Disorders of the Gastrointestinal System, 2nd Edition
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Crohn’s disease Unlike ulcerative colitis, which is con- fined to the colon, Crohn’s disease is an inflammation of any portion of the GI tract and usually extends through all lay- ers of the intestinal wall (Ghazi, 2019). The inflammation associated with Crohn’s disease has a slow and steady progres- sion with periods of remission and flares. Inflammation causes edema, ulceration of the mucosa, abscesses, and the develop- ment of fissures and fistulas as the ulcers move through tissues, granulomas, and pseudo polyps (Ghazi, 2019).
external pouch is worn over the stoma, usually located in the right lower abdo- men just below the belt line to the right of the naval (Fleshner, 2021). Kock pouch or continent ileostomy In this procedure, a pouch is formed from a small loop of the terminal ileum and a valve from the distal ileum. This results in a stoma located just above the pubic hairline. The pouch is emptied peri- odically via a catheter inserted in the sto- ma (Fleshner, 2021). Nursing considerations for ulcerative meticulously. Remain alert to fluid and electrolyte imbalances, and encourage the patient to consume fluids and maintain a nutritious diet. ● Monitor lab tests for evidence of electrolyte imbalance and decreased hemoglobin and hematocrit levels (Rowe, 2020). ● Provide thorough skin care after each bowel movement, gently cleansing colitis include the following: ● Monitor intake and output the area around the rectum and avoiding rough towels and harsh cleansers. To avoid skin breakdown, help the patient to turn frequently (at least every two hours) if on bed rest. Administer topical medications as prescribed to assist with healing UC- related skin rashes (Leblanc, 2023). ● Provide patient education about ostomy care. Patients are likely to need emotional support (Doty, 2019). ● Explain the importance of regular medical follow-up care (Basson, 2022).
Figure 10. Pseudopolyps with Inflammatory Bowel Disease
Note . Uthman., E. (2000). Chronic ulcerative colitis. https:// commons.wikimedia.org/w/index.php?curid=840134. In public domain. The diseased segments of the bowel become thicker, shorter, and narrower due to inflammation. Bowel narrowing can cause intestinal obstruction and wors- en if the patient has existing damage from previous flares. Scarring, infections, and damage related to fistulas and abscess - es are also common problems. Inflamed bowel loops often form an attachment between diseased and normal bowel loops, causing adhesions (Ghazi, 2019).
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