Crohn’s Disease

scarring. unpredictable and recurrent with involvement of the multiple regions of the intestines. • Intestinal swelling. • Caused by the Inflammation of the Intestines. abcesses and even fistulas. but most commonly affects the ileum. • Inflammation involves the full thickness of the bowels (intestinal walls).• Crohn’s Disease is one of the 2 most common type of IBD. obstruction. getting to know CD. • Slowly progressive. ulcerations. • Can affect any part of the gastrointestinal system. .

unable to recognize and destroy bacteria over reaction of the immune system uncontrolled inflammation and destruction of intestinal cells • Bacterial Infection. Mycobacterium species What causes CD? . • NOD2/CARD15 on Chromosome 16. immune and environmental factors.• Exact cause still unknown. • Includes combination of genetic.

• • • • • • • Recent unintentional weight loss Frequency and consistency of stools Presence of blood in stools Fever Abdominal pain Steatorrhea Anorexia What to ASSESS? .

masses or visible peristalsis Ulcerations.• • • • • • Findings similar to acute appendicitis Distention. fissures or fistulas on perianal area Decreased/absence of bowel sounds High-pitched or rushing sounds on narrow bowel loops Pain around umbilicus before and after bowel movements What to ASSESS? .

• • • • • • • • • Severe diarrhea Nutritional imbalances Fluids and electrolyte imbalance Malnourishment/Debilitation Weight loss Hemorrhage Anemia* Peritonitis CA of the small intestines/colon (rare) Complications of CD. .

strictures and fistulas • Colonoscopy* • Biopsy for malignancies of cells Diagnostic findings .• • • • • Low serum levels of follic acid and cobalamin Decreased albumin levels Pyuria (ureteral obstruction/enterovesical fistula) Low Mg and K serum levels X-ray/CT Scan may show narrowing. ulcerations.

Drug Therapy • Budosenide (Glucocorticoid) – delivers high local glucocorticoid concentrations to the terminal ileum and right side of the colon Sepsis can results if fistulas/abcesses are present. these drugs may mask the symptoms of infection • Metronidazole • Azathioprine & Methotrexate • Inflizimab & Adalimumab Nonsurgical Interventions .

Nutrition Therapy • TPN upon hospitalization • Elemental/semi-elemental products such as Vivonex absorbed in the jejunum allowing the distal small intestine and colon to rest • Low salt diet upon remission • Nutritional supplements (Ensure. Sustacal) • Avoidance of G.I stimulants • Requires at least 3000 calories a day to promote healing of fistulas Nonsurgical Interventions .

•MIS – resection of the intestines •Colostomy •Anastomosis •Stricturoplasty Surgical Interventions .

high caloric diet • Instruct to avoid G. symptoms and complications and when to notify the HC provider • Incorporate drug teaching/supplements • Low residue.• Monitor nutrition/hydration status • Monitor untoward signs and symptoms • Teach client the course of the disease.I stimulants/irritants • Encourage to take rests. especially during exacerbations of the disease – Stress Management • Fistula/Colostomy Care Nursing Management .

Colostomy Care .

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