Inflammatory Intestinal Disorders Flashcards
Appendicitis
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
Gatroenteritis
Diarrhea and vomiting due to inflammation of stomach and small intestine.
May be bacterial, viral, or parasitic.
Novovirus
Do not want to give diarrheals.
Think about skin care.
Chronic inflammatory bowel disease(ulcerative colitis& cronh’s)
Common characteristics
Occurs in younger people(15-40).
Remissions and flare ups
Etiology unknown
Ulcerative colitis
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
Cronh’s
Most often effects ileum.
Deep inflammation.
5-6 soft,loose,nonbloody stools daily.
More prone to developing abscesses and fistulas.
Symptoms of cronh’s
Malabsorption&anemia.
Steatorrhea
Fistulas and adhesions are common
Osteoporosis(not absorbing calcium very well)
Common signs and symptoms of cronh’s and ulcerative colitis
Diarrhea and incontinence
Pain
Potential for bleeding and anemia
Aminosicylates(asacol)
For UC and CD
Glucocorticoids(prednisone)
(UC)
Helps decrease inflammation of UC
Monoclonal antibodies(Humira)
(UC,CD)
Decrease inflammation.
Given via injection
Azathioprine(imuran)
(CD)
Decreases inflammation well in cronh’s disease
Antidiarrheals for IBD
Use with caution to prevent toxic mega colon.
Mega colon: massive dilation of the colon that can lead to gangrene and peritonitis.
RX for IBD
Goal is remission.
Rest the bowels with NPO status.
Nutrition via TPN or elemental fluids.(fluids made for easy absorption)
Probiotics with IBD
Restores good bacteria
Often out on bed rest
Monitor I&O
CD and UC at high risk for..
Fistulas Electrolyte imbalances(especially hypokalemia) Dehydration&malnutrition Skin integrity problems Peritonitis
Possible surgery for CD
Common to have several surgeries over a lifetime.
Resection and anastomosis of small bowel.
Resection of fistula
Possibly surgery for UC
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.
Ileostomy care
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.
Diverticulosis and diverticulitis
Once you have diverticulosis you are at risk for diverticulitis
Foods to avoid with IBD
Carbonated beverages Pepper Nuts Corn Dried fruits Smoking
Diverticulosis
Presence of many abnormal pouch like Herniations in the wall of the intestines
Diverticulitis
Inflammation of the diverticula
Complications of diverticulitis
Peritonitis
Abscess formation
Bleeding(may cause anemia)
Pain on LLQ
Management of acute stage diverticulitis
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
Management of diverticulitis chronic stage
Increase fiber gradually to 25-35g
Provide adequate fluids to prevent obstruction from fiber.
Avoid ingestable foods
Celiac disease
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
Celiac disease S/S
Diarrhea/bloating
ADHD in kids is linked with celiac disease.
GI symptoms
Fatigue& migraines in adults
Avoid trigger foods:Gluten
Appendicitis location
Acute inflammatory disorder.
Happens at mcburney’s point(RLQ near umbilicus)
No enemas, laxatives, or hear therapy
