IBS, intestional obstruction, appendicitis, celiac, diverticular disease

IBS

Chronic functional disorder characterized by recurrent abdominal pain associated with disordered bowel movements, which may include diarrhea, constipation or both

Percentage of people that report symptoms? Who does this occur more in?

15%

occurs in women more than men

What are triggers of IBS

- chronic stress

- sleep deprivation

- surgery

- infections

- diverticulitis

- some foods

Clinical manifestations of IBS

- alterations

- pain

- bloating

- abdominal distension

Assessment finding for IBS

- stool studies

- contrast radiography

- proctoscopy

- barium enema

- colonoscopy

- manometry

- electromyography

Patient learning needs for IBS

- medication management

- complementary medicine

- dietary changes

- food diary

- adequate fluid intake

- avoid alcohol and smoking

- relaxation techniques

Intestinal obstruction

When blockage prevents the normal flow of intestinal contents through the intestinal tract

Mechanical obstruction: intestinal obstruction

Intraluminal obstruction or mural obstruction from pressure on intestinal wall

Functional or paralytic obstruction

- the intestinal musculature cannot propel the contents along the bowel

- the black age also can be temporary and result of the manipulation of bowel during surgery

nursing management for intestinal obstruction: goals

- maintaining the function of nasogastric tube

- assessing and measuring the nasogastric output

- assessing of fluid and electrolyte imbalance

- monitor nutritional status

- assess for manifestations consistent with resolution

Appendicitis

Most frequent cause of acute abdomen in the US. Most common reason emergency abdominal surgery

Patho for appendicitis

Appendix becomes inflamed and edematousbas a result of becoming kinked or occluded by fecalith or lymphoid hyperplasia, the inflammatory process then increases intraluminal pressure, causing edema and obstruction of the orifice.

When the appendix is obstructed what occur?

Becomes ischemic, bacterial overgrowth occurs, and eventually gangrene or perforation occurs

Management for appendicitis: goals

- relieving pain

- preventing fluid volume deficit

- reducing anxiety

- prevent or treat surgical site infection

- prevent atelectasis

- maintaining skin integrity

- attaining optimal nutrition

Celiac disease

A disorder of malabsorption caused by an autoimmune response to consumption of products that contain the protein gluten, women tend to get it twice as often as men

What is gluten found in most often?

- wheat

- barely

- rye

- grains malt

- dextrin

- brewers yeast

Manifestations of celiac

- diarrhea

- steatorrhea

- abdominal pain

- abdominal distension

- flatulence

- weight loss

- delayed puberty in children

Management of celiac

- it's chronic, non curable, lifelong

- no meds to treat

- refrain from exposure to gluten in foods

- consult with dietitian

Fat soluable vitamins

A, D, E, K

IBS education good to know

- exercise (3x a week)

- keep journal for diet, symptoms, and stress levels

Diverticulum

Sac-like herniation of the lining of the bowel that extends through a defect in the muscle layer, may occur anywhere in the intestine but most common is in the sigmoid colon

Diverticulosis

Mutiple diverticula without inflammation

Diverticulitis

Infection and inflammation of diverticula

Diverticular disease increases with? What is it associated with?

Increases with age, and associated with low fiber diet

Management for diverticulitis

- encourage fluid intake of atleast 2L/day

- soft foods with increased fiber, such as cooked veggies

- individualized exercise program

- bulk laxatives (psyllium) and stool softener

Signs and symptoms of Diverticular disease

Fever

chill

pain LLQ

Labs for diverticular disease

Decrease H/H

Increase WBC