Disorders of the Gastrointestinal System, 2nd Edition
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Cirrhosis symptoms depend on the extent of the damage and its effect on other body systems. Some patients have no symptoms and maintain a normal life, while others become gravely ill. Signs and symptoms of cirrhosis typically cor- respond with the conditions listed above and include the following (Wolf, 2020): ● Abdominal distention related to ascites, infection, or disease progression, often bulging out at the flanks. ● Confusion, aggression, or change in the level of consciousness. ● Changes in blood sugar. Cirrhosis can be diagnosed, and its se- verity can be determined with a range of blood tests, imaging, and liver biop- sy. Complete blood count, liver function tests, hepatitis testing, and testing for autoimmune disorders are often used to assess nutrition, the severity of liver dysfunction, and other associated condi- tions. Imaging and biopsy are most help- ful for assessing the amount of scarring and damage on the liver and identifying any blockages that may be present as a result (Goldberg & Chopra, 2021). Although cirrhosis damage cannot be reversed, treatment to slow the progres- sion, stop additional damage, and pre- vent other related conditions from occur- ring is usually initiated. ● Weight changes. ● Abdominal pain. ● Unexplained GI bleeding. Often, treatment focuses on the relief of symptoms. Management to prevent chronic liver disease includes avoidance of alcohol, vaccination for hepatitis B and hepatitis C, high-quality nutrition with weight reduction if needed, and preven- tion of dehydration, hypotension, and in- fection (Sharma & John, 2022). If ascites is
present and causes discomfort or injury to a patient, the patient may undergo peri- toneal dialysis to remove the fluid and re - lieve the pressure. | NURSING ALERT Patients with cirrhosis are at extremely high risk for esophageal and gastro- intestinal varices. Even if a patient is undergoing treatment for liver dis- ease or on medications to lower por- tal pressure, varices present before treatment will not resolve. The nurse should monitor closely for chang- es in complete blood count, level of consciousness, signs of bleeding, or changes in vital signs. If concerns are identified, the provider should be no - tified immediately (Meseeha & Attia, 2022). Inflammatory bowel diseases Ulcerative colitis (UC) and Crohn’s dis- ease (CD) are both inflammatory bow - el diseases caused by an inappropriate autoimmune response targeting the GI system. These conditions affect different portions of the GI tract, but differentiat- ing between the two conditions is prob- lematic in about 15% of cases, which are referred to as indeterminate colitis (IC) (Venkateswaran et al., 2021). Both UC and CD are identified as inflammatory bowel diseases (IBD) and are chronic illnesses with periods of exacerbation and remis- sion. UC is confined to the colon, while CD can affect the entire GI tract (Rowe, 2020). There is a genetic component to both types of IBD. There is a genetic compo- nent to both types of IBD. Recent studies have indicated genetic factors linked to the gut microbiota may predispose indi-
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