Crohn's disease case study

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Emily HawleyKNH 411Case Study #11: Crohn’s Disease1.What is inflammatory bowel disease? What does current medical literature indicate regarding its etiology?a.Inflammatory bowels disease is an autoimmune, chronic inflammatory condition of the gastrointestinal tract: IBD is actually the term designating a syndrome consisting of two diagnoses: ulcerative colitis and Crohn’s disease. (Nelms 377) The complete etiology of both ulcerative colitis and Crohn’s disease is unknown at the present time, however it is understood that severalfactors play a role in the conditions. These include environmental considerations such as diet, smoking, infectious agents, physiological changes in the small intestine from which an abnormal inflammatory response is triggered, and intestinal flora.There is a very strong association between genetics and IBS. There is evidence shows that with a positive family history, 5-15% of patients will have IBS. Identical twins there is a 44% chance and fraternal a 3.8% chance (415).Several tests can be done in order to diagnose inflammatory bowel disease. These include abdominal ultrasound, MRI, CT scan, and antiglycan antibodies. The most prevalentway to diagnose and describe Crohn’s disease is using the CDAI. A score of over 150 indicates a flare-up of the disease, and a score over 300 means the patient is experiencing a severe exacerbation of the disease. Calprotectin, lactoferrin, and polymorphonucler nuetrophil electase levels in the stool have been found to be indicative of exacerbations of Crohn’s disease as well. Low albumin levels and elevated WBC are also common. In the case of ulcerative colitis, more than 5 daily bowel movements, large amounts of hematochezia, temperature above 37.5°C, pulse aboveor equal to 90/min, and hemoglobin less than 10 g/dL are all indicative of severe activity of ulcerative colitis (416).2.Mr. Sims was initially diagnosed with ulcerative colitis and then diagnosedwith Crohn’s. How could this happen? What are the similarities and differences between Crohn’s Disease and ulcerative colitis?