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InflammatoryBowel
n/a
Question | Answer |
---|---|
Inflammatory Bowel Disease | Immuniologically-related disorders that include: Chrohn's Disease & Ulcerative colitis. |
IBD: I | Characterized by chronic, recurrent inflammation of the intestinal tract. |
S & SX | Long periods of remission with episodes of acute inflammation. |
Possible Causes: | Infectious diseases; autoimmune reaction; food allergies & Heredity. |
Ulcerative Colitis | Inflammation and ulceration of the colon and rectum. |
Other | Peaks between 15-25. Both sexs. |
Diffuse Inflammation | Inflammation directed towards the mucosa and submucosa. The inflammation alternates periods of remission & exacerbations. |
Patho: | UC usually begins in the rectum and sigmoid colon and spreads up the colon in a continuous pattern. Multiple abscesses develop in the intestinal glands. Abscesses break via into the submucosa and leave an ulcer. |
Patho II | The ulcer destroys the submucosa resulting bleeding and diarrhea. Fluid & electrolyte losses, protein loss and polyps. |
Patho II | Granular tissue develops & the mucosa musculature becomes thickened and shortens the colon. |
Major symptoms: | Bloody diarrhea and abdominal pain. Weight loss. |
Complications: Intestinal | Hemorrhage, perforation, strictures, colon dilation, cancer and toxic megacolon. |
Complications: Extraintestinal | R/t to Colitis or R/t to immune system. |
DX: | Colonoscopy, sigmoidoscopy, barium enema, CBC, electrolytes, BUN, Creatinine, albumin & culture stools. |
Care: Drug of choice | Sulfasalazine & 5-ASA: to treat episodes and maintain remission. |
Other Drugs: | Corticosteriods: inflammation. Immunosuppressive drugs: suppress the immune system. Anti-microbial drugs: treat secondary infection. |
Surgery: Indications | Failure to respond to treatment, frequent episodes, massive bleeding and developed dysplasia or carcinoma. |
Total colectomy and ileoanal reservoir | Removes the small intestine and rectum. Small intestine are folded and stapled together. The internal walls are removed thus forming a reservoir. This reserovir is stapled where the rectum was. |
Post-Op care: | Observe signs for hemorrhage, ab abscess, small bowel obstruction, dehydration & other complications. |
Nutrition therapy: | Low-residue diet provides low in fibre which will result in reduced amount of fecal material in the lower GI tract. High calorie and protein diet. Vitamin and Iron supplements. |