Inflammatory Bowel Disease

Question 1

Causes of altered bowel habit

Answer 1

IBD:
- Crohns
- Ulcerative colitis
Coeliacs
IBS
Gastritis
Bowel obstruction
Tropical sprue

Question 2

Questions to ask when consulting with a patient

Answer 2

How long have you have had these altered bowel movements?
What consistency is your stool, does it change is consistency?
Is there blood present in your stool?
How often a day do you go to the toilet?
Is the pain relieved after defecation?
Is the pain worse on eating?
Do you have any pain in your stomach?

Question 3

Investigations

Answer 3

Bloods:
- FBC = (anaemia = low, iron, folate, b12)
- P-ANCA
- CRP/ESR
- Leukocytes
- Anti-TTG/Anti-EMA
- WBC, MC+S, Cultures
Stool:
- Faecal calprotectin
Endoscopy and biopsy

Question 4

What is a stoma?

Answer 4

• An opening on the abdomen that can be connected to either your digestive or urinary system to allow waste to be diverted out your body

Question 5

What is a colostomy?

Answer 5

• A colostomy is when a part of your large bowel or colon is pulled through from an incision made on your abdomen to form a stoma. There are two types of colostomy that can be formed.

Question 6

How to care a stoma bag

Answer 6

Use right side pouch and skin barrier opening
Change the pouching system regularly
Clean skin around stoma with water
Watch for sensitivities or allergies - tape, paste, adhesive