Is it Crohn's Disease or Ulcerative Colitis?

I grew tired of all those annoying tables comparing Crohn's Disease (CD) with Ulcerative Colitis (UC). I've boiled these tables down to a few"rules" to look for in the stem of the question.

• 1st rule: If the rectum is spared, it's CD. Or another way to put it is that UC will always start from the rectum and move up, without skip lesions.
• 2nd rule: If there are fistulas, its CD. Remember that CD is transmural.
• 3rd rule: if it involves the small intestine, its NEVER UC. UC will never move past the ileocecal valve, so if there is terminal ileal involvement, it must be CD.
• 4th rule: if there are granulomas, its CD.
  

Hope this helps.

Is it jaundice... or too many carrots?

• TOO MUCH BILIRUBIN BEING PRODUCED ("hemolytic jaundice")
• Ineffective hematopoiesis", i.e., normoblasts dying in the bone marrow
• Thalassemias (even mild ones like beta-thal minor)
• Megaloblastic anemias (folate or B12 deficiencies)
• Intravascular hemolysis (many causes)
  
• Extravascular hemolysis
• Big hematomas
• GI bleeding

• LIVER FAILS TO TAKE UP AND/OR CONJUGATE BILIRUBIN ("hepatocellular jaundice")
• Newborns (don’t give opiates (except meperidine), sulfonamides)
• Hypoperfusion (CHF)
• Bad alcoholism
• Hepatitis (many causes)
• Cirrhosis (many causes)
• Glucuronyl transferase (solubilizes bilirubin)
• Gilbert’s non-disease [worse w/ fasting)
• Crigler-Najjar

• LIVER DOESN'T SEND BILIRUBIN TO THE RIGHT PLACE ("cholestatic jaundice" water soluble so urine can be darker)
• Problems with the liver cells
• Drugs (estrogen, anabolic steroids)
• Dubin-Johnson (pigmented) non-disease
• These people lack a pump
• Rotor (non-pigmented) non-disease.
• Problems with the bile ducts in the liver
• Biliary cirrhosis
• Biliary atresia
• Problems with the bile ducts beyond the liver (surgical)
• Gallstone in the common duct (the only time a gallstone in the gallbladder will cause jaundice is in Mirizzi Syndrome)Cancer (i.e., biliary, pancreatic, ampullary)
• Iatrogenic (i.e., the surgeon nicked the common bile duct)
  

BTW: the eye sclera should never be yellow if the "jaundice" from carrots.

2 for 1 deal... Achalasia and Hirschsprung's Disease

Achalasia is the Hirschsprung's of the esophagus. Both are missing the Auerbach's plexus (or myenteric plexus). Both have problems relaxing. Achalasia causes a megaesophagus and Hischsprung's causes a mega colon.

Note that Chagas disease = achalasia + Hirschsprung's. Chagas disease can cause both a megaesophagus and a megacolon.

Bile Acid Secretion

Acid secretion in stomach