IBD, Inflammatory bowel disease

Clinic

• IBD is a group of inflammatory conditions of the colon and small intestine
• Crohn's disease and ulcerative colitis being the principal types.
• Crohn's disease affects the small intestine and large intestine, as well as the mouth, esophagus, stomach and the anus
• Ulcerative colitis primarily affects the colon and the rectum.

Sign / Symptoms

It may seem that Crohn's and UC are very different diseases, but both may present with similar following symptoms:

GI tract

	Crohn's disease	Ulcerative colitis
Defecation	Often porridge-like, sometimes steatorrhea	Often mucus-like and with blood
Tenesmus	Less common	More common
Fever	Common	Indicates severe disease
Fistulae	Common	Seldom
Weight loss	Often	More seldom

• Abdominal pain
• Diarrhea mixed with Bloody Mucus discharge
• Weight loss, Anemia /Malabsorption /Steatorrhea (Crohn> UC )
• Fecal incontinence
• Bowel movements Increased
• Proctitis (UC> Crohn)
  • Urgency or rectal tenesmus + Little stool
  • Tenesmus may be misinterpreted as constipation

• Mega colon / Colon cancer (UC> Crohn)
• Terminal ileum involvement (Crohn> UC )
• Cholangitis (UC> Crohn)
• Crohn involve GI mucus membrane in patchy but deep form which ends in Stenosis/ Abcess / Fistulae but UC involvement is Shallow and Continuous.

Extra GI

• Anemia is the most prevalent extra intestinal complication

• Episcleritis / Iritis/ Uveitis
• Primary sclerosing cholangitis (UC> Crohn)
• Ankylosing spondylitis / Sacroiliitis / Poly-Arthritis
• Pyoderma gangrenosum (Crohn> UC )
• Erythema nodosum (Crohn> UC )
• Non-thyroidal illness syndrome (NTIS)
• Deep vein thrombosis (DVT)
• Bronchiolitis obliterans organizing pneumonia (BOOP)

• Abdominal pain
• Diarrhea
• Rectal bleeding
• Mucus covered Stool
• Severe internal Cramps/ Spasms in pelvis region
• Weight loss

Static complications

• Mega colon

Miasms

• CMV : Sclerosing Cholingitis, Fistula, Uveitis,
• MTB: Ankylosing spondylitis / Sacroiliitis / Pyoderma gangrenosum, Arthritis, Uveitis, Cholingitis
• HSV-1

Note: Due to high prevalence of Bloody, painful stool in UC, I suggest HSV-1, In comparison MTB / CMV is good candidate of Crohn because of Fistula.

First class remedies

Diseases - CROHN'S, disease Aloe ars. chin. merc-c

1.1 Merc-c

• Severe epigastric sensitivity: feeling of pain and bruising in the abdomen, especially in the area of cecum and transverse colon.
• Dysentery: Tenesmus that does not amel with defecation and has become permanent
• Hot, bloody, slimy, foul-smelling stools
• Severe cutting pains
• Severe Abdominal distention+ High sensitivity to touch
• Unceasing green bilious vomiting

1.2 Orni

• Feeling of struggle and twisting in the chest and stomach that started from the pyloric valve of the stomach + Flatus passing + Feeling of a ball rolling from one side of the abdomen to another
• Pain increases when food passes through the pyloric valve

• Coated tongue
• Anorexia + Nausea / Vomiting + Weight loss
• Stomach ulcer even with bleeding
• Coffee-ground Vomiting
• Frequent flatulence + foul-smelling flatus passing
• Pain and emptiness in the epigastrium

Ant-c

Podo

Lyc