inﬂ ammatory bowel disease
in the lining of the
characterized by intermittent exacerbations alternating with
complete symptomatic remission. Major symptoms include
abdominal pain, diarrhea, anemia, weight loss, bleeding
from the rectum, and passage of mucus. Pathologically, the
is predominantly conF
ned to the
in contrast to
, which is transmu-
ral. Grossly, ulcerative colitis produces shallow ulcers and
. Histologic features include
, and loss of mucin
. Treatment includes anti-inﬂ ammatory drugs
and immunosuppressants to control the symptoms and
achieve remission. The risk for the development of adeno-
carcinoma is high in patients with ulcerative colitis, so sur-
is necessary to detect
early dysplasia of the glandular epithelium. Surgical removal
of the colon is necessary in severe refractory cases or in cases
where severe dysplasia or adenocarcinoma is detected.
chronic autoimmune inﬂ ammatory
that may affect any location, from
the oral cavity to the anus, but mostly involves the
. Crohn disease is characterized by
asymmetric and segmental inﬂ ammation extending through
the intestinal wall (
) from the
. Crohn disease characteristically involves areas of the
bowel separated by intervening uninvolved areas or “
. Symptoms include abdominal pain, diarrhea, vom-
iting, and weight loss. Pathologic changes include mucosal
neutrophil and mononuclear cell inF ltration, ulceration,
mucosal F ssures, F
stulae, serosal adhesions, abscesses,
, and noncaseating granulomas. Treatment focuses
on relieving symptoms through immunosuppressive agents
to prevent relapse and complications. This image shows
colonic mucosa with depletion of goblet cells,
within the lamina propria, chronic inﬂ amma-
tion, and neutrophils invading the crypt cells.
: the reversible change of one mature type of epithelium to an intestinal type epithelium; may be seen
in chronic gastritis when goblet cells are present within the gastric mucosa; considered a risk factor for the development of
gastric adenocarcinoma (±ig. 15-8B).
: general term for abdominal pain or indigestion associated with the intake of food (±ig. 15-10C).
: the reversible change of one mature type of epithelium to a gastric type epithelium; seen in peptic
duodenitis when the normal epithelial lining with goblet cells is replaced with a gastric foveolar–type mucosa in response
to exposure to increased levels of stomach acid (±ig. 15-10C).
: found in cases of chronic inﬂ ammatory bowel disease; consists of polypoid mounds of mucosa created by
regenerating glandular epithelium; not considered true polyps, hence the name (±igs. 15-18A and 15-20A,B).
: an aggregate of neutrophils present within a colon crypt, usually associated with inﬂ
disease, particularly ulcerative colitis (±ig. 15-20A).
: an indicator of acute colitis; appreciated histologically by the inF
ltration of neutrophils with the crypt cells of
the colon (±ig. 15-20B).
Pathological and Clinical Terms for the Digestive Tract