Ulcerative Colitis and Crohn’s Disease
Ulcerative Colitis vs. Crohn's Disease
Crohn's Disease
- Inflammation and ulceration anywhere from mouth to anus.
- Scattered patches
- Cobblestone appearance
- Affects entire bowel wall (even outer most layer- the serosa)
Ulcerative Colitis
- Inflammation and ulceration in the innermost lining (mucosa and submucosa) of the colon and rectum only.
- Continuous (not scattered)
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Crohn's Diease Signs and Symptoms
- Fatty stool
- Right lower Abdominal pain
- Tenderness, cramping, distention
- Blood in stool.
- Mouth and GI ulcers
- ∼ 6 semi-formed stools/day
- Fever
- Malnutrition (worse than UC)
- Fissures with anal bleeding
- Fistulas
Ulcerative Colitis Signs and Symptoms
- NO fatty stools
- Abdominal pain with defecation
- Tenderness, cramping, distention
- Blood in stool
- 10-20 liquid stools/day and recurrent bloody diarrhea (w/pus + mucus)
- Electrolyte imbalances and metabolic acidosis
- Fever
- Â Malnutrition
- NO fistula
Crohn's Diease Complications
- Abscess
- FistulaÂ
- Severe malnutrition (especially if affecting small intesting where nutrients are absorbed)
- Fissures if in anal area
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Ulcerative Colitis Complications
- Lead-pipe sign- large intestine appears smooth
- Ulceration can lead to rupture of bowels and peritonitis
- Toxic megacolon- large intestine dilates due to inflammation and cannot function
- Dehydration
- Risk for hemorrhage & shock
Crohn's Diease Treatment
- NO CURE
- Diet: Low fat for steatorrhea, restricted fiber with no fruit or vegetables, and elimination of dairy products for lactose deficiency.
- Avoid fruits and veggies with skin, cruciferous veggies, oatmeal, whole wheat bread and cereals.
- Antibiotics, corticosteroids, anticholinergics, salicylates such as sulfasalazine (anti-inflammatories), immunosuppressants, analgesics, bulk hydrophilic drugs to treat diarrhea.
- Monitor bowel movements/Weight
- Encourage fluids
- May need TPN or end up with an ostomy
Ulcerative Colitis Treatment
- Low fat, high protein, high calorie diet
- Antibiotics, corticosteroids, anticholinergics, salicylates such as sulfasalazine (Anti-inflammatories), and analgesics
- Psyllium often given to prolong remissions
- Monitor bowel movements
- Daily weights and IV hydration
- Monitor for toxic megacolon and peritonitis (abdominal pain, tachycardia, abdominal distention)
- Cure: COLECTOMY
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NCLEX Alert
Crohn’s Disease VS Ulcervative Colitis
Is it Crohn’s Disease or Ulcerative Colitis?