Inflammatory Bowel Diseases Flashcards
Chronic inflammatory process affecting the mucosa and submucosa of the sigmoid colon and rectum
Ulcerative Colitis
Subacute or chronic inflammatory bowel disease affecting segmental areas along the entire wall of the GI tract
Most commonly noted within the terminal ileum
Crohn’s Disease (regional enteritis)
Drug Therapy: Inflammatory Bowel Disease
- Salicylate Compounds
- Oral or IV Corticosteroids
- Immunosuppressive Drugs
- Anti-Diarrheal Drugs
Diet Therapy: Inflammatory Bowel Disease
If client has severe symptoms
- NPO
- Total Parenteral Nutrition (TPN)
Diet Therapy: Inflammatory Bowel Disease
Avoid
Whole-wheat grains
Nuts
fresh fruits and vegetables
lactose containing foods
caffeinated beverages
Pepper
Alcohol
smoking
Indications for Surgery: Inflammatory Bowel Disease
Bowel perforation
Toxic megacolon
Hemorrhage
Colon cancer
Failure of conventional treatment
Surgical Interventions: Inflammatory Bowel Disease
- Total Proctocolectomy with Permanent Ileostomy
- Total Proctocolectomy with Continent Ileostomy
- Total Colectomy with Ileoanal Anastomosis
Drug Therapy
Management of ulcerative colitis
Inhibit prostaglandin synthesis to reduce inflammation
Adverse effects: leukopenia and anemia
Salicylate Compounds
Example: Sulfasalazine (azulfidine)
Drug Therapy
To reduce inflammation
Side effects: hyperglycemia, osteoporosis, PUD, increased risk for infection
Oral or IV Corticosteroids
Drug Therapy
Should be given in combination with steroids to be effective
To reduce inflammation
Adverse effects: thrombocytopenia, leukopenia, anemia, renal failure, hepatotoxicity, infection, headache, stomatitis
Immunosuppressive Drugs
Example: Cyclosporine, Mercaptopurine
Drug Therapy
Given for refractory disease or for toxic megacolon
An immunoglobulin G that neutralizes activity of tumor necrosis factor
Infliximab (Remicade)
Surgical Management: Inflammatory Bowel Disease
Terminal ileum is pulled through the abdominal wall and forms a stoma or ostomy
Total Proctocolectomy with Permanent Ileostomy
Surgical Management: Inflammatory Bowel Disease
Alternative to traditional ileostomy with external pouch
Creation of an internal reservoir called a “Kock’s Ileostomy” or “Ileal Reservoir” to be drained periodically
Total Proctocolectomy with Continent Ileostomy (Kock Ileostomy)
Surgical Management: Inflammatory Bowel Disease
Removal of the colon and rectum with anastomosis of the ileum and the anal canal
Total Colectomy with Ileoanal Anastomosis (Ileorectostomy)
