Ulcerative Colitis
Essay by review • February 27, 2011 • Essay • 609 Words (3 Pages) • 1,299 Views
Ulcerative Colitis
Introduction
* U.C. is characterized by remissions and exacerbations of inflammation in the colon and/or rectum.
* Chronic process affects the intestinal mucosal lining.
* Causes a loss of surface epithelium, ulcerations and possible abscess formation.
* Results in loose stools containing blood and mucus, malabsorption, thickening of colon wall.
* Symptoms: abdominal pain, diarrhea, and rectal bleeding.
Pathophysiology
* Disease begins in rectum proceeds toward cecum.
* Acute: epithelial cell damage and loss, ulcerations, redness, bleeding.
Chronic: Fibrosis and retraction of the bowel, muscle hypertrophy, deposition of fat and fibrous tissue, narrower shorter colon.
Complications
* Colon Cancer
* Intestinal perforation with resultant peritonitis and fistula formation
* Toxic megacolon
* Hemorrhage
* Increased risk of colon cancer
* Abscess formation
* Malabsorption
* Bowel obstruction
* Extraintestinal clinical manifestations: arthritis, hepatic and biliary disease, oral and skin lesions, ocular disorders.
Etiology
* Exact etiology unknown
* Abnormal response to normal flora
* Defect in intestinal permeability
* Psychological
* Genetically inherited
Incidence/Prevalence
* Incidence: Approx. 2-10 new cases per 100,000 persons.
* Prevalence: Approx. 40-100 cases per 100,000 people in the U.S.
* Age: Peak incidence occurs between the ages of 15-25 and 55-65.
* Sex: Females are more often affected then men. Geographic Distribution: There is a higher distribution of U.C. in Northern Europe and North America
* Family History: You have a ten fold risk of having U.C. if you have a first degree relative with the disease
* Cultural Considerations: U.C. is 4-5 times more common in the Jewish population specifically the Jewish European or Ashkenazi
* Racial Considerations: U.C. is more common in whites although the incidence of black individuals with the disease is increasing
Assessment
* History
- Family History
- Previous and Current Therapy
- Diet History
- History of weight loss
* Ask about symptoms of acute Ulcerative Colitis which include:
- Abdominal pain
- Cramping
- Urgency
- Diarrhea with up to 10-20 liquid bloody stools per day
- Anorexia
- Fatigue
- Arthritis
- Mouth sores
- Vision problems
- Skin disorders
Physical Assessment
* Signs and Symptoms
-Abdominal Pain
-Bloody diarrhea
-Tenesmus (uncontrolled straining)
* Physical Exam
-vital signs (usually within normal limits)
-Abdominal distension along the colon, palpate for increased tenderness. Note any localized areas of abdominal pain or cramping over diseased bowel
-Client may be febrile and tachycardic
Psychosocial Examination
* Evaluate client's understanding of the illness.
* How it impacts his/her lifestyle.
* Encourage and support the client while exploring the following:
-relationship of life events to disease exacerbation
-Stress factors that produce symptoms
-Family, social support systems
-concerns of genetic basis
Laboratory Assessment
* Lab tests
-Hematocrit: May be low
-Hemoglobin:
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