.D.A.M., PubMed). Retrieved May 15, 2011. Harpin, A. (2008). Ulcerative Colitis Practice Guidelines in adults (Rep.). Retrieved May 15, 2011, from AdvancesInMedicine website: www.advances-in-medicine.com Ulcerative colitis is a chronic disease specifically of the immune system, where the immune system is very powerful, and attacks the large intestine. Acute and chronic infections, including food poisoning Inflammatory disorders (ulcerative colitis, Crohn's colitis, lymphocytic and collagenous colitis) Past radiation to the large bowel CureRemedies (2009, October 13). Ulcerative Colitis: Fun Facts (Canada, A.D.A.M.). Retrieved from http://cureremedies.org/ Gihealth. (n.d.). Preventing Colon Cancer [Web log post]. Retrieved May 15, 2011, from http://www.gihealth.com Solberg IC, Lygren I, Jahnsen J, Aadland E, et al. "Clinical course during the first 10 years of ulcerative colitis: results from a population-based inception cohort (IBSEN Study)." Scand J Gastroenterol 2009;44:431-440. 24 Mar 2010 Abdominal pain and cramping that usually disappears after a bowel movement Abdominal sounds (a gurgling or splashing sound heard over the intestine) Blood and pus in the

Colitis

Transcript: Microscopic Colitis by Abby Belisle What is Colitis? What is Colitis? Colitis is a chronic digestive disease that refers to inflammation of the inner lining of the colon. Different Forms Different Forms Microscopic colitis Ulcerative colitis Crohn’s colitis Diversion colitis Ischemic colitis Infectious colitis Fulminant colitis Collagenous colitis Chemical colitis Lymphocytic colitis Atypical colitis SYMPTOMS Depending on the cause, general symptoms may include... abdominal pain/tenderness depression rapid weight loss, loss of appetite swelling of colon tissue cramping mucus and/or blood in stool and rectal bleeding diarrhea and/or constipation Signs and symptoms of microscopic colitis include: Chronic watery diarrhea Abdominal pain, cramps or bloating Weight loss Nausea Fecal incontinence Dehydration Symptoms Food Symptom Triggers Triggers Alcohol Caffeine Carbonated beverages Dairy products Dried beans, peas, dried fruits or berries Foods containing sulfur or sulfate Foods high in fiber Hot sauces and spicy foods Meats Nuts Raw vegetables Refined sugar Seeds Detection blood tests (complete blood count, electrolytes, kidney function and inflammatory marker tests) urine and stool samples Colonoscopy barium enema Detection CAUSE Cause is unclear, however... medications bacteria viruses autoimmune disease bile acid Cause RISK FACTORS Risk Factors Age: 50-70 Sex: Women more likely Autoimmune disease: ex. celiac disease, thyroid disease, type 1 diabetes, etc Genetic link: history of IBS Smoking: especially in ages 16-44 SPECIFIC STRUCTURE Specific Structure continued TREATMENT Treatment See a gastroenterologist review medications make recommendations Medications Pain relievers, such as aspirin, ibuprofen Proton pump inhibitors including lansoprazole (Prevacid), esomeprazole (Nexium) Selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft) Eating, Diet, Nutrition avoid foods drink plenty of liquids milk- and gluten-free diet PROGNOSIS Prognosis Most people are successfully treated for microscopic colitis The condition does not increase your risk of colon cancer Symptoms come and go, spmetimes resolve on their own Some possible risk factors Perforation (rupture) of the bowel Fulminant colitis Toxic megacolon Increased risk of colorectal cancer SOURCES Sources https://www.medicinenet.com/colitis_symptoms_and_signs/symptoms.htm https://www.mayoclinic.org/diseases-conditions/microscopic-colitis/symptoms-causes/syc-20351478 https://www.medicinenet.com/lymphocytic_colitis/article.htm https://www.gwhospital.com/conditions-services/digestive-disorder-center/colitis#:~:text=Colitis%20is%20a%20chronic%20digestive,causes%20of%20an%20inflamed%20colon https://www.healthline.com/health/ulcerative-colitis-take-control-true-stories#4

