Pathophysiology of Inflammatory Bowel Disease – Advanced Pathophysiology response 2
Type of document Essay
1 Page Double Spaced Subject area Nursing
Academic Level Master
Style APA
References 3
Order description:
Please respond to chikas post Offer alternative common treatments for the disorders.
Share insight on how the factor you selected impacts the treatment of alterations of digestive function also use the some of the following readings and resources as references
Required Readings
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Chapter 35, “Structure and Function of the Digestive System”
This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.
Chapter 36, “Alterations of Digestive Function”
This chapter presents information relating to disorders of the gastrointestinal tract and accessory organs of digestion. It also covers the pathogenesis, clinical manifestations, evaluation, and treatment of gastroesophageal reflux disease, gastritis, peptic ulcer disease, inflammatory bowel disease, and irritable bowel syndrome.
Chapter 37, “Alterations of Digestive Function in Children”
This chapter presents information relating to disorders of the gastrointestinal tract and liver that affect children. It focuses on congenital impairment, inflammatory disorders, metabolic disorders, as well as the impairment of digestion, absorption, and nutrition.
Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
Chapter 13, “Gastrointestinal Disease”
This chapter provides a foundation for exploring gastrointestinal disorders by reviewing the structure and function of the GI tract. It also describes mechanisms of regulation of GI tract disorders such as acid-peptic disease, inflammatory bowel disease, and irritable bowel syndrome.
Chapter 14, “Liver Disease”
This chapter reviews the structure and function of the liver. It then explores the clinical presentation, etiology, pathogenesis, pathology, and clinical manifestations of three liver disorders: acute hepatitis, chronic hepatitis, and cirrhosis.
Chapter 15, “Disorders of the Exocrine Pancreas”
This chapter begins by reviewing the anatomy, histology, and physiology of the exocrine pancreas. It then examines the clinical presentation, etiology, pathology, pathogenesis, and clinical manifestations of acute and chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer.
de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787
Required Media
Laureate Education, Inc. (Executive Producer). (2012c). The gastrointestinal system. Baltimore, MD: Author.
This media presentation outlines the pathophysiology of the gastrointestinal system and associated alterations.
Optional Resources
American Liver Foundation (2016). Retrieved from http://www.liverfoundation.org/
National Digestive Diseases Information Clearinghouse. (2016). Retrieved from http://digestive.niddk.nih.gov/index.aspx
The Pathophysiology of Inflammatory Bowel Disease
There are two types of inflammatory bowel disease (IBD) namely Ulcerative Colitis and Crohn’s disease. The pathogenesis of both diseases is still unknown. Mucosal ulceration and inflammation of the GI tract are features they both have in common (Hammer & McPhee, 2015). With Crohn’s disease, the inflammation can affect any part of the GI tract, the ascending colon, and transverse colon is the most common site of the disease, although the large and small intestines, particularly the ileum, may also be involved (Huether & McCance, 2017). A characteristic feature is the presence of a discontinuous pattern of ulceration and inflammation that occurs in the bowel wall (Hammer & McPhee, 2015). This feature creates a cobblestone appearance forming projections of inflamed tissue that surround the ulcerations (Huether & McCance, 2017). Common complications of Crohn’s Disease include perforation, fistula formation, abscess formation, and small intestinal obstruction (Hammer and McPhee, 2015). Common symptoms include diarrhea, rectal bleeding if the colon is involved, weight loss, abdominal pain. Malabsorption of vitamin B12 may occur if the ileum is involved causing anemia. Deficiencies in folic acid and vitamin D absorption also occurs, and proteins may be lost leading to hypoalbuminemia (Huether & McCance, 2017).
In Ulcerative Colitis (UC), the inflammation occurs mostly in the mucosa of the rectum and sigmoid colon. The inflammation begins at the base of the crypt of Lieberkuhn in the large intestine, while the disease begins in the rectum and may spread across the entire colon (Huether & McCance, 2017). The mucosa becomes hyperemic and appears dark red and velvety and occurs continuously. The destruction and inflammation of the mucosa cause bleeding, cramping pain, and an urge to defecate. Common symptoms include diarrhea, with the passage of a small amount of blood and purulent mucus (Huether & McCance, 2017). Severe UC may affect the entire colon and causes abdominal pain, fever, increased pulse rate, bloody stools, frequent diarrhea. Fluid loss, bleeding and inflammation results in weight loss, dehydration, fever, and anemia (Huether & McCance, 2017).
