Inflammatory Bowel Disease Flashcards Preview

MS Module 2 > Inflammatory Bowel Disease > Flashcards

Flashcards in Inflammatory Bowel Disease Deck (31)
Loading flashcards...
1

Inflammatory Bowel Disease

Characterized by chronic, recurrent inflammation of the GI tract
Autoimmune disease

2

Ulcerative Colitis

Inflammation and ulceration of the colon and rectum
Works its way from rectum up to the cecum
First layer of large intestine
Sloughing off of layer

3

Crohn's Disease

Inflammation of any segment of the GI tract from mouth to anus

4

Clinical Manifestations of IBD

Diarrhea
Bloody stools
Weight loss
Abdominal pain
Fever
Fatigue

5

IBD Local Complications

Hemorrhage
Strictures
Perforation (with possible peritonitis)
Fistulas
Colonic dilation (toxic megacolon)
High risk for colorectal cancer
C. Diff infection
Liver failure

6

Peritonitis

Inflammation of peritoneum
Rigid, hard washboard abdomen with pain and fever
Can be life threatening

7

Toxic Megacolon

Dilated colon accompanied by bloating and sometimes fever, abdominal pain, or shock
More common with ulcerative colitis

8

Crohn's Disease Clinical Manifestations

Diarrhea
Crampy abdominal pain
Less Common
-Weight loss when small intestine involved
-Rectal bleeding
-Fever or other systemic symptoms

9

Crohn's Disease Pattern of inflammation/Complications

Inflammation involves all layers of bowel wall
Can occur anywhere in GI tract
Skip Lesions
Strictures
Abscesses (peritonitis, fistulas)
Nutritional problems
Small intestinal cancer

10

Skip Lesions

Cobblestone appearance, normal bowel appears present between diseased portions

11

Ulcerative Colitis Pattern of Inflammation

Diarrhea with large fluid & electrolyte loss
Breakdown of cells
Areas of inflamed mucosa

12

Ulcerative Colitis Clinical Manifestations

Bloody Diarrhea
Abdominal Pain
In Severe Forms:
-Fever
-Rapid weight loss of more than 10% of total body weight
-Anemia
-Tachycardia
-Dehydration

13

Diagnostic Studies

H&P examination
Blood Studies
Stool Cultures
Imaging Studies
Endoscopy

14

Blood Studies Include

CBC, WBC, Serum electrolyte levels, Serum protein levels, ESR, C-Reactive Protein

15

Sulfasalazine

Decreases GI inflammation and is effective in achieving and maintaining remission for mild to moderately severe attacks. Contains sulfapyridine so it reaches the colon for absorption.

16

Aminosalicyaltes

For mild to moderate Crohn's disease, especially when the colon is involved, but are more effective for ulcerative colitis. Help achieve and maintain remission.
*may cause yellowish discoloration of skin, avoid sunlight until photosensitivity is determined.

17

Antimicrobials

Used to treat IBD. Drugs like metronidazole and ciprofloxacin.

18

Corticosteroids

Decrease inflammation and used to achieve remission.
Helpful for acute flare ups.
Given for shortest possible time because of s/e associated with long-term use.

19

Immunosuppressants

Suppresses immune response and maintain remission after corticosteroid induction therapy.

20

Other drug therapies

Biologic Therapy

21

Goals of Drug Treatment

Induce and maintain remission.
Reduce quantity and quality of severity of flare ups.

22

Nutritional Therapy

Dietary Consultant
Overall, IBD patients need to eat a balanced, healthy diet w/ sufficient calories, protein, nutrients.

23

Goals of Diet Management

Provide adequate nutrition w/o exacerbating symptoms
Correct and prevent malnutrition
Replace fluid and electrolyte losses
Prevent weight loss

24

Nutritional deficiencies are due to

Decreased oral intake
Blood loss
Malabsorption of nutrients (depends on location of inflammation)

25

Medications that can contribute to nutritional problems

Sulfasalazine: daily folic acid supplements indicated
Corticosteroids: Ca supplements to prevent osteoporosis, potassium supplements
Vit D Deficiency is common

26

During acute exacerbations...

Regular diet may not be tolerated
Liquid enteral feedings preferred (high in calories/nutrients, lactose free, easily absorbed)
Regular foods are reintroduced gradually

27

Surgical Therapy

Exacerbations are debilitating and frequent (massive bleeding, perforation, strictures, obstruction, dysplasia, carcinoma)
*Surgery is indicated if treatment fails

28

Postoperative Care

Ileostomy: monitoring of stoma viability, mucocutaneous juncture, peristomal skin integrity

29

Gerontologic Considerations

Second peak of disease onset occurs in 60s
Distal colon is usually invovlved in ulcerative colitis
Diagnosis can be difficult

30

Sed Rate

ESR (erythrocyte sedimentation rate)
test that indirectly measures how much inflammation is in the body; how long it takes to separate