UC, Crohn's, and Pancreatitis Flashcards

Ulcerative Colitis (UC)

  • Inflammatory bowel disease primarily affecting the large intestine and/or rectum.
  • Causes inflammation and ulcers.
  • No cure currently exists.
  • Appearance:
    • Normal colon: smooth, pink, healthy tissue.
    • UC colon: patchy white areas (similar to thrush).

Etiology of UC

  • Strong genetic component; family history is common.
  • Possible immune system dysfunction (autoimmune).
  • Environmental factors: stress, infections, medications.
  • Microbiome changes: disruptions in normal gut bacteria.

Signs and Symptoms of UC

  • Blood and pus in the stool.
  • Urgency to defecate.
  • Feeling of incomplete bowel evacuation.
  • Remissions and flares (unpredictable).
  • Fever (sometimes infection is present).
  • Pain: cramping in the lower intestine.
  • Weight loss: due to diarrhea and malabsorption; also, patients may refrain from eating to avoid needing the bathroom.

Labs to Monitor for UC

  • White blood cell count (WBC):
    • Looking for infection
  • Hemoglobin and Hematocrit:
    • Looking for anemia
  • Inflammatory markers:
    • Sedimentation rate (SED rate) or Erythrocyte Sedimentation Rate (ESR).
    • C-reactive protein (CRP).

Diagnostic Confirmation for UC

  • Colonoscopy.
  • Sigmoidoscopy.
  • Barium enemas and CT scans are also used.

Medications for UC

  • Aminosalicylates (e.g., mesalamine).
  • Corticosteroids: to quickly reduce inflammation during flares.
  • Immunomodulators: Methotrexate (used for autoimmune diseases; mild chemotherapeutic agent).
  • Biologics: Used often in cancer and autoimmune treatments
    • Often end in "-mab".
  • JAK inhibitors: e.g., Tofacitinib (Xeljanz).
  • Antibiotics: for infections.

Nursing Interventions for UC

  • Symptom management: pain management and nutritional support.
  • Bowel management.
  • Monitoring for complications, especially bleeding.
  • Watch for signs of anemia (fatigue, headaches).

Crohn's Disease

  • Chronic inflammation that can occur anywhere in the digestive tract (unlike UC, which is limited to the large intestine).
  • Characterized by patchy areas of inflammation; tissue appears red and inflamed, not healthy pink.
  • Also has flares and remissions.

Etiology of Crohn's

  • Exact cause is unknown.
  • Strong link to genetics.
  • Environmental factors, lifestyle.
  • Considered an autoimmune disorder.
  • Certain foods, infections (e.g., Epstein-Barr virus), smoking.

Symptoms of Crohn's Disease

  • Loss of appetite.
  • Blood in the stool.
  • Fatigue.
  • Mouth sores.
  • Aches and cramping.
  • Weight loss.
  • Diarrhea.

Complications of Crohn's Disease

  • Bowel obstructions.
  • Ulcers.
  • Fistulas: abnormal connections between organs or vessels.
  • Increased risk of colon cancer.

Diagnostic Tests for Crohn's

  • Fecal calprotectin and lactoferrin: proteins released by white blood cells.
  • Stool samples (looking for C. diff in hospitalized patients).
  • Ova and parasite (O&P) testing (usually negative).
  • CAT scans, MRIs, ultrasounds, biopsies.

Medications and Interventions for Crohn's

  • Anti-inflammatory drugs (steroids).
  • Immunosuppressants.
  • Biologics (same as UC).
  • Surgery: Colon resections (removal of part of the colon).
  • Nursing interventions: Similar to UC: pain management, controlling inflammation, nutrition.
  • May require bowel rest (temporary colostomy).

Ulcerative Colitis vs. Crohn's Disease

  • Onset is between ages 15 to 35.

Pancreatitis

  • Inflammation of the pancreas.
  • Two main functions:
    • Aids in digestion (enzymes and fluids).
    • Regulates blood glucose (insulin and glucagon).

Pancreatic Function

  • Exocrine (digestion):
    • Produces digestive enzymes: lipase, amylase, and trypsin.
    • These enzymes break down carbohydrates, fats, and proteins.
    • Enzymes are released into the small intestine through the pancreatic duct.
    • Secretes bicarbonate to neutralize acid.
  • Endocrine (hormones):
    • Produces insulin (decreases blood sugar) and glucagon (increases blood sugar).
    • Insulin \uparrow, Glucagon \downarrow.
    • These hormones regulate blood sugar.

Pathophysiology of Pancreatitis

  • Acute pancreatitis: Premature activation of enzymes causes autodigestion (the pancreas digests itself) and inflammation.
  • Chronic pancreatitis: Irreversible damage leading to pancreatic insufficiency.
  • Can lead to diabetes, malabsorption.

Causes of Pancreatitis

  • Excessive alcohol intake.
  • Trauma.
  • Medications.
  • Infections.
  • Tumors.
  • Genetic factors.
  • High triglycerides
  • Hypercalcemia (high calcium levels).
  • Gallstones.

Signs and Symptoms of Pancreatitis

  • Abdominal pain.
  • Fever, chills.
  • Nausea, vomiting.
  • Tender and swollen abdomen.
  • Rapid pulse.
  • Indigestion.
  • Severe abdominal pain (radiating to the back).
  • Fatigue.
  • Tachycardia.

Diagnostic Tests for Pancreatitis

  • Labs:
    • Amylase and lipase.
    • Glucose.
    • Triglycerides.
    • Calcium levels.
    • Liver function tests.
    • White blood cell count.
    • Pancreatic function tests.
  • Imaging:
    • Ultrasound.
    • CT scan.
    • ERCP (Endoscopic Retrograde Cholangiopancreatography).

Treatment and Interventions for Pancreatitis

  • Pain management (analgesics; avoid heavy opioids initially).
  • Antibiotics (if infection is suspected).
  • Hydration and nutritional support.
  • Low-fat diet.
  • Monitoring vital signs, fluids, labs, bleeding, medications.
  • Patient education.