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Ulcerative Colitis
Mr. Keshchandra Singh
Asst. Professor
S.O.N
Definition
It is an inflammation of colon. Which is usually starts from rectum and
spreads to colon and slowly it involves intestinal membranes and all the
layers of intestine (large) and cause ulcers.
Causes
• Stress
• Bacterial and viral infection
• Allergic
• Auto immune reaction
Pathophysiology
Inflammation of rectal mucosa
Ulcer formation
Collection of fibrous tissue
around the ulcer
Due to scar, disturb absorption
ability of mucosa
Clinical Manifestations
• Melaena (Diarrhoea with blood) >20 timesday
• Weight loss
• Low grade fever
• Colicky pain
• Anorexia
• Rectal bleeding
• Tenesumus (cramping pain in stomach)
• Painful straining
• Tachycardia
• Vitamin K deficiency
Diagnostic Evaluation
• Stool examination
• Abdominal X-ray
• Computed tomography
• Magnetic Resonance Imaging (MRI)
• Sigmoidoscopy or clonscopy
• Blood studies (Less Hb,RBC,WBC,ESR.)
Complications
• Haemorrhage
• Absess formation
• Anal fistula
• Colon malignancy
• Malnutrition
• Anaemia
• Rectal fistula
• Ractal prolapse
Medical Management
• Antidiarrheal, e.g., Metronidazole, Tindazole
• Antiemetic, e.g., Domeperidone
• Antibacterials, e.g., Ciprofloxacin, Sulfasalazine
• Corticosteroids (for reduce inflammation), e.g., Prednisone
• Immunomodular agents, e.g., Azathioprine, Cyclophosphamide.
Surgical Management
• Proctosigmoidectomy
• Restorative proctocolectomy with ileal pouch and anastomosis
• Ileostomy
Nursing Management
Assessment
• Take medical history of patient.
• Assess food related habits.
• Assess severity, type, location of abdominal pain.
• Assess the problem of the patient (e.g., Anorexia, Nausea, Vomiting).
Nursing Diagnosis
• Pain related to disease.
• Altered nutrition related to pain, nausea, vomiting.
• Knowledge deficit related to disease condition.
• Anxiety related to disease.
Nursing Care During Surgery
1. Preoperative care
• To give knowledge about post-operative complication to the patient,
e.g., surrounding skin irritation and obstruction, stenosis of
surrounding muscles.
• Tell to patient about location of ileostomy.
• To give knowledge about some procedures like ileostomy irrigation
and care of abdomen.
2.Post-operative care
• Provide proper nutritional diet to patient.
• Provide knowledge about ileostomy care.
• Provide knee-chest position.
• Tell abut ileostomy irrigation to patients.

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Ulcerative Colitis.pptx

  • 1. Ulcerative Colitis Mr. Keshchandra Singh Asst. Professor S.O.N
  • 2. Definition It is an inflammation of colon. Which is usually starts from rectum and spreads to colon and slowly it involves intestinal membranes and all the layers of intestine (large) and cause ulcers.
  • 3. Causes • Stress • Bacterial and viral infection • Allergic • Auto immune reaction
  • 4. Pathophysiology Inflammation of rectal mucosa Ulcer formation Collection of fibrous tissue around the ulcer Due to scar, disturb absorption ability of mucosa
  • 5. Clinical Manifestations • Melaena (Diarrhoea with blood) >20 timesday • Weight loss • Low grade fever • Colicky pain • Anorexia • Rectal bleeding • Tenesumus (cramping pain in stomach) • Painful straining • Tachycardia • Vitamin K deficiency
  • 6. Diagnostic Evaluation • Stool examination • Abdominal X-ray • Computed tomography • Magnetic Resonance Imaging (MRI) • Sigmoidoscopy or clonscopy • Blood studies (Less Hb,RBC,WBC,ESR.)
  • 7. Complications • Haemorrhage • Absess formation • Anal fistula • Colon malignancy • Malnutrition • Anaemia • Rectal fistula • Ractal prolapse
  • 8. Medical Management • Antidiarrheal, e.g., Metronidazole, Tindazole • Antiemetic, e.g., Domeperidone • Antibacterials, e.g., Ciprofloxacin, Sulfasalazine • Corticosteroids (for reduce inflammation), e.g., Prednisone • Immunomodular agents, e.g., Azathioprine, Cyclophosphamide.
  • 9. Surgical Management • Proctosigmoidectomy • Restorative proctocolectomy with ileal pouch and anastomosis • Ileostomy
  • 10. Nursing Management Assessment • Take medical history of patient. • Assess food related habits. • Assess severity, type, location of abdominal pain. • Assess the problem of the patient (e.g., Anorexia, Nausea, Vomiting).
  • 11. Nursing Diagnosis • Pain related to disease. • Altered nutrition related to pain, nausea, vomiting. • Knowledge deficit related to disease condition. • Anxiety related to disease.
  • 12. Nursing Care During Surgery 1. Preoperative care • To give knowledge about post-operative complication to the patient, e.g., surrounding skin irritation and obstruction, stenosis of surrounding muscles. • Tell to patient about location of ileostomy. • To give knowledge about some procedures like ileostomy irrigation and care of abdomen.
  • 13. 2.Post-operative care • Provide proper nutritional diet to patient. • Provide knowledge about ileostomy care. • Provide knee-chest position. • Tell abut ileostomy irrigation to patients.