Week 5 - inflammatory bowel disease Flashcards
What part does ulcerative colitis affect?
rectum and colon
What part does crohn’s affect?
mouth to anus
What diagnostic tests are used for IBS?
- Hx &Physical
- Endoscopy
-Capsule endoscopy - Barium Studies - xray
- FOBT- measures amount of blood in stool
- Blood work:
-CBC
-ESR, C-reactive protein- inflammation
-Electrolytes
What are the main differences btwn Crohn’s & ulcerative colitis?
- blood
- crohn’s - non-bloody
-ulcerative - bloody diarrhea - Location
- crohn’s - mouth to anus (often illium)
- ulcerative - starts distally in rectum and moves up intestine - Curative or not
- crohn’s - flare ups post surgery- not curative- needs multiple surgeries
- ulcerative- curative post surgery
In ulcerative colitis, complications are related more to inflammation and dialatation. What are these complications and why?
- Hemorrhage d/t perforation - mucosal lining issues
- colonic dilatatian - colon too dilated
- Toxic megacolon - big dilation and paralysis leads to perforation
- Colerectal cancer higher risk if UC for >10 years
in Crohn’s disease complications usually occur d/t deep longitudinal ulcers. Crohn’s = cobblestone appearance. What are the complications and why?
- Strictures/obstructions - d/t deep ulcers
- intra-abdominal abscess d/t perforation
- Malabsorption
- *Fistulas btwn bowel & bladder =feces in urine + UTI
What is a cardinal feature in Crohn’s?
Fistulas btwn bowel & bladder = feces in urine
What are theExtra-intestinal Complications of Ulcerative Colitis and Crohn’s ? ie) not in the bowel
- DVT - thrombolytic events
- Eye issues
- Joint issues- arthritis
- Spine issues
- Skin issues
In the acute phase of UC and Crohn’s why do we monitor amount, type, colour, severity of diarrhea?
b/c it helps us know how /what kind of fluids to replace
What are 3 interventions we can do for someone’s nutrition and fluid & electrolyte balance?
-IV (D5W1/2NS with K+) – short term
-Total Parenteral Nutrition (TPN) – short term
-Enteral nutrition (elemental)
What is the main non-medical intervention we can do for people with acute flare up of IBS?
bowel rest- NPO
What are the 4 things we do when someone has acute flare up of IBS?
- monitor/adjust nutrtion & fluid and electrolytes
- Daily weights
- Perianal care - meticulous
- help relieve symptoms, anxiety & stress
What are the 6 things we monitor for in people with Acute flare up of IBS?
-Dehydration
-Fatigue
-Skin breakdown
-Ineffective coping strategies
-Intra/ extraintestinal complications
-Blood in stool
What is the MAIN drug used for UC?
***5-ASA - Sulphasalazine – long term (works best in large intestine to decrease inflammation)
What drugs/vitamins are used to help during maitenence phase of IBS?
-5-ASA - Sulphasalazine – long term
-Corticosteroid Drugs -prednisone
-Immunosuppressant’s –cyclosporine (Neoral)
-Immunomodulators- infliximab (Remicade)
-Vitamins- oral iron (ferrous gluconate), IV iron (iron dextran)
- Antidiarrheal- diphenoxylate (Lomotil)
