Lecture on Gastrointestinal System and Inflammatory Bowel Disease

Introduction

• Importance of having a solid understanding of gastrointestinal system & inflammatory bowel diseases (IBD).
• Focus on preparing for practical nursing roles rather than exams.
• Engage with the material actively, reflecting on personal experiences and understanding.
• Specific discussion on Crohn's Disease and Ulcerative Colitis.

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Crohn's Disease

Overview

• Not fully understood; possible factors:
  • Genetic predisposition
  • Altered immune response (autoimmune)
  • Altered response to gut microorganisms
• Characterized by exacerbations and remissions.

Triggers

• Food sensitivities
• Stress
• Poor sleep quality
• Environmental toxins

Age of Onset

• Typically 15 to 40 years old.
• Also known as Regional Enteritis.

Pathophysiology

• Lesions can develop anywhere in the GI system, commonly in the distal ileum and ascending colon.
• Lesions are transmural (through the full thickness of the bowel wall).
• Leads to:
  • Abscesses
  • Ulcers
  • Fistulas
  • Scarring and fibrosis
  • Potential stenosis

Symptoms

• Varies based on location of lesions.
• Small bowel lesions:
  • Nutrient absorption issues
• Large bowel lesions:
  • Water and electrolyte absorption issues
• Abdominal pain in the right lower quadrant.
• Malnutrition, weight loss, anemia.

Nursing Assessment

• Head-to-toe assessment with focus on GI and cardiovascular systems.
• Nutritional status assessment.
• Psychosocial care and stress management.

Medical Management

• Diagnostic tests: X-rays, MRIs, CT scans, colonoscopy.
• Lab tests: CBC, BMP, ESR, C-reactive protein, albumin.
• Medications:
  • Corticosteroids
  • Amino salicylates
  • Immunomodulators
  • Monoclonal antibodies
  • Antibiotics
• Nutritional support and hydration.
• Potential surgical interventions: Ileostomy.

Complications

• Anorexia, weight loss, malnutrition.
• Osteoporosis, strictures, obstructions.
• Increased risk for colon cancer, bowel perforation, hemorrhage.

Nursing Considerations

• Monitor anemia and signs of shock.
• Provide oral care, monitor IV fluids and intake/output.
• Manage NG tube if needed.
• Administer medications and monitor effects.
• Educate and empower patient.
• Address psychosocial concerns.

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Ulcerative Colitis

Overview

• Chronic disease affecting mucosal and submucosal layers of colon and rectum.
• Periods of remission and exacerbation.

Triggers & Causes

• Similar to Crohn's: Genetic predisposition, altered immune response.

Age of Onset

• Typically 15 to 40 years old.

Pathophysiology

• Lesions start at rectum and progress proximally.
• Inflammation affects only the inner lining.
• Causes significant bleeding, narrowing, thickening of the bowel.

Symptoms

• Severe, bloody diarrhea; frequent episodes.
• Lower left quadrant pain.
• Electrolyte imbalances, dehydration.
• Anemia due to blood loss.

Nursing Assessment

• Similar head-to-toe assessment as in Crohn’s.
• Focus on cardiovascular system due to anemia.

Medical Management

• Similar diagnostic tests and labs as in Crohn’s.
• Parenteral feedings and hydration.
• Blood transfusions for severe anemia.
• Potential for colectomy to cure.
• Medications: Corticosteroids, Amino salicylates, Immunomodulators.

Complications

• Anorexia, weight loss, malnutrition.
• Life-threatening complication: Toxic megacolon.

Nursing Considerations

• Monitor anemia and shock indicators.
• IV fluids and NG tube management.
• Administer and monitor medications.
• Educate and support the patient.
• Listening to patient concerns empathetically.

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Conclusion

• Reflect on similarities and differences between Crohn's and Ulcerative Colitis.
• Consider personal impact if affected by these diseases.
• Further study and review recommended for comprehensive understanding.