#138 Inflammatory Bowel Disease: Crohn’s and Ulcerative Colitis From The Curbsiders

Here is the link to the podcast and show notes of #138 Inflammatory Bowel Disease: Crohn’s and Ulcerative, FEBRUARY 4, 2019 By DR PAUL WILLIAMS from The Curbsiders. The show notes and podcast are outstanding [I always say that but they always are].

The clinical information begins at 11:25.

The show notes should be reviewed in their entirety as they are full of pearls.

I’ve put in the time stamps for my convenience:

Time Stamps

Intro and background
  • 00:00 Sponsor: MKSAP 18
  • 00:32 Disclaimer, Intro, guest bio
  • 04:05 Guest one-liner, Adam’s movie rec – RBG (documentary), career advice, Paul’s movie rec – Edge of Tomorrow
  • 09:25 Sponsor: ACP’s MKSAP 18
  • 11:25 Definitions and pathophysiology of inflammatory bowel disease (IBD)
Ulcerative Colitis
  • 13:40 A case of ulcerative colitis; Classic symptoms; Initial approach and basic differential diagnosis
  • 19:10 Smoking and ulcerative colitis
  • 21:17 Initial workup for suspected IBD; Fecal calprotectin
  • 25:50 A bit more on CRP and IBD
  • 26:55 When to refer for colonoscopy
  • 27:58 Back to the case; a typical colonoscopy reports in ulcerative colitis (UC)
  • 30:33 Extraintestinal manifestations of UC
  • 34:50 Initial counseling for newly diagnosed IBD; natural history of IBD, prognosis
  • 39:50 Treatment of ulcerative colitis
  • 43:02 Some specifics on steroids, plus topical therapies
Crohn’s disease
  • 47:05 A case of Crohn’s disease; initial approach and differential diagnosis
  • 50:25 Initial diagnostic testing; colonoscopy findings in Crohn’s; IBD trivia
  • 53:58 Treatment of Crohn’s disease
  • 58:26 Specifics about biologic therapy for IBD; Endpoints
  • 62:25 Steroid sparing agents, immunomodulators like azathioprine, 6-mercaptopurine
  • 64:48 Can drug therapy be stopped or tapered in IBD?
  • 66:50 Prognosis in Crohn’s and initial patient counseling
Primary Care considerations
  • 68:35 Surveillance endoscopy,
  • 71:47 Do diet and lifestyle changes for IBD work? What about pregnancy?
  • 76:31 Immunizations
  • 79:25 Bone health, osteoporosis and IBD, screening for iron and nutritional deficiencies
  • 82:27 Take home points
  • 86:28 Outro


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