11. Celiac Disease, Crohn's Disease, Ulcerative colitis | USMLE Step 1 Pathology 

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Celiac Disease, Crohn's Disease, Ulcerative Colitis
Celiac disease, Crohn's disease, and ulcerative colitis are all chronic inflammatory conditions affecting the gastrointestinal tract, albeit with distinct pathophysiological mechanisms and clinical presentations. Celiac disease is an autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals, leading to small intestinal mucosal injury, villous atrophy, and malabsorption of nutrients. Patients typically present with gastrointestinal symptoms (such as diarrhea, abdominal pain, and bloating) as well as extraintestinal manifestations (like dermatitis herpetiformis and osteoporosis). Diagnosis involves serological testing for specific antibodies (e.g., anti-tissue transglutaminase antibodies) and confirmation through duodenal biopsy showing characteristic histological changes. Treatment primarily involves strict adherence to a gluten-free diet, which can reverse mucosal damage and alleviate symptoms.
Crohn's disease is a type of inflammatory bowel disease characterized by transmural inflammation and skip lesions that can affect any part of the gastrointestinal tract. Patients may present with abdominal pain, diarrhea (often non-bloody), weight loss, and extraintestinal manifestations like arthritis and uveitis. Endoscopic findings typically reveal cobblestoning, skip lesions, and ulcerations. Diagnosis is established through a combination of clinical evaluation, endoscopic examination, imaging studies (such as CT or MRI), and histopathological analysis of biopsy specimens. Treatment aims to induce and maintain remission through medications (including aminosalicylates, corticosteroids, immunomodulators, and biologics) and, in some cases, surgical resection of affected bowel segments.
Ulcerative colitis, another subtype of inflammatory bowel disease, primarily affects the colon and rectum, causing continuous mucosal inflammation starting from the rectum. Patients present with symptoms such as bloody diarrhea, abdominal pain, urgency, and tenesmus. Endoscopic findings typically include diffuse friability, erythema, and ulcerations. Diagnosis is made through clinical evaluation, endoscopy with biopsy, imaging studies, and laboratory tests. Treatment aims to induce and maintain remission through medications (similar to Crohn's disease) and, in severe cases or complications like toxic megacolon or dysplasia, surgical options like colectomy may be necessary.👩‍⚕️💊📋
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