NSG 2522 Exam 2
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| What is a chronic bowel disorder that affects frequency of defecation and consistency of stool, sometimes called 'spastic colon'? | Irritable Bowel Syndrome (IBS)
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| What are some factors associated with IBS? | hereditary, physiological, stress or conditions(depression and anxiety), high fat diet, irritating foods, alcohol consumption, and smoking. The cause is unknown.
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| What are the s/s of IBS? | abd cramping, abd bloating, constipation and diarrhea altering, and pain
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| Describe IBS-C. | IBS-C: sometimes spasms delay the bowel movement, causing stool to remain in colon too long, too much H2O absorbed, stool becomes hard and leads to constipation. Treat with Lubiprostone.
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| Describe IBS-D. | IBS-D: spasms push stool through colon so rapidly, fluid can't be absorbed, resulting in diarrhea. Treat with Alosetron (Lotronex).
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| Describe IBS-A. | IBS-A: alternating stool patterns of diarrhea then constipation
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| What is the diagnostic criteria for IBS? | Recurrent abd pain or discomfort at least 3 days a month in past 3 months with 2 or more of the following: 1)improvement with defecation, 2)onset associated with change in frequency of stool, 3)onset associated with change in appearance (form) of stool.
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| How to treat IBS? | Find irritating foods and restrict them, high fiber diet, exercise, Hydrophilic Colliods, Antidiarrheals, Antidepressants, Antispasmodic agents, probiotics, artichoke leaf extract, peppermint oil, and caraway oil.
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| What is a group of chronic disorders (Crohn's and UC) that result in inflammation or ulceration of bowel lining? | Inflammatory Bowel Disease (IBD)
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| What are some causes of IBD? | genetics
autoimmune/defective regulation of immune suppression- overactive immune response that won't "turn off"
environmental- pesticides, food additives, radiation, NSAIDS, smoking, stress, infectious agent in mucosal barrier
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| What are the s/s of IBD? | abd pain, diarrhea, fever, weight loss, anemia/fatigue, and systemic inflammation
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| How to treat IBD? | resect bad bowel, ostomy, and meds
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| What is Crohn's Disease? | effects from mouth to anus, unknown cause, skip disease, it's a subacute and chronic inflammation of GI tract that extends through all layers, onset is usually insidious (nonspecific)
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| What are the s/s of Crohn's Disease? | diarrhea(not bloody), abd pain(intermittent, cramping, or continuous), steatorrhea, abd guarding, tenderness, distension, fatigue, fever, and perennial ulcerations
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| What is the disease process of Crohn's Disease? | the disease process begins with edema and thickening mucosa, ulcers appear on inflamed mucosa, cobblestone lesions, fistulas, fissures, and abscesses form as inflammation extends into peritoneum
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| How to treat Crohn's? | Sulfasalazine(lg intestine), corticosteroids, immunosuppressants, Flagyl, Remicade, nutrition- low residue, roughage, and fat, high calorie and protein, avoid milk products and GI stimulants, surgery to preserve bowel, it doesn't cure
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| What is Ulcerative Colitis? | recurrent and ulcerative inflammatory disease of mucosal and submucosal layers of colon and rectum with an unknown cause, it affects from the rectum to the colon, with bloody diarrhea
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| What is the patho of UC? | diffuse inflammation, shredding of colonic epithelium, mucosa is edematous and inflamed, abscesses form and infiltrate, bowel narrows, shortens, and thickens, symptoms can 'flare up', colon is hyperemic, and sutopoylps can project into bowel lumen
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| What are the s/s of UC? | bloody diarrhea, abd pain, tenesmus(uncontrollable straining), passage of mucus and pus, and if severe may have diarrhea 10-20x/day
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| How to treat UC? | sulfasalazine, corticosteroids, Imuran, antidiarrheal, indications for surgery: pt doesn't respond to treatment, frequent and debilitating exacerbations, hemorrhage, perforation, toxic megacolon, strictures, obstructions, dysplasia, or carcinoma
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