Rectal-sparing, transmural, deep ulceration, fissures, strictures, fistula , aphthous ulceration, skip lesions with microscopic non-caseating granulomas

Unknown aetiology but increased incidence in those with relatives with IBD and increased incidence in smokers

Abdominal pain, fever, malaise, diarrhoea, weight loss, joint pain, back pain 

Abdominal tenderness, perianal fistulas, anal skin tags, pyoderma gangrenosum, clubbing, aphthous ulcers, iritis and erythema nodosum

Bloods: FBC shows anaemia, reduced Ferritin, raised CRP / ESR, LFTs

Microbiology: Stool cultures 

Imaging: Abdominal X-Ray shows colonic dilatation in acute flares

Colonoscopy to assess large bowel and terminal ileal disease 

Barium Follow-Through to assess for small bowel strictures

MRI small bowel shows thickening and strictures

MRI Pelvis in perianal disease assessing for abcess or fistulae

Conservative: Smoking cessation, elemental diet

Medical: Steroids to induce remission, maintenance is  5-aminosalicylates (e.g. 

mesalazine, sulphasalazine), azathioprine or 6-mercaptopurine, biologic    agents such as infliximab and adalimumab are 2nd line

Surgical: Stricture correction, laying open fistulas and resection of diseased bowel

80% of patients will have surgery at some stage. 

Overall mortality is slightly higher than normal population