unit 9: lower GI

inflammatory bowel disease

immunological disorder including crohns disease and ulcerative colitis

how is inflammatory bowel disease characterized by

chronic, recurrent inflammation of intestinal tract

unknown cause and cure (autoimmune)

ulcerative colitis patho

diffuse inflammation beginning in rectum and spreading up to the colon in continuous pattern

where does inflammation occur in UC

mucosa and submucosa

Ulcerative colitis manifestations

bloody diarrhea, abdominal pain, tenesmus, rectal bleeding, mucus in stool, 10-20 BM a day, weight loss

complications of ulcerative colitis

intestinal - hemorrhage, perforation, toxic megacolon, dilation and paralysis, colonic dilation

extraintestinal - skin lesions, anemia, joint pain, mouth ulcers, conjunctivitis, kidney stones, gallstones

surgical therapy for ulcerative colitis

total proctocolectomy with permanent ileostomy or with ileoanal reservoir

crohn’s disease

systemic autoimmune disease disorder with abnormal inflammation of GI tract (mouth to anus)

where is crohn’s disease most commonly seen?

terminal ileum and colon

how is crohn’s disease characterized

skip lesions, inflammation of all layers of the bowel, deep, longitudinal lacerations, penetrate edematous mucosa

clinical manifestations of crohn’s

diarrhea, fatigue, abdo pain, weight loss, fever, arthritis, anemia, malnutrition, electrolyte imbalances

complications of crohn’s disease

intestinal - strictures and obstructions, fistulas, peritonitis

extraintestinal - arthritis, liver disease, cholelithasis, ankylosing spondylitis, osteoporosis, renal disease, kidney stones

inflammatory disease diagnostic studies

blood - cbc, serum electrolyte levels, serum protein levels,

stool - pus, blood, mucus

sigmoidoscopy

collaborative care of IDB

rest of bowel, control inflammation, combat infection, correct malnutrition, symptom relief

nutritional therapy for IDB

LOW fiber diet, replace fluid and electrolytes, supplements, prevent weight loss

drug therapy for IDB

anti-microbial, 5-aminosalicylates, corticosteroids, antidiarrheal, immunosuppressants, vitamins

ostomy surgery types

ileostomy, cecostomy, colostomy

places - ascending, transverse, descending and sigmoid colostomies

post-op care of an ostomy

signs of hemorrhage, drain output, stoma care, raised, pink, warm,