Chrons Disease Crohn's disease is a chronic inflammation of the digestive tract.

It can affect any part of the digestive tract from the mouth to the anus but usually involves the terminal part of the small intestine, the beginning of the large intestine (cecum), and the area around the anus. The inflammation causes uncomfortable and bothersome symptoms and may produce serious damage to the digestive tract. Crohn's disease is sometimes called regional enteritis or ileitis. Cause: Idiopathic Current theories suggest that genetics, environment, diet, blood vessel abnormalities, and/or even psychosocial factors cause Crohn's disease. Probably the most popular theory is that Crohn's disease is caused by the immune system overreacting to infection by a virus or bacterium. Crohn's disease apparently is not caused by emotional distress. Crohn's disease definitely runs in families. People who have Crohn's disease may have an inherited predisposition to abnormal immunologic response to one or more provoking factors.

Risk Factors M>F More prevalent in Whites. Higher prevalence in Urban areas than in Rural areas. More common in Jewish people than among other ethnic or social groups.

Signs and Symptoms

Diarrhea - Waxes and wanes; stool may contain mucus, blood, or pus. Pain in the abdomen - Crampy or steady; in the right lower part of the abdomen or around the belly button; often relieved temporarily by having a bowel movement Bloating after eating - Less common, usually seen in cases of bowel obstruction Constipation - Usually seen in cases of bowel obstruction Pain or bleeding with bowel movement Infection of the urinary tract or vagina - Suggests a fistula from the intestinal tract
Flatulence Steatorrhea Fever, Malaise and Anorexia

Diagnosis

Barium contrast studies: This is a series of x-ray films taken after you drink a contrast material containing a chalky substance called barium. The barium allows the intestine to show up better than on a plain x-ray film. Barium studies are very useful in defining the nature, distribution, and severity of the disease. The barium studies may include an upper GI series (x-ray films of the upper part of the digestive system) and a small bowel followthrough (x-ray films of the small intestine). Barium enema: This works on the same principal as the barium contrast studies of the upper digestive system, but the barium is introduced into the lower digestive tract through the rectum. This test is done to see whether your colon and rectum are involved, and to what extent. CT scan or, in some cases, ultrasound is helpful in assessing complications outside of the intestine, such as fistulas, an abscess, or abnormalities of the liver, bile duct, or kidneys. MRI may be used instead. Colonoscopy

Treatment No Cure: Supportive

Surgical Management Sub or total Colectomy

Nursing Intervention 1. 2. 3. 4. 5. 6. Provide emotional support to the patient and his family. Schedule patient care to include rest periods throughout the day. If the patient is receiving parenteral nutrition, provide meticulous site care. Give iron supplements and blood transfusion as ordered. Administer medications as ordered. Provide good patient hygiene and meticulous oral care if the patient is restricted to nothing by mouth. 7. Record fluid intake and output, weigh the patient daily. 8. If the patient is receiving TPN, monitor his condition closely. 9. Evaluate the effectiveness of medication administration. 10. Emphasize the importance of adequate rest. 11. Give the patient a list of foods to avoid, including lactose-containing milk products, spicy or fried high-residue foods.

12. Teach the patient about the prescribed medications, their desires effects and possible adverse reactions.