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INFLAMMATORY BOWEL DISORDERS (Appendicitis (Assessment findings and…

- - - - Regional enteritis begins with inflammatory oedema and thickening of the mucosa , which develops into ulcers. characteristic multiple, sharply demarcated granulomatous lesions surrounded by normal mucus membrane. these lesions are interspersed between normal segments of the bowel, thus they are called skip lesions. The disease affect full thickness of the intestinal wall with the submucosal layer being affected most, because of marked fibrotic changes in it, while smooth muscle layers of the bowel are relatively spread from the disease process. Fissures and crevices develop on the affected area with surrounding oedematous submucosal tissue assuming the appearance of a cobblestone
    - - Fatigue
      - Symptoms of Crohn`s disease can range from mild to severe. they usually develop gradually but sometimes will come on without warning
      - Blood in your stool
      - Abdominal pain and cramping
      - Pain or drainage near or around the anus due to imflammation from tunnel into the skin (fistula)
    - - Immune system When your immune system tries to fight of invadiding micro organisism, an abnormal immune rsponse casues the immune system to attack the cells in the digestive tract
      - Heredity Crohn`s is more common in people who have family members with the disease, so genes may play a role in making people more susceptible
    - - Age
      - Family history
      - Cigarette smoking
    - - Arresting the inflammatory process
      - Promoting comfort and healing
      - Maintaining adequate nutrition and fluid volume
      - Early identification and treatment of complications
  - - - The aim is at relieving pain, controling diarrhoea, improving nutrition, relieving anxiety and enhancing coping mechanisisms
    - - Mild symptoms are controlled by by avoidance of caffeine, lactose in milk, highly spiced foods and gas-forming
      - Surgical intervention is indicated if the patient does not respond to conservative treatment.
      - Removal of the rectum and entire colon and creation of an ileostomy or ileal anastomosis may be performed
      - Antibiotics to fight infections and let your large intestine heal
    - - Ulcerative colitis often presents as diffuse inflammation of the colonic mucosa with oedema and multiple areas of desquamation and necrosis. The inflammatory process is continuous. Ulceration is a superficial but may extend over large area. Characteristic lesions form in the crypts of Lieberkuhn found in the base of mucosal layer and eventually from crypt abscesses. These lesions contain leukocytes, lymphocytes, red cells, and culminate into absesses. Tongue-like projections produces further (psudopolyps) also devvelop. Secondary infection produces further inflammation. The bowel eventually inflexible as fibrotic scar tissue forms.
    - - Laxatives, narcotics, anticholinergics and hyperlalaemia are reported as contributing factors to the more severe form of ulcerative colitis
    - - Happens when your immune system makes a mistake. Normally it attacks invaders in your body, like common cold, but when you have UC your immune system thinks food, good gut bacteria and cells that line your colon are the intruders
    - - Ulcerative colitis often follows a pattern of remissions and exacerbations. Diarrhoea is the most typical
      - On physical examination, tachycardia, hypertension and tachypnoea, fever and pallor may be detected related to bleeding infection.
      - Cramy belly pain
      - sudden urges to empty your colon right away
      - Not being able to hold your stool in
      - Not feeling hyngry
- - - - The history of the patient with diverticulosis reveals : Bowel irregularity with chronic constipation and intervals of diarrhoea
      - Narrowing of the bowel may results in narrow flat stool and increased costipation
      - Complaints of weakness and fatigue, other complains include anorexia, nausea and abdominal distension
  - - - Maintain a normal elimination pattern and increase fluid in take
      - Establish a schedule for eating and defecation
      - Prescribe exercise programme which should serve to promote bowel movement
      - Avoid all factors that increase intra-abdominal passing stools, vomiting, lifting and tight or restrictive clothing