Introduction, anatomy of GI tract, definition, cause & risk factors, pathophysiology, types, clinical manifestations, diagnostic tests, medical management, surgical management and nursing management, complications of Regional Enteritis/Crohn's Disease.
2. It can affect any area of the GI tract, from the
mouth to the anus, but it most commonly
affects the lower part of the small intestine.
4. Crohn’s disease is granulomatous
inflammation of terminal ileum and adjoining
colon, resulting in ulceration, stricturing,
fistula & abscess formation.
5. Exact cause is unknown.
Familial
Genetic disorders
Environmental factors(Intestinal helminth
infection)
Immunological disorders(due to
production of inflammatory cytokines,
interleukins, chemokines & TNF- α)
Smoking –strong association
Non-steroidal anti-inflammatory
drugs(NSAIDs)
8. The symptoms may vary depending on the
severity & location of the disease.
Crampy abdominal pain
Fatigue
Pain with passing stool(Tenesmus)
Persistent watery diarrhea
Fever
Loss of appetite
Unintentional weight loss
General malaise
11. Thorough physical examination
Blood tests to check for anemia, WBC count
Stool test
Barium x-ray
Sigmoidoscopy/Colonoscopy
Biopsy from the lesion
12. Depends on the severity & extent of the
disease.
A. PHARMACOLOGIC INTERVENTIONS-
1. Anti-inflammatory drugs-
• Mesalamine
• Sulfasalazine
• 5-ASA agents, such as Asacol, Dipentum, or
Pentase
2. Cortisone or steroids
14. High protein, high calorie diet is given by oral or
parenteral route.
Plasma & blood transfusions are given for anemia &
hypoproteinaemia.
Low fat diet or milk free diet improves lactose
deficiency or malabsorption.
Low residue or high fibre diet is also supplemented to
reduce colics.
Supplementation of iron, folic acid, calcium, vitamin
D, electrolytes whenever deficiency occurs.
Total parenteral nutrition (TPN) has been
demonstrated to be effective in controlling the disease
actively & complications of crohn’s disease.
15. Surgery to remove a damaged portion of GI
tract or to close fistulas or remove scar
tissue.
16. Surgical procedures include resection of the
affected area with anastomosis, colectomy
with ileostomy, or colectomy with ileorectal
anastomosis, depending on the area of bowel
involved.
19. Diarrhea related to inflammatory bowel disease
Impaired nutrition less than body requirements related
to anorexia & malabsorption
Fluid volume deficit related to anorexia, nausea, diarrhea
Acute pain related to increased peristalsis & cramping
Impaired skin integrity related to frequent loose stools
Ineffective coping related to repeated episodes of
diarrhea
20. Intestinal obstruction
Peritonitis
Fistula formation( Enterovesical fistula,
enterovaginal fistula)
Extraintestinal manifestations(Arthritis,uveitis)
Slight increased risk of development of
carcinoma of the colon