Colitis

Transcript: 1. Anal fissures, anorectal abscess, ileitis, granulomas... 2. Person with hemachromatosis just came back from a cheese tasting tour in WI and southern Ontario... 3. A patient who is 1 year out from cancer of the spine... 4. A patient who dislikes spaghetti warehouse... Ulcerative Colitis Signs to point you elsewhere Let's keep it flowin'... Bread and butter - let's just endo/colo! What do we HAVE to be careful of before we just go sticking things where the sun don't shine? Colitis (in a nutshell - or in this case, poop burgers?) Board Fun-Facts Name some complications of long term UC? Let's run the algorithm of treatment... Define TM and what do we do do about it?! Complications and Tx What are the symptoms? Other manifestations, or extraintestinal manifestations (EIM)s? How is the official diagnosis made? Labs? What tests boosts a positive p-ANCA to 97% specificity in diagnosing ulcerative colitis?

COLITIS

Transcript: Additional symptoms: YOU NEED 8 GLASSES OF WATER A DAY! DRINK UP! - Although there may not be new research, after the large intestine and rectum are removed, an Ileostomy bag is surgically placed - It is attached to your part of your bowel, known as the stoma, which will now stick out from the right side of your abdomen, allowing the extraction of stool Prognosis - Although there is no cure for Colitis research is still in progress - Moderate exercise can help stabilize bowel function and improve mood - Yoga helps to release tension and relaxes the body Brief intro about Colitis VIDEOS - Some symptoms of Colitis may include: - Abdominal pain - Consistent and immediate bowel movements - Cramp and Fever - The most common symptom is bloody diarrhea which also may contain pus and mucus - More server signs of Colitis may be in the terms of the digestion of food or the digestive system. The large intestine is known to be the area where leftover 20% of nutrients can be absorbed, due to Colitis forming within the large intestine, it is unable to pursue its initial function. - Considering the immune system is not working accordingly, other organs may be at risk, ex: liver, kidneys, rashes may form, as well as eye failure - Consuming calcium may worsen disease Diagnosis Of Colitis Weight loss Loss of appetite Dehydration - Colitis has somewhat been proven to be a an inherited disease, ex: If you have a family member with Colitis, it is likely you will to. - Colitis is known to be triggered by bacteria, viruses, and environmental toxins, this triggers the immune system to attack the cells lining the colon - Many Doctors say food allergies are the cause of Colitis, but many disagree - The true causes of Colitis is still dull, but research is still progressing over the years Surgery - Once a person has developed Colitis, it becomes a "life long" disease - Colitis commonly occurs in adults around the age of 30 to late 60's - The lining of the large intestine becomes infected, killing the cells that line the large intestine, forming ulcers or holes in the colon wall - As of right now treatments for Colitis are still undergoing development - Less sever symptoms are treated with medication for each individual symptom - Some treatments include certain drugs and therapy, depending on how sever it is surgery may be an option - Regulatory check up Causes of Colitis THANKS FOR LISTENING:) Current Research 25-40% of people with server Colitis have to have their colon removed The only disruption with the removal of the colon is that it won't be able absorb left over nutrients After the small intestine goes through its proper function the left over food is released through the anus or through other techniques Treatments For Colitis - Colitis is a condition that cannot be cured - Given certain periods of time symptoms tend to worsen - Colitis can affect people differently. People with a more mild form of Colitis undergo very few treatments - Colitis cannot be prevented. 5% of people develop colon cancer after having Colitis - Joining a support group for Colitis, will also assist those with Colitis Symptoms Of Colitis X-ray of Colitis General Information - For light symptoms of Ulcerative Colitis, medication such as Anti-inflammatory drugs are used - Ex: Sulfasalazine - Medication for diarrhea include Lomotil, Lofene Types of Colitis - Colitis is commonly known as a disease caused by inflammation or irritation within the lining of the large intestine (colon) - This encourages the disposal of fetes in the digestive system to work inappropriately Definition of Colitis CONT... Colitis Under Microscope Ileostomy Bag COLITIS By: Sarah and Krishinder Medication Mucous Colitis - To begin the diagnosis process of Colitis a physician may ask multiple questions such as When did the symptoms begin? How long have the symptoms lasted? How often do they come and go? What foods make the symptoms better or worse - The doctor will also take a series of tests which include: Blood tests Fetes Samples: Stool sample used to detect blood and parasites -Testing is further done with the use of a device called the Barium X-ray The intestine is filled with barium, a white chalk like substance, which allows the x-ray to pick up better pictures of the infected intestine - Additional tests include: Ultrasound, CT scan, and Endoscope, 1. Ulcerative Colitis 2. Mucous Colitis Ulcerative Colitis

