ulcerative colitis Flashcards
ulcerative colitis: dx and lab testing (9)
*CBC
*electrolyte panel
*fecal occult
*colonoscopy
*double contrast barium enema
*CT
*MRI
*transabdominal ultrasound
*small bowl series
inflammatory patterns
*differs from crohn’s disease that can occur anywhere in the GI tract, UC starts usually in the rectum and moves in a continual fashion to the cecum (limited to bowel)
*occurs in the mucosal layer (innermost layer of bowel wall)
*water and electrolytes are not absorbed through inflamed mucosa, resulting in diarrhea w/ large fluid and electrolyte loss through stool
*breakdown of cells results in protein loss through the stool
*formation of pseudopolyps -> tongue-like projections in the bowel lumen
daily stool count
*mild disease: diarrhea of no more than 4 semi-formed stools daily w/ small amounts of blood
*Moderate disease: increased stool output of up to 10 stools daily w/ increased bleeding (and s/s of bleeding: malaise, mild anemia, anorexia)
*Severe disease: diarrhea is bloody containing mucus and occurs 10-20 times daily
long term management
*emotional support: assist pt in accepting the chronicity of IBD and learning ways to cope with its recurrent, unpredictable nature
*teach about importance of rest and diet management, perianal care, drug actions and SEs, s/s of recurrence of disease, when to seek medical care, ways to reduce stress
*find ways that pt can realistically engage in self-care
*assist in setting short term and long term goals
*psychotherapy and behavioral therapies: help deal with depression, anxiety, and frustration
long term complications
*cancer: increased incidence of colorectal cancer after 10 yrs of disease
*C diff.: increased incidence and severity
*toxic megacolon: common
*perforation: common d/t toxic megacolon
*strictures can occur occasionally
*perianal abscess and fistulas are rare but do occur
clinical manifestations
bloody diarrhea and abd pain
