Flashcards in Exam 2 chapter 24 Deck (25)
condition characterized by intermittent and recurrent abdominal pain and stool pattern irregularities?
Irritable Bowel Syndrome (IBS)
symptoms of IBS
The Rome III criteria
abd pain and discomfort lasting 3 months
starting at least 6 months ago
The pain has
relieved by defecation
onset assoc with change in fx of stool
onset assoc with change in stool appearance
Problems not associated with IBS
Nutritional therapy for patient with IBS
eliminate gas producing foods
what should patient with IBS add to their diet
what medication may be given to a patient with IBS to control diarrhea and fecal urgency
why may anticholinergic be prescribe for a patient with IBS
Pantheline (Pro Banthine)
to decrease smooth muscle spasm decreasing cramping and constipation
what medication may be prescribed to treat women with IBS whose chief complaint is chronic constipation
it increases the effects of serotonin in the intestines, thereby increasing motility.
Teach pts to report severe diarrhea accompanied by dizziness or orthostatic hypotension.
Patient teaching for IBS
avoid alcohol and cigarettes
eat at regular times
chew food slowly and thoroughly
fluids should not be taken with meals = abd distention.
inflammatory Bowel Disease
characterized by recurrent inflammation of the intestinal tract.
periods of remission interspersed with periods of exacerbation
cause is unknown
Tx relies on medications to treat inflammation and maintain remission.
Types of inflammatory bowel diease
beginning in the rectum and spreading up the colon in a continuous pattern.
inflammation and ulcerations occur in mucosa and submucosa.
multiple abscesses develop, break through into submucosa, leaving ulceration.
bleeding and perforation
clinical manifestations of ulcerative colitis
diarrhea (blood common)
dehydration and electrolyte imbalances
Vitamin K deficiency
what are some complications for ulcerative colitis
highly vascular granulation tissue
symptoms of toxic megacolon in patient with ulcerative colitis
abd pain and distention
what type of surgery will be indicated for a patient with toxic megacolon who does not respond within 24 to 72 hours to medical management?
why do patient with IBD have significantly increase risk for osteoporotic fractures
decreased bone mineral density
what are some labs to monitor for in patient with ulcerative colitis
H and H
adverse sequelae to the use of corticosteroids are
hirsutism (abnormal hair growth)
steroid induced diabetes mellitus
poor wound healing
loss of bone density
what is a common procedure performed for strictures of the small intestines?
Laparoscope guided strictureplasty
the blocked or narrowed sections of the intestines are widened, leaving the intestines intact.
surgical removal of colon
complete excision of colon, rectum and anus
proctocolectomy with ileostomy
recommended when the rectum is severely diseased
what is the procedure of choice when a rectum can be preserved for a patient with ulcerative colitis
restorative proctocolectomy with ileal pouch