Inflammatory Bowel Disease

Tori Chee, MD, MBA, Aaron L. Moody, MD and Samuel Livingston, MD, FAAFP Reviewed 06/2019

BASICS

DESCRIPTION

Inflammatory bowel disease (IBD) includes two separate clinical entities: ulcerative colitis (UC) and Crohn disease (CD). UC and CD are both uncontrolled immune-mediated inflammatory...

DIAGNOSIS

HISTORY

Chronic/episodic abdominal pain, nausea/vomiting, bloody diarrhea, tenesmus, urgency, fever, weight loss, joint swelling/redness, localized abdominal tenderness, nocturnal diarrhea, a...

TREATMENT

GENERAL MEASURES

Assess inflammatory status and risk stratify patients into high or low risk via symptoms and histology.
Use Crohn’s Disease Activity Index (CDAI) to quantify severity of CD. S...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Postoperative monitoring at 6 to 12 months after surgically induced remission if not receiving pharmacologic monitoring (6)[B]

Patient Monitoring

Assess comorbid c...

REFERENCES

Malik TA. Inflammatory bowel disease: historical perspective, epidemiology, and risk factors. Surg Clin North Am. 2015;95(6):1105–1122. [View Abstract on OvidMedline]

Clark C, Turner...

CODES

ICD10

K51 Ulcerative colitis
K50.918 Crohn’s disease, unspecified, with other complications
K50.919 Crohn’s disease, unspecified, with unspecified complications
K51.8 Other ulcerative colitis
K50.01 ...

CLINICAL PEARLS

Although history can usually differentiate between UC and CD, endoscopy is required for diagnosis to assess disease burden and to help guide therapy.
Use CDAI to determine severity.
5-AS...

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