Medical Surgical Nursing

1. CROHN’S DISEASE
Sanita Libin

2. Definition
 Regional enteritis / granulomatous
enteritis/Inflammatory bowel disease
 Can affect any part of the GI tract
 Chronic inflammatory bowel disease that
affect the lining of the GI tract.
Commonly affecting ilieum

4. Causes & Risk factors
 Idiopathic
 Linked probably with immune system
 Risk factors … Family history
 Jewish ancestry
 Smoking
 NSAIDS

6. Types
Colonic disease
common symptoms are
* Diarrhea
* General malaise
* Anorexia & Weight loss
* Persistent abdominal discomfort
* Pain in lower abdominal quadrant & left side
* Symptoms can mimic diverticulitis

7. Perianal disease
 Present more than 2/3rd of pt with
crohn,s disease
 Painless & asymptomatic
 It become painful when there is abscess

8. Small bowel disease
 Present with abdominal pain(Right lower
quadrant)
 Diarrhea
 Anorexia & wt loss
 Peripheral edema with low serum albumin
 Fever

9. Gastro duodenal crohns disease
 Affecting gastro duodenal region
 Occurs in 5% of people
 Symptoms resembles peptic ulcer

10. Sign & Symptoms
Main symptoms
 Crampy abdominal pain
 Fever
 Fatigue &general
malaise
 Anorexia & Weight loss
 Pain in passing stool
 Persistent watery
diarrhea
Other symptoms
 Constipation
 Eye inflammation
 Fistula, anal fissure
 Arthritis
 Liver inflammation
 Moth ulcer
 Rectal bleeding
 Skin lump or sore

11. Diagnostic evaluation
 HC & PE
 Blood test (anemia)
 Barium meal
 X- ray
 Sigmoidoscopy
 Colonoscopy

12. Management
Depend up on the severity and extend of
disease
 Medical management
Anti inflammation drug
Sulfasalazine
Mesalamine
Cortisone & steroid
Prednisone

13. Immune system suppressor
Block immune reaction that contribute to
inflammation
Azathioprine
Infliximab (Remicade) to control thhe immune
response
Antibiotic
Ampicillin
sulfonamide
cephalosporin
Anti diarrhoel
loparamide
codeine

14. Diet & nutrition management
 Balanced diet with sufficient calorie
 Total pare nteral nutrition
Surgical management
Colectomy with Ileostomy

15. Thank you