Inflammatory Bowel Disease (IBD): UC vs. Crohn’s, Diagnosis, Management & Nursing Care

Etiology of IBD

Unknown, but linked to environmental triggers, immunity, and genetics

IBD Gender Breakdown

Males more commonly get Ulcerative Colitis (UC); females more commonly get Crohn disease

IBD Peak Age of Onset

15 to 35 years old

IBD High-Risk Ethnicities

Caucasian and Ashkenazic Jewish origin

IBD Geographic Distribution

More common in developed countries, northern climates, and urban areas

IBD Risk Factors

Smoking, antibiotics, NSAIDs, appendicitis, and diet

Common Symptoms of IBD

Mild to severe diarrhea, abdominal pain, bloody or loose stools, urgency to defecate, rectal tenesmus, decreased appetite, weight loss, fatigue, and fever

IBD Diagnostic Methods

Stool samples, endoscopy or colonoscopy, and imaging studies (MRI or CT)

IBD Elevated Lab Markers

Increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)

IBD Decreased Lab Markers

Decreased hemoglobin (anemia), decreased folic acid, and decreased vitamin B12 levels

Ulcerative Colitis (UC) Affected Location

Rectum to cecum (colon)

Crohn Disease Affected Location

Mouth to anus (characterized by a cobblestone appearance)

Ulcerative Colitis (UC) Stool Characteristics

Liquid, bloody stools

Crohn Disease Stool Characteristics

Loose soft stools

Ulcerative Colitis (UC) Primary Diagnostic View

Colonoscopy

Crohn Disease Primary Diagnostic View

Endoscopy

Ulcerative Colitis (UC) Complications

Hemorrhage, perforated bowel, megacolon, and colorectal cancer

Crohn Disease Complications

Fistula, stricture, abscess, and malnutrition

Recommended Lifestyle & Physical Modifications for IBD

Exercise and decrease stress

Recommended Diet for IBD Management

Low-residue, high-calorie, high-protein, vitamin-rich, and mineral-rich diet

Recommended Meal Patterns for IBD

Small, frequent meals with snacks

Recommended Food Texture Habits for IBD

Soft foods that are chewed thoroughly

Dietary Items to Avoid with IBD

Gas-producing foods, nuts, kernels, seeds, and high-fiber/high-cellulose foods

Gastrointestinal Stimulants to Avoid with IBD

Stimulants, laxatives, or enemas

Substances to Avoid with IBD

Smoking, caffeine, carbonated beverages, and alcohol

Medication Restriction for Ileostomy Patients

Avoid taking enteric-coated and capsule medications

IBD Nursing Assessment: Nutrition

Monitor daily weights and overall nutritional intake

IBD Nursing Assessment: Fluid and Electrolytes

Monitor vital signs, mental status, urinary output (watch for decrease), tachycardia, hematocrit, hemoglobin, and electrolyte levels

IBD Nursing Assessment: Pain Control

Perform pain assessment and evaluate the effectiveness of interventions

IBD Nursing Assessment: Skin Integrity

Assess for redness, irritation, excoriation, anal fissures, and abscesses

IBD Nursing Assessment: Stress Management

Evaluate coping mechanisms and support systems