GPs have central role in managing IBD

23 Oct 2008Paid-up subscribers

Ulcerative colitis (UC) and Crohn's disease together constitute inflammatory bowel disease (IBD). The prevalence of UC is about 30-100 per 100,000 and 30-50 per 100,000 for Crohn's disease. They characteristically present in young adults, but may present at any time of life, including childhood and old age, and a second peak of incidence is now recognised in the sixth decade of life. UC always affects the rectum and then progresses to a variable extent around the colon, but never extends into the small bowel. By contrast, Crohn's disease may occur anywhere in the GI tract, from the mouth to the anus, with skip lesions - inflamed areas affected by Crohn's disease - separated by areas of apparently normal mucosa. The ileocaecal region is the most common site. Crohn's also frequently affects the colon, and can diffusely affect the small bowel. It rarely occurs in the oesophagus, stomach and duodenum. It is important that GPs have a high index of suspicion of IBD and initiate appropriate treatment for patients undergoing relapse of the disease. GPs also have a vital role in the monitoring of patients, often in collaboration with gastroenterologists, particularly for those patients on immunosuppressant therapy.

October 2008: Tailor treatment to the patient in irritable bowel syndrome

15 Oct 2008Paid-up subscribers

What dietary changes may help patients with irritable bowel syndrome? What drug treatments should be considered? When should patients be referred?

October 2007: Red flags are key to managing dyspepsia

01 Oct 2007Paid-up subscribers

Which patients should be referred for endoscopy? When should H.pylori testing be carried out? Which symptoms are suggestive of gastric carcinoma?

October 2007: Managing patients with diverticulitis

01 Oct 2007Paid-up subscribers

Who is at risk of diverticular disease? When is surgery indicated? What are the non-surgical options?

October 2007: Coeliac disease often goes undiagnosed

01 Oct 2007Paid-up subscribers

What are the typical presenting features of coeliac disease? How can GPs screen for coeliac disease? Is there an association with other conditions?