This document describes a case of a patient with refractory left-sided ulcerative colitis. The patient presented with a history of loose stools mixed with blood and was diagnosed with ulcerative colitis 1.5 years ago. Colonoscopy and biopsy reports confirmed left-sided ulcerative colitis. The patient was treated with corticosteroids, mesalamine, and antibiotics, which resulted in decreased bleeding and normalization of stool consistency by day 6. The treatment plan aims to induce remission and maintain quality of life through medication, monitoring, and lifestyle modifications.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation. Severe constipation includes obstipation (failure to pass stools or gas) and fecal impaction, which can progress to bowel obstruction and become life-threatening.
Constipation is a symptom with many causes. These causes are of two types: obstructed defecation and colonic slow transit (or hypo mobility). About 50 percent of people evaluated for constipation at tertiary referral hospitals have obstructed defecation. This type of constipation has mechanical and functional causes. Causes of colonic slow transit constipation include diet, hormonal disorders such as hypothyroidism, side effects of medications, and rarely heavy metal toxicity. Because constipation is a symptom, not a disease, effective treatment of constipation may require first determining the cause. Treatments include changes in dietary habits, laxatives, enemas, biofeedback, and in particular situations surgery may be required.
Constipation is common; in the general population rates of constipation varies from 2–30 percent. In elderly people living in care homes the rate of constipation is 50–75 percent.[4] In the United States expenditures on medications for constipation are greater than US$250 million per year.
The definition of constipation includes the following:
infrequent bowel movements (typically three times or fewer per week)
difficulty during defecation (straining during more than 25% of bowel movements or a subjective sensation of hard stools; straining in this context is a strong effort to push out stool often by holding one's breath and by pushing the respective muscles in the abdominal area hard), or
the sensation of incomplete bowel evacuation.
The Rome III criteria are widely used to diagnose chronic constipation, and are helpful in separating cases of chronic functional constipation from less-serious instances.
Another definition states that less than three bowel movements per week and straining on more than 75% of occasions represents constipation in clinical surveys.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation. Severe constipation includes obstipation (failure to pass stools or gas) and fecal impaction, which can progress to bowel obstruction and become life-threatening.
Constipation is a symptom with many causes. These causes are of two types: obstructed defecation and colonic slow transit (or hypo mobility). About 50 percent of people evaluated for constipation at tertiary referral hospitals have obstructed defecation. This type of constipation has mechanical and functional causes. Causes of colonic slow transit constipation include diet, hormonal disorders such as hypothyroidism, side effects of medications, and rarely heavy metal toxicity. Because constipation is a symptom, not a disease, effective treatment of constipation may require first determining the cause. Treatments include changes in dietary habits, laxatives, enemas, biofeedback, and in particular situations surgery may be required.
Constipation is common; in the general population rates of constipation varies from 2–30 percent. In elderly people living in care homes the rate of constipation is 50–75 percent.[4] In the United States expenditures on medications for constipation are greater than US$250 million per year.
The definition of constipation includes the following:
infrequent bowel movements (typically three times or fewer per week)
difficulty during defecation (straining during more than 25% of bowel movements or a subjective sensation of hard stools; straining in this context is a strong effort to push out stool often by holding one's breath and by pushing the respective muscles in the abdominal area hard), or
the sensation of incomplete bowel evacuation.
The Rome III criteria are widely used to diagnose chronic constipation, and are helpful in separating cases of chronic functional constipation from less-serious instances.
Another definition states that less than three bowel movements per week and straining on more than 75% of occasions represents constipation in clinical surveys.
A case study on Pangastritis with pancreatitis martinshaji
this case study describes about Pangastritis with pancreatitis , which details about the treatment, management , diagnosis, patient counselling, pharmacist interventions & discussions are followed in this case .
please comment
thank u
martinsuja369@gmail.com
Intestinal obstruction is the mechanical impairment which is partial or complete blockage of the bowel that results in the failure of the passage of intestinal content through the intestine.
---------- Forwarded message ----------
From: UCD Graduate '09 None <ucdgrad09@gmail.com>
Date: 2009/2/12
Subject: Bambury tutorial Upper GI Surgery
To: ucdgrad09@gmail.com
She does not know that we have this so please don't print it and bring it to
the lecture
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2. Ulcerative colitis is a chronic inflammation of the large intestine
(colon). The colon is the part of the digestive system where water
is removed from undigested material, and the remaining waste
material is stored
3. Left-sided colitis: As the name
suggests, inflammation extends from
the rectum up through the sigmoid and
descending colon, which are located in
the upper left part of the abdomen.
