- Is a chronic inflammatory

bowel disease that causes ongoing inflammation and ulcers (open sores) in the innermost layers of the large intestine (colon) and rectum.

- The ulcers bleed and produce pus and mucus, and the inflammation causes the colon to empty frequently, causing diarrhea.

- Ulcerative colitis is almost similar to Crohn's disease, another inflammatory bowel disease.

Feature INCIDENCE
Age of Onset Family History Gender of prevalence

Ulcerative Colitis

Crohns Disease

Any age; 10-40 years Less common

Any age; 10-30 years More common

Equal in men and women Equal in men and women

Cancer risk

Increased

Increased

Feature
PATHOPHYSIOLOGY Location of lesion

Ulcerative Colitis

Crohns Disease

Colon and rectum, no skip lesions Mucosal layer involved Rare Common Rare Rare

Inflammation and ulceration Granulomas Friable mucosa Fistuale and abscesses Strictures and possible obstruction

All of GI tract: mouth to anus, skip lesions common Entire intestinal wall involved Common Less common Common Common

Feature
CLINICAL MANIFESTATION

Ulcerative Colitis

Crohns Disease

Abdominal pain Diarrhea Bloody stools Abdominal mass Small intestinal malabsorption Steatorrhea Potential for malignancy Clinical course

Occasional Common Common Rare Rare Rare Common Remission and exacerbation

Common Common Less common Common Common Common Common Remission and exacerbation

NPO status except for oral medications

Colitis interferes with its ability to absorb water from the intestinal contents and allows leakage of important electrolytes, such as potassium and chloride, into your stool. Thus, would cause further problems in bowel movement or exacerbation of diarrhea would occur.

Sulfasalazine 2g po qid
It works to reduce the inflammation in the colon caused by ulcerative colitis and then as a maintenance therapy to maintain remission.

D5W in 0.9% Nacl with 40 mEq KCL at 125 ml/hr

People with IBD (ulcerative colitis or Crohn's disease) often have trouble absorbing nutrients from their intestine, and may have low levels of potassium and other important nutrients.

Solumedrol 100mg IV q 6
Corticosteroids affect metabolism in various ways and modify the immune system. Corticosteroids also block inflammation and are used in a wide variety of inflammatory diseases affecting many organs.

Common Laboratory Findings

Bloody diarrhea Cellular mucosal breakdown Diarrhea and vomiting Toxic megacolon

Diarrhea related to inflamed intestinal mucosa Altered nutrition: less than body requirements related to malabsorption Altered comfort: acute pain related to inflamed mucosa Deficient fluid volume related to anorexia, nausea, diarrhea Risk for impaired skin integrity related to malnutrition and diarrhea Activity intolerance related to fatigue Anxiety related to impending surgery Ineffective coping related to repeated episodes of diarrhea

Electrolyte imbalance Cardiac dysrhythmias related to electrolyte depletion GI bleeding w/ fluid volume loss Perforation of the bowel

 Ardizzone S. Ulcerative colitis. Orphanet encyclopedia. September 2003: (Ebook)  Black, J. and Jane Hokanson Hawks. (2004). Medical-Surgical Nursing: Clinical management for positive outcomes. 7th ed. Singapore: Elsevier Pte. Ltd.  Kozier, B. et. Al. (2008). Fundamentals of nursing, 8th ed. Singapore: Pearson Education South Asia Pte. Ltd.  Lewis, S. et. Al. (2007). Medical surgical nursing: Assessment & management of clinical problems, 7th ed. St. Louis, Missouri: Mosby Inc.  Smeltzer, S. (2008). Brunner & Suddarths textbook of medical-surgical nursing, 11th ed. Philadelphia: Lippincott Williams & Wilkins.  Ulcerative colitis. http://www.livestrong.com/article/484043-colitis-lowpotassium/#ixzz1S31mPbc5  Ulcerative colitis. http://www.umm.edu/altmed/articles/ulcerative-colitis-000166.htm

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