Inflammatory Intestinal Disorders

Question 1

Appendicitis

Answer 1

Often occurs most in young adults especially young men.

S/S: pain in the RLQ.
Rebound tenderness is common(feels better when you put pressure on it)

TX: minimally invasive surgery

Question 2

Gatroenteritis

Answer 2

Diarrhea and vomiting due to inflammation of stomach and small intestine.

May be bacterial, viral, or parasitic.

Question 3

Novovirus

Answer 3

Do not want to give diarrheals.

Think about skin care.

Question 4

Chronic inflammatory bowel disease(ulcerative colitis& cronh’s)

Common characteristics

Answer 4

Occurs in younger people(15-40).

Remissions and flare ups
Etiology unknown

Question 5

Ulcerative colitis

Answer 5

Most often in the rectum and descending colon.

Ages 15-25 common.
Shallow ulcerations
May have>10 bloody stools with mucous per day.

Linked to increased incidence to colorectal cancer

Question 6

Cronh’s

Answer 6

Most often effects ileum.
Deep inflammation.
5-6 soft,loose,nonbloody stools daily.

More prone to developing abscesses and fistulas.

Question 7

Symptoms of cronh’s

Answer 7

Malabsorption&anemia.
Steatorrhea

Fistulas and adhesions are common

Osteoporosis(not absorbing calcium very well)

Question 8

Common signs and symptoms of cronh’s and ulcerative colitis

Answer 8

Diarrhea and incontinence
Pain

Potential for bleeding and anemia

Question 9

Aminosicylates(asacol)

Answer 9

For UC and CD

Question 10

Glucocorticoids(prednisone)

Answer 10

(UC)

Helps decrease inflammation of UC

Question 11

Monoclonal antibodies(Humira)

Answer 11

(UC,CD)

Decrease inflammation.

Given via injection

Question 12

Azathioprine(imuran)

Answer 12

(CD)

Decreases inflammation well in cronh’s disease

Question 13

Antidiarrheals for IBD

Answer 13

Use with caution to prevent toxic mega colon.

Mega colon: massive dilation of the colon that can lead to gangrene and peritonitis.

Question 14

RX for IBD

Answer 14

Goal is remission.

Rest the bowels with NPO status.
Nutrition via TPN or elemental fluids.(fluids made for easy absorption)

Question 15

Probiotics with IBD

Answer 15

Restores good bacteria
Often out on bed rest
Monitor I&O

Question 16

CD and UC at high risk for..

Answer 16

Fistulas
Electrolyte imbalances(especially hypokalemia)
 Dehydration&malnutrition 
Skin integrity problems 
Peritonitis

Question 17

Possible surgery for CD

Answer 17

Common to have several surgeries over a lifetime.

Resection and anastomosis of small bowel.

Resection of fistula

Question 18

Possibly surgery for UC

Answer 18

Protocolectomy with permanent ileostomy.

Protocolectomy with ileo-anal pouch

• 2-3 stage surgical process
• take colon out take down small intestine and hook to rectum.

Question 19

Ileostomy care

Answer 19

Can become easily blocked.
Avoid capsule and enteric coated medication.
Should have loose stool every 6-12 hours.

Drink enough water and take on Na.
Protect skin from drainage.
Must wear pouch at all times.

Question 20

Diverticulosis and diverticulitis

Answer 20

Once you have diverticulosis you are at risk for diverticulitis

Question 21

Foods to avoid with IBD

Answer 21

Carbonated beverages 
Pepper 
Nuts
Corn 
Dried fruits
Smoking

Question 22

Diverticulosis

Answer 22

Presence of many abnormal pouch like Herniations in the wall of the intestines

Question 23

Diverticulitis

Answer 23

Inflammation of the diverticula

Question 24

Complications of diverticulitis

Answer 24

Peritonitis
Abscess formation
Bleeding(may cause anemia)
Pain on LLQ

Question 25

Management of acute stage diverticulitis

Answer 25

Antibiotics
Pain relief
Low fiber diet(don’t want too formed stools)
Correct dehydration with IV therapy.
No laxatives or enemas(may cause rupture)
Sometimes surgery(may cut that part of the colon out)

After surgery may have a temporary colostomy

Question 26

Management of diverticulitis chronic stage

Answer 26

Increase fiber gradually to 25-35g

Provide adequate fluids to prevent obstruction from fiber.

Avoid ingestable foods

Question 27

Celiac disease

Answer 27

Form of inflammatory disease(can diagnose with blood test)

Hypersensitivity response to gluten(wheat,barley,rye)

Gluten sensitivity is not the same as Celiac disease

Question 28

Celiac disease S/S

Answer 28

Diarrhea/bloating
ADHD in kids is linked with celiac disease.

GI symptoms
Fatigue& migraines in adults

Avoid trigger foods:Gluten

Question 29

Appendicitis location

Answer 29

Acute inflammatory disorder.
Happens at mcburney’s point(RLQ near umbilicus)

No enemas, laxatives, or hear therapy