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Colitis

Transcript: Colitis is caused by Chron's disease, Ulcerative Colitis, Allergic Reactions, Microscopic Colitis Things can be normal for years and then one day the symptoms hit. Nausea, abdominal pain, and in some cases bloody stool. It can take months to be diagnosed because they're so normal. Sometimes genetic factors come into play depending on the type. https://www.medicinenet.com/colitis/article.htm Symptoms Can it be cured? Causes Prevention By: Joseph Rhodes and Kyler Smith That's not happening Colitis Sources Colitis Life https://www.chronscolitisfoundation.org/what-is-ulcerative-colitis/colitis-treatment-options.....html Fever, chills, fatigue, dehydration, eye inflammation, joint swelling, joint swelling, canker sores, skin inflammation, and blood in stool It can be treated but it can't be cured. There are several options. Surgery, medication, combination therapy, diet and nutrition ;) Logo

Colitis

Transcript: By Marissa Patton Ulcerative Colitis Non-Communicable Disaease Non-Communicable Disaease Ulcerative Colitis is a non-communicable disease, which means that Ulcerative Colitis cannot be passed from person to person, like a virus like the flu can. Although there have been many studies, no scientist is yet sure of the cause of Ulcerative Colitis. While there is no specific cause, there are potential causes: the genes of a person, his or her immune system, and something in his or her environment. Overall, something causes the inflammation of the intestines. How do you get it? How do you get it? -The first true finding of Ulcerative Colitis is unknown. -Some claim that the first record of chronic diarrhea was documented during 360 BCE. -Inflammation in the stomach was recorded in the 1800's from some medical schools. -In 1859, the term Ulcerative Colitis was first used to describe a condition. -In January, 1909, the Royal Society of Medicine had a conference where over 300 cases of Ulcerative Colitis were discussed. History History -Ulcerative colitis affects as many as 907,000 Americans -Men and women are equally likely to be affected -Most people are diagnosed in their mid-30s. -Older men are more likely to be diagnosed than older women. -Ulcerative colitis runs in families -Nearly 20 percent of people with ulcerative colitis will have a relative with UC. -The disease is common among white people of European origin and people of Jewish heritage. Prevelance Prevelance -Medication for ulcerative colitis can reduce inflammation of the colon. -Diarrhea, bleeding, and abdominal pain can be reduced and controlled with medication. -When medicine is not affective, surgery is an option. -Removal of the colon or parts of the colon, Treatment Treatment Usually, Ulcerative Colitis does not end in death. UC can result in bowel issues, reoccuring bowel inflammation, and stomach irritability. In severe cases, UC can result in the use of an ostomy bag, removable of particular foods in a diet, and up to three surgeries for reversal of ostomy bag. Prognosis Prognosis The major body system that is affected is the digestive system. The colon can be severly damaged, inflamed, or in severe cases, removed. Colitis can spread all over the colon, leading to severe pain and bowel issues. Are body systems affected? Are body systems affected? -bowel movements become looser and urgent. -persistent diarrhea -abdominal pain -bloody stool Ulcerative Colitis can be diagnosed through lab tests of fecal matter and blood. A colonoscopy is also an option to test colon health. Symptoms and Diagnosis Symptoms and Diagnosis About two years ago, my sister was diagnosed with Ulcerative Colitis. She suffered immensely and ultimately had to have her colon removed. It was very emotional watching her go through three surgeries, one giving her a temporary ostomy bag. I enjoy learning more about the subject and doing the most research I can do understand what my sister suffered from and how she got the disease. Why did I choose this disease? Why did I choose this disease? -Crohns and Colitis Foundation is an amazing organization focused on informing people about colitis and its affects on those around them. The foundation's website holds very helpful information including support groups and educational links. Support Groups Support Groups Mulder, D. J., Noble, A. J., Justinich, C. J., & Duffin, J. M. (2014). Tale of two diseases: The history of inflammatory bowel disease Journal of Crohns and Colitis Oxford Academic.. Journal of Crohn's and Colitis Crohn's and Colitis; What is Colitis? (2018). Crohn's and Colitis Foundation. What are Crohn’s disease and ulcerative colitis?(2017). Take Steps: Crohn's and Colitis Foundation. Bibliography Bibliography Educational Images: Educational Images:

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