Signs and symptoms include bloody
diarrhoea, abdominal cramping and pain
on the left side
4. REASON FOR ADMISSION
History of loose stools since 1 week{8 times daily}, associated
with blood mixed stools
Patient is also a k/c/o of ulcerative colitis since 1.5 years{drug
induced}
No history of fever , anorexia , weight loss, vomiting, etc..
NSAID induced
No pallor/icterus
5. PREVIOUS REPORTS..
10/01/2013 : histopathology report of colon was Active
ulcerative colitis
On 1/09/2013: colonoscopy report was: ulcerative colitis left
sided
On 17/10/2013: biopsy report was : acute ulcerative colitis
6. DAY 1..
Bp:110/70 mmhg
pulse: 78bpm
CVS
RS
NAD
CNS
Adv:HB,ESR,PCV,TC,DC,RBS,PBS,SE,TSH,LFT,ECG,AntiHCV,Elisa
Plan for colonoscopy tomorrow
8. LFT:( mg/dl)
AST: 15 (0-40)
stool microscopy:
No inflammatory cells and parasite
ALT: 12 (0-40)
ova or cyst are not seen.
ALP: 204 (40-376)
ECG: WNL
Albumin: 3.4 ( 3.5-5)
9. MEDICATIONS..
Inj hydrocortisone iv q6h 100 mg
PROCTOCLYSIS-ENEMA
1-0-1
Capsule VSL3
1-0-0
Tablet mesalamine po 1.2mg 2-0-0
Tablet pantoprazole po 40mg 1-0-0
Tablet eldicet{Pinaverium} po 50 mg 1-0-1
10. DAY 2..
Bp:110/70 mmhg
CVS
RS
NAD
CNS
pulse: 80bpm
Patient passed stools mixed with blood, patient advised for
PROCTOCLYSIS-ENEMA for colonoscopy
Colonoscopy report: IBD- proctosigmoiditis
11. Ulcerative proctitis. In this form of ulcerative colitis,
inflammation is confined to the area closest to the anus
(rectum), and for some people, rectal bleeding may be the
only sign of the disease
Proctosigmoiditis. This form involves the rectum and
the lower end of the colon, known as the sigmoid colon..
13. DAY 4.
Bp:120/80bpm
pulse: 80bpm
CVS
RS
NAD
CNS
Freequency of loose stools decreased, decreased amount of blood in the
stool
ADV:to stop Inj hydrocortisone
Started tablet Methylprednisolone 16 mg po 2-0-0
Tablet calcium carbonate
500 mg po 0-1-0
14. DAY 5..
Bp: 110/70mmhg
pulse: 78bpm
CVS
RS
NAD
CNS
P/A-soft, patient complaints of semi solid stools not associated
with blood{ 3-4} episodes
ADV:CST
15. DAY 6..
Bp: 120/80 mmhg
pulse: 80bpm
CVS
RS
NAD
CNS
Patient did not have any complaints of loose stools, no history of
blood in the stool
ADV: CST
18. FINAL DIAGNOSIS
Based on subjective and objective evidence
ulcerative colitis with refractory – left sided
colitis
19. GOALS OF TREATMENT
Terminate the acute attack and induce clinical remission.
Maintain remission during quiescent symptom-free periods.
Control symptoms during symptomatic periods.
Prevent or control complications.
Avoid surgery, if possible.
Use the most cost-effective drug treatment.
Maintain or improve quality of life.
21. WHEN SURGERY INDICATED????
1. Fails to respond to medical management acutely or
chronically,
2. Develops uncontrollable drug-related complications,
3. Experiences impaired quality of life from the disease or its
drug therapy,
4. Develops carcinoma of the rectum or colon.
22. SURGICAL METHODS..
Total proctocolectomy with ileostomy :Total proctocolectomy
with ileostomy is surgery to remove all of the colon (large
intestine) and rectum. Then a hole in abdomen, called a stoma,
is made. Waste will move from the small intestine, out the
stoma, and into a plastic ostomy bag.
23. ILEAL POUCH ANAL ANASTOMOSIS
The most common procedure for ulcerative colitis is pelvic
pouch or ileal pouch anal anastomosis (IPAA). colon and
rectum will be removed. A new rectum, called a J-pouch, will
be fashioned out of small intestine. This type of surgery
allows to have bowel movements .
24. CONTINENT ILEOSTOMY:
The least common surgery for UC is continent ileostomy. Also
called the Kock pouch, it's a very technical surgery.. During
the procedure colon and rectum are removed. Small
intestine is used to create a holding place (reservoir) for
waste that will be drained from a valve in abdomen
29. LIFE STYLE MODIFICATIONS:
A well-balanced, nutritious diet can help maintain health and a
normal body weight.
Pain medications that contain nonsteroidal antiinflammatory drugs
(NSAIDS), such as ibuprofen and naproxen ,are not usually
recommended
