Crohn's disease is the inflammation of the terminal ileus. Ulcerative colitis is the inflammation of the distal colon. Both may be caused by autoimmune response characterized by exacerbation and remissions.
The bowel develops shallow ulcers; the woman experiences chronic diarrhea (4-24x/day), weight loss, occult blood in stool, and nausea and vomiting. In crohn's, there is malabsorption of vitamin B12, folic acid, iron, calcium, fats, and vitamins ADEK. The predominant symptom for ulcerative colitis is rectal bleeding.
Complications are nutritional deficiencies, toxic megacolon and other extraintestinal manifestations (arthritis, ankylosing spondylitis, clubbing of fingers, anemia). Colon cancer is common.
Therapy is total GIT rest by administration of TPN; Sulfasalazine maybe continued without fetal injury.
Specific goals of nursiong care for inflammatory bowel disease:
- maintain and correct nutritional and fluid status
- relieve discomfort
- diarrhea
- prevent complications
- provide physical rest and comfort
- relieve pain
- restore blood volume
- prvide emotional support
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