Crohn's Disease

Crohn’s disease (Regional Enteritis)

- Chronic recurrent inflammation of the mucosa of the bowel both small and large

- Usually affects the terminal ileum, cecum, and ascending colon

- Regional enteritis if limited to small intestines

- Crohn’s colitis if it is in the colon

- Characterized by granulomas that nay affect all the walls of the bowel resulting to thickening, narrowing and scarring of intestinal wall

- Affects both sexes equally at about 15-30 y/o

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Risk factor

- could be hereditary

- Etiology

- Unknown but associated with bacterial or viral infections, autoimmune, psychologic and diet- allergies

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v Early lesions starts as ulcers and develop into deep fissures that penetrates through the wall of intestines creating fistulas

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- As progresses, inflammation of the bowel increases and walls become congested and thick causing narrowed lumen

- Clinical Manifestations

- Crampy abdominal pain, increase in peristalsis

- Diarrhea with mucus and pus

- Abdominal distention

- Fever

- Anorexia, nausea and vomiting

- Weight loss

- Malnutrition

- Anemia

- Dehydration

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- Diagnostics

- History

- Barium enema- detects ulcers, fissures and fistula; string sign

- Coloscopy

- CBC: Hgb, Hct

- Management

- Antimicrobial – sulfasalazine decrease inflammation but should be given with adequate fluids to prevent crystalluria

- Corticosteroids –

- Antidiarrheal, anti cholinergic

- Ileostomy, colostomy

- Nursing Intervention

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- High protein, high calorie, low residue diet with no milk products and gas forming foods

- Weight daily and monitor kcal counts

- Record number and characteristic of stool

- Promote rest and comfort

- Maintain skin integrity and provide skin care

- Minimize and prevent stress as possible