LECTURE: OESOPHAGUS AND STOMACH DISORDERS WEEK: 4 INFLAMMATORY BOWEL DISEASE (BD) CLASSIFICATIONS: Chronic condition resulting in inappropriate mucosal immune activation: IBD is an umbrella term For: Crohn's disease Involves any area of the small and/ or large intestine At the terminal ileum or valve of the caecum CAUSES: Intestinal microbiota Host immune responses Genetically predisposed individuals COMPLICATIONS: A long-term complication is the development of neoplasia (a) benign or malignant tumour ) Is Frequently transmural (can go through the 4 layers of the GI tract) Skips lesions ( every second tract) Ulcerative colitis Limited to the colon and rectum Lesions only extend down to the mucosa or submucosa IBD Is not to be confused with irritable bowel syndrome (IBS) which is a motility disorder with no clear aetiology or pathophysiology Begins as dysplasia Risk increases based on: Duration of disease Extent of involvement Inflammation Feature Crohn's Disease Bowel region affected Ileum + colon Rectal involvement Sometimes Always Distribution Skip lesions Ulcers Deep Malignant potential With colonic involvement Ulcerative Colitis Colon only Diffuse Superficial Yes GASTROINTESTINAL POLYPS AND TUMOURS Projecting growth of tissue From the mucus membrane Polyps can be classified as: Non-neoplastic polyps Hyperplastic polyps Neoplastic polyps Adenomas HYPERPLASTIC POLYPS Commonly Found in the colon in people over the age of 60 Cause is not Fully understood but may involve a pile up of goblet cells due to: Decrease epithelial cell turnover Delayed shedding of surface epithelial cells Not neoplastic