The Pathophysiology of Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) is characterized by recurrent episodes of abdominal pain, bloating, and diarrhea alternating with constipation in the absence of detectable organic disease or structural deformities (Hammer & McPhee, 2015). A main characteristic of IBS is an alternation between diarrhea and constipation. IBS has unknown pathophysiology although there is increasing evidence that suggests the presence of organic causes of the disease (Huether & McCance, 2017). According to Hammer & McPhee (2015), stress has an impact on the symptoms associated with IBS. In reference to stool formation, individuals with IBS are grouped into diarrhea-predominant, constipation-predominant, mixed/alternating and unsubtyped IBS (Blagden et al., 2015). Clinical manifestations of IBS include lower abdominal pain and constipation in women and diarrhea in men (Huether & McCance, 2017).
Similarities and Differences Between IBD and IBS
A major similarity between IBD and IBS is the presence of abdominal pain, however a major difference is that with IBD, acute flares of inflammation followed by periods of remission occurs while in IBS, there is the occurrence of altered bowel habits and abdominal pain, in the absence of an organic cause (Ceuleers et al., 2016). Another difference is that IBD is a treatable disease but IBS cannot be cured, only its symptoms can be managed. Both diseases are chronic and has a debilitating effect, the pathology of IBD is well known as well as its diagnosis and treatment, however, the etiology of IBS is undefined causing frustration among patients who regards the illness as “nothing diagnosis” for their symptoms (Blagden et al., 2015, p. 268). Several features they both have in common include chronic abdominal discomfort, diarrhea and constipation, urgency and bloating; they also differ from each other in that in IBS, there is the absence of symptoms inflammation such as weight loss, fever (Casey, 2017). Also, individuals with IBS, do not experience malnutrition (anemia and iron deficiency), obstructive symptoms and blood in the stool (Casey, 2015).
Common Treatments for IBD and IBS
The treatment of IBD is geared towards the severity of the symptoms along with the extent of the mucosal damage, and as a result, it is usually individualized (Huether & McCance, 2017). The goal of treatment is to promote mucosal healing. 5-aminosalicylate therapy followed by steroids can be used to treat mild to moderate symptoms while severe symptoms are treated with thioprine and immunomodulatory agents (cyclosporine and tumor necrosis factor (Huether & McCance, 2017). For patients that are malnourished, total parental nutrition may be required. Surgical resection of the colon may be necessary for patients with unsuccessful therapy. Unfortunately, there is no cure for IBS, and its treatment is also individualized. Treatments for symptoms include the use of laxatives and fiber, antidiarrheal, antispasmodic, low-dose antidepressants. Patients with Crohn’s Disease who smoke can be encouraged to quit smoking because smoking increases the risk of developing a severe form of the disease and might result in poor response to treatment (Huether & McCance, 2017).
Behavior as an Impact on IBD and IBS
Examples of behavior that have an impact on the pathogenesis of both IBD and IBS include smoking, the use of oral contraceptive, living in an urban environment, perinatal or childhood exposure to infection and antibiotics and atypical mycobacterial infections (Quigley, 2016). Stress as also been reported to increase the severity of both diseases, especially chronic sustained stressors (Bengtsson, Sjoberg, Candamio, Lerman & Ohlsson, 2013). These writers furthered explained that anxiety and depression have been linked to a severe manifestation of IBD and IBS and shows an increasing number of mast cells.
References
Bengtsson, M., Sjoberg, K., Candamio, M., Lerman, A., & Ohlsson, B. (2013). Anxiety in close relationships is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease. European Journal of Internal Medicine, 24(3), 266-272.
Blagden, S., Kingstone, T., Soundy, A., Lee, R., Singh, S., & Roberts, L. (n.d). A Comparative Study of Quality of Life in Persons with Irritable Bowel Syndrome and Inflammatory Bowel Disease. Gastroenterology Nursing, 38(4), 268-278
Casey, G. (2017). Inflammatory bowel disease. Kai Tiaki Nursing New Zealand, 23(2), 20-26.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Quigley, E. M. (2016). Overlapping irritable bowel syndrome and inflammatory bowel disease: less to this than meets the eye?. Therapeutic Advances In Gastroenterology, 9(2), 199-212. doi:10.1177/1756283X1562123
