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35 Cards in this Set
- Front
- Back
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What are the differences between IBS and IBD?
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IBS is very common, more in women
Exact cause is unknown Does not mean you have a psychological problem; stress can precipitate symptoms though Very predominant of Middle Eastern descent Diets high in fat, any stimulating or irritating food |
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What is the patho for IBS?
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Most likely a functional disorder of GI motility
Motility changes can be related to many sources Tissue under a microscope looks like normal, healthy tissue New research = possible role of serotonin |
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What are the IBS clinical manifestations?
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Alteration in bowel pattern
Pain Stools Mucous in stool Sensation of incomplete emptying Pain after meals Pain relief with defecation |
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What is the IBS Diet education made up of?
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Need to stay away from: soda, foods high in fat, coffee, chocolate
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What are the non-pharmacologic ways to tx IBS?
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Stress reduction, coping mechanisms, exercise
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What are the IBS Pharmacological management
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Antispasmotics
Antidiarrheals - Lomotil Bulk forming laxatives Antidepressants Newer medications |
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IBD – inflammatory bowel disease
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Ulcerative colitis / regional enteritis
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Most commonly in the terminal ileum (ileocecal junction)
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Crohn's disease
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-Cause is unknown; perhaps environmental
-Can occur anywhere in the GI tract |
Crohn's disease
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Swelling and inflammation can cause severe pain
Causes frequent emptying of the GI tract Cobblestone appearance (its patchy) |
Crohn's disease
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Can obstruct lumen and end up with an obstruction
Can have healthy bowel in-between diseased portions Usually does not affect rectum |
Crohn's disease
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Abdominal pain
Pain in the right lower quadrant |
(Crohn’s disease) clinical manifestations
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Not relieved by defecation
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(Crohn’s disease) clinical manifestations
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Chronic diarrhea (usually non-bloody)
Steatorrhea (fatty frothy looking stool) |
(Crohn’s disease) clinical manifestations
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Weight loss
Nutritional deficits Malnutrition |
(Crohn’s disease) clinical manifestations
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Nausea and vomiting
Complications (fistulas, fissures, abscesses) Systemic manifestations Possible autoimmune reason to this disorder |
(Crohn’s disease) clinical manifestations
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What are the diagnostic tests you could use to diagnose someone with Crohn's disease?
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Upper GI barium swallow
Lower GI barium enema Endoscopy – upper GI Endoscopy – lower GI (colonoscopy) CT scan |
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What are the Lab tests for crohn's disease?
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Stool
CBC Sedimentation rate Serum albumin and protein Looking for malnutrition component |
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whole connecting one part of an organ or structure to another.
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Fistula
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What are some complications and things you would see with perforation?
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Stool in the bottom of the cavity
Gas rises and can cause referred shoulder pain or difficulty breathing Cause massive infection |
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What are some reasons for surgery for someone with crohn's disease?
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Obstruction from strictures
Acute or chronic abdominal pain Fissures Most common is anal fissure Almost look like a tear Fistulas Ulcers Causes pain and bleeding Cancer |
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Lesions are continuous
Begins distally and moves proximally |
UC patho
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Pain – left lower quadrant
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Ulcerative colitis
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Rectal bleeding
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Ulcerative colitis
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Anemia – as a result of the bleeding
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Ulcerative colitis
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Stools
Painful straining at defecation Urge to defecate often |
Ulcerative colitis
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Nausea, vomiting
Weight loss Fluid and electrolyte imbalance Tenesmus |
Ulcerative colitis
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what are the Diagnostic tests for ulcerative colitis?
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Abdominal x-ray
Sigmoidoscopy Endoscopy lower GI (colonoscopy) Lower GI barium enema CT scan MRI Abdominal ultrasound Leukocyte scanning Show area of inflammation |
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What are the labs for ulcerative colitis?
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CBC
Sedimentation rate Calcium Electrolytes |
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What are the Ulcerative colitis complications?
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Toxic megacolon
Medical emergency Strictures Perforation Colon cancer Can develop pseudopolyps |
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What are the indications for surgery to help with ulcerative colitis?
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Uncontrolled diarrhea
Bleeding Perforation Cancer Toxic megacolon |
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What kinds of meds are given for ulcerative colitis?
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Anti-inflammatory
Antibiotics Used for secondary infections Corticosteroids Help with the inflammation Immunosuppressants |
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What is the dietary management for ulcerative colitis?
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Low residue, high protein, high calorie diet
Avoid precipitating foods Fluids Electrolytes Vitamin supplements TPN with acute flare ups |
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Tell me about TPN.
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Must go through a central line
Is a hypertonic solution Bags of solution must be refrigerated Take it out about 1 hour before hanging the bag so it’s not so cold going into the body Always make sure you have another bag when your current bag is getting low Because it is a hypertonic solution it is very high in sugar; pancreas is secreting lots of insulin; when abruptly disconnected can cause hypoglycemic reaction Often add insulin to the bag; common to have a sliding scale on top of that |
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What are the psychosocial implications of IBD?
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Fatigue
Activity restriction Depression Anxiety Grief Control Work Financial Socialization Isolation Support system Sexuality |
