IBD, Inflammatory bowel disease

Clinic

• IBD is a group of inflammatory conditions of the colon and small intestine
• It causes inflammation and ulcers (sores) of digestive tract.
• 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:

	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

GI tract	Extra GI	Static Complication
Abdominal pain Rectal bleeding Mucus covered Stool Severe internal Cramps/ Spasms in pelvis region Diarrhea mixed with Bloody Mucus discharge Weight loss, Anemia /Malabsorption /Steatorrhea(Crohn> UC) Bowel movements Increased Proctitis (UC> Crohn): Urgency or rectal tenesmus + Little stool Tenesmus may be misinterpreted as constipation Fecal incontinence 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.	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)	Mega colon Colon cancer (UC> Crohn)

Miasms

• CMV : Sclerosing Cholingitis, Fistula, Uveitis, Colitis
• MTB: Ankylosing spondylitis / Sacroiliitis / Pyoderma gangrenosum, Arthritis, Uveitis, Cholingitis, Colitis and GI tract Ulceration
• HSV-1: Proctitis

New Idea

• Crohn involve GI mucus membrane in patchy but deep form which ends in Stenosis/ Abcess / Fistulae but UC involvement is Shallow and Continuous.
• Does it mean UC entity is Colitis and Crohn's is Ulceration.
• If so, I can say Crohn's miasm is only MTB and UC's is CMV. If Rectum / Anus is involved, then HSV is the only miasm
• 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.