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Inflammatory Bowel Disease
• General term used for:
– Ulcerative colitis
– Crohn’s disease
– Both are characterized by ext...
Famous People with UC
Ulcerative Colitis
• Area of chronic inflammation of mucosa and
• submucosa in the rectum and spread to the
• cecum that r...
Causes???????
• Crypt abcessess
Ulcerative Colitis
• Manifestations
– Colon becomes edematous and develops
bleeding lesions & ulcers
– Scar tissue develop...
• Weight loss
• Anorexia
• Malaise
• Dehydration and electrolyte imbalances
• Anemia
• Abdominal tenderness and cramping
Mild Disease
Moderate
Severe and fulminant
• May affect quality of life; patient may be fearful
to leave house
• Complications include: hemorrhage, abscess
formation...
Ulcerative Colitis
• Collaborative Management :
– Medical management:
• Rest is required to decrease intestinal activity
•...
• Medications –
• Aminosalicylates – deliver 5-ASA to the affected
area– read these drugs!
– Glucocorticoid – prednisone =...
Cont. Collaborative Care
• Surgery
– Total proctocoloctomy (removal of colon) with permanent
ileostomy – is curative
– Koc...
Protocolectomy
Kock Surgery
• Continent Ileostomy
Coping with flares
• The above website will take you to a slide
show on how to cope with UC flare ups.
Crohn’s disease
• Chronic inflammation of GI mucosa occurring
anywhere from mouth to anus but most common
in terminal ileu...
• Evidence is mounting that Crohn's disease
is not an autoimmune disease, but an
immune response to a bacteria - most
like...
Crohn’s disease
• Manifestations: vary patient to patient – common:
– Diarrhea(5 to 6 liquid to semi formed stools/day) is...
Crohn’s disease
• Collaborative Management:
– Diagnostic – see Ulcerative Colitis (UC)
– Medical management: similar to UC...
Crohn's disease Ulcerative colitis
Defecation
Often porridge-like[3],
sometimes steatorrhea
Often mucus-like
and with bloo...
Crohn’s disease
• Surgical:
– Avoided if possible; not curative, mostly just
used to treat complications
– Performed if no...
Nursing Diagnoses
• Diarrhea related to inflammation of the bowel
mucosa
• Acute pain
• Knowledge deficit
• Imbalanced nut...
Website for children and teens
Inflammation spring 2013 narrated(1)
Inflammation spring 2013 narrated(1)
Inflammation spring 2013 narrated(1)
Inflammation spring 2013 narrated(1)
Inflammation spring 2013 narrated(1)
Inflammation spring 2013 narrated(1)
Inflammation spring 2013 narrated(1)
Inflammation spring 2013 narrated(1)
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Inflammation spring 2013 narrated(1)

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Transcript of "Inflammation spring 2013 narrated(1)"

  1. 1. Inflammatory Bowel Disease • General term used for: – Ulcerative colitis – Crohn’s disease – Both are characterized by extraintestinal and systemic features but are very distinctive
  2. 2. Famous People with UC
  3. 3. Ulcerative Colitis • Area of chronic inflammation of mucosa and • submucosa in the rectum and spread to the • cecum that results in poor absorption of nutrients • Periods of exacerbations and remission • Can range in severity from mild to severe
  4. 4. Causes??????? • Crypt abcessess
  5. 5. Ulcerative Colitis • Manifestations – Colon becomes edematous and develops bleeding lesions & ulcers – Scar tissue develops and causes elasticity and loss of absorption • Diarrhea – Severe – Bloody • Vitamin K deficiency
  6. 6. • Weight loss • Anorexia • Malaise • Dehydration and electrolyte imbalances • Anemia • Abdominal tenderness and cramping
  7. 7. Mild Disease
  8. 8. Moderate
  9. 9. Severe and fulminant
  10. 10. • May affect quality of life; patient may be fearful to leave house • Complications include: hemorrhage, abscess formation, malabsorption, bowel obstruction, bowel perforation, increased risk for colon cancer. • Diagnosed by colonoscopy; barium enema can show differences between UC and Crohn's
  11. 11. Ulcerative Colitis • Collaborative Management : – Medical management: • Rest is required to decrease intestinal activity • Diet therapy – Low-residue, high protein diet with vitamins and iron; in severe cases, nothing by mouth to rest the bowel; TPN will be ordered in severe cases – Avoid gas-forming foods, milk products, and foods with whole grains, nuts, alcohol, ETC
  12. 12. • Medications – • Aminosalicylates – deliver 5-ASA to the affected area– read these drugs! – Glucocorticoid – prednisone = given during an exacerbation to decrease the inflammation process of the bowel – – Immunomodulators – Antidiarrheals – Dangerous! Toxic Megacolon – New – Fecal bacterial transplantation therapy
  13. 13. Cont. Collaborative Care • Surgery – Total proctocoloctomy (removal of colon) with permanent ileostomy – is curative – Kock ileostomy – Ileoanal anastomosis with ileoanal resevoir – Review NUR 111 Elimination – for ostomy care! – Post op care • Encourage patient to talk about concerns related to disease process and its effect on lifestyle
  14. 14. Protocolectomy
  15. 15. Kock Surgery • Continent Ileostomy
  16. 16. Coping with flares • The above website will take you to a slide show on how to cope with UC flare ups.
  17. 17. Crohn’s disease • Chronic inflammation of GI mucosa occurring anywhere from mouth to anus but most common in terminal ileum • Characterized by exacerbations and remissions • Leads to thickening and scarring, a narrowed lumen, malabsorption • Lesions extend to all thickness of bowel wall and are prone to fistulas, ulcerations and abscesses • Lesions have a “cobblestone appearance” with sections of normal mucosa between lesions called “skip” lesions.
  18. 18. • Evidence is mounting that Crohn's disease is not an autoimmune disease, but an immune response to a bacteria - most likely candidate being "mycobacterium avium paratuberculosis
  19. 19. Crohn’s disease • Manifestations: vary patient to patient – common: – Diarrhea(5 to 6 liquid to semi formed stools/day) is most common symptom(usually without blood); steatorrhea (fatty stool) may occur – Abdominal pain n RLQ and distention – Low-grade fever • Others: – Weight loss – Malnutrition More that with UC – Fatigue, malaise – Dehydration – Complications
  20. 20. Crohn’s disease • Collaborative Management: – Diagnostic – see Ulcerative Colitis (UC) – Medical management: similar to UC • Diet: – Provide prescribed diet: usually high calorie, high protein; – Encourage intake of prescribed nutritional supplements – Daily weight, maintain calorie count, and monitor I and O – During severe exacerbations: NPO and TPN • Medications: – Same as UC with the following: » Budesonide (Entocort EC); metronidazole (Flagyl)
  21. 21. Crohn's disease Ulcerative colitis Defecation Often porridge-like[3], sometimes steatorrhea Often mucus-like and with blood[3] Tenesmus Less common[3] More common[3] Fever Common[3] Indicates severe disease[3] Fistulae Common[4] Seldom Weight loss Often More seldom Symptoms in Crohn's disease vs. ulcerative colitis [ v · d · e ]
  22. 22. Crohn’s disease • Surgical: – Avoided if possible; not curative, mostly just used to treat complications – Performed if not improved medically – Allow patient to express fears and anxiety about course of illness and possibility of surgical intervention
  23. 23. Nursing Diagnoses • Diarrhea related to inflammation of the bowel mucosa • Acute pain • Knowledge deficit • Imbalanced nutrition: Less than body requirements • Impaired skin integrity • Risk for FVD • PC: anemia • Differential Features of UC and Crohn’s Disease
  24. 24. Website for children and teens
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