week 8 Advanced Pathoophysiology response 1 Inflammatory Bowel Disease

week 8 Advanced Pathoophysiology response 1 Inflammatory Bowel Disease

Title       week 8 Advanced Pathoophysiology response 1

Prefered Language style               English (U.S.)

Type of document           Essay

Number of pages/words              1 Page Double Spaced (approx 275 words per page)

Subject area         Nursing

Academic Level Master

Style      APA

Number of sources/references 3

Order description:

Please respond to 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

This is traceys post to respond to

Tracey Rusnak

WK 8 Discussion

COLLAPSE

NURS-6501-15: Advanced Pathophysiology

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is an umbrella term used to describe diseases associated with a chronic inflammation of the intestines (Drugs.com, 2012). Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic relapsing disorders thought to be caused by susceptibility genes, environmental factors, alterations in epithelial cell barrier functions, or an altered immune response to intestinal micro-flora (Huether & McCance, 2017). When an environmental factor or infectious agent alters the barrier function of the mucosal epithelium it leads to a loss of immune tolerance to normal intestinal antigens. Dendric cells become activated and trigger the production of proinflammatory cytokines and chemokines. UC begins in the rectum and may extend proximally to the entire colon (Huether & McCance, 2017). The mucosa becomes hyperemic with a dark red and velvety appearance. Small erosions lead to ulcers, abscess formation, and necrosis of the mucosa. This destruction of the mucosa and inflammation is responsible for the bleeding, cramping pain, urge to defecate, and frequent diarrhea associated with UC. CD can be difficult to differentiate from UC. CD can occur anywhere in the colon but the most common sites are the ascending and transverse colon. Projections of inflamed tissue surrounded by ulcerations give CD a cobblestone appearance (Huether & McCance, 2017). Symptoms of CD are similar to UC and depend on the location and severity of the inflammation. Clinical manifestations of IBD include diarrhea, weight loss, anemia, fatigue, abdominal cramping, and bloody stools (National Digestive Diseases Information Clearinghouse, 2016).

Irritable Bowel Syndrome

According to Hammer & McPhee (2014), irritable bowel syndrome (IBS) is characterized by altered bowel habits and abdominal pain in the absence of any detectable organic pathological process or structural abnormalities. An alteration between diarrhea and constipation are the characteristics of IBS. The cause of IBS is thought to be a dysfunction of how the brain and the intestines work together. The intestines can become more sensitive (visceral hyperalgesia) and change how the muscles in your bowel contract (peristaltic contractions) which leads to diarrhea, constipation, or both. The most common symptoms of IBS are abdominal pain, diarrhea, constipation, bloating, whitish mucus in the stool, and a feeling of incomplete defecation (National Digestive Diseases Information Clearinghouse, 2016).

Treatment

Treatment for IBD involves promoting mucosal healing and reducing the inflammation. Pharmacological treatment includes corticosteroids, aminosalicylates, immunosuppressive agents, antibiotics, and biological agents. The type of pharmacological agent used is dependent on the presence of UC or CD, the severity of disease, and whether the treatment is targeted at active disease or maintenance of remission. Surgical resection of the colon may be required if other forms of therapy are unsuccessful (Arcangelo, Peterson, Wilbur, & Reinhold, 2017).

Treatment for IBS aims at treating the symptoms. Therapies include laxatives, fiber, antidiarrheals, antispasmodics, prosecretory drugs, low-dose antidepressants, visceral analgesics, and serotonin agonists and antagonists (Huether & McCance, 2017). No specific diet works for all patients so an individualized adjustment of foods is recommended to control symptoms (Drugs.com, 2018). Other therapies include stress reduction, avoidance of caffeine, prebiotics and probiotics, exercise, or cognitive-behavioral therapy (Huether & McCance, 2017).

Behaviors: Diet & Stress

Dietary changes can help reduce symptoms of IBD and IBS. Dietary recommendations include avoiding carbonated drinks, increasing fluid intake, and eating small frequent meals. A high fiber diet is advised for the treatment of IBS; however, popcorn, vegetable skins, and high-fiber foods should be avoided while symptoms of IBD are present. Keeping a food diary for both disorders is recommended to help identify troublesome foods (National Digestive Diseases Information Clearinghouse, 2016). Lastly, avoiding stress through exercise and behavior health therapies can help reduce symptoms and decrease exacerbations.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017).

Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA:

Lippincott Williams & Wilkins.

Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical

medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis,

MO: Mosby.

National Digestive Diseases Information Clearinghouse. (2016). Retrieved from

http://digestive.niddk.nih.gov/index.aspx