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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

1
Malik TA. Inflammatory bowel disease: historical perspective, epidemiology, and risk factors. Surg Clin North Am.  2015;95(6):1105–1122. [View Abstract on OvidMedline]
2
Clark C, Turner...

SEE ALSO

Crohn Disease; Ulcerative Colitis 

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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