NURS 6501 – Inflammatory Bowel Disorder

NURS 6501 – Inflammatory Bowel Disorder

NURS 6501 – Inflammatory Bowel Disorder

Inflammatory bowel disorder is defined as abdominal discomfort or pain associated with changes in bowel habits that occur at least three days per month during the previous three months.(Hammer & McPhee, 2014). Changes in bowel habits may include symptoms predominantly related to either diarrhea or constipation, but may also include a mixed sensation that alternates between diarrhea and constipation.

Irritable Bowel Syndrome is a chronic, relapsing, inflammatory disorder that affects the gastrointestinal tract. Irritable Bowel Syndrome  includes Cohn’s Disease and ulcerative colitis. Characteristic symptoms of inflammatory bowel disease include diarrhea that has persisted for more than 2 weeks, rectal bleeding, inflammatory mass, weight loss, perianal  disease, and fever. (Huether & McCance, 2017).

Inflammatory bowel disorder  and  irritable bowel syndrome  have some features in common, such as symptoms and demographics.

• Affects people under the age of 50
• Bacterial infection may cause both IBS and IBD

• May be caused by inflammation
• May result from changes to the gut environment
• Both have similar intestinal symptoms
• Both may have an indirect effect on other bodily systems, such as the skin, bone, and joints
• IBS is more prevalent than IBD
• IBS is typically found worldwide despite some variations in location, but IBD is more commonly found only in urban or Westernized locations
• Females are more likely to have IBS than IBD
• IBD may be caused by genetic factors, but a genetic factor is not clearly documented for IBS
• IBS symptoms may be triggered by dietary or environmental factors at any time, while IBD may be more unpredictable
• IBS is mostly managed by addressing symptoms in a less structured manner with drugs and lifestyle changes, while IBD is managed using a step-wise approach with various drugs
• IBS is a functional bowel disorder, which means that it is characterized by symptoms that occur in the gastrointestinal tract and is not due to structural changes in the body. IBD is not a functional bowel disorder. IBD is a chronic inflammatory disease of the gut that may change the structure of the intestines, which can be diagnosed with imaging tests.

After determining that other conditions are not mimicking irritable bowel syndrome (IBS) symptoms and the elimination of any possible triggers, recommended treatment for IBS includes gut-based strategies and centrally (brain-gut) based strategies. Gut-based strategies target the main digestive symptoms of IBS, such as diarrhea, constipation, bloating, gas, abdominal pain. Centrally based strategies act throughout the entire body, improving pain and well-being.( Huether &McCance,2017) . Some of the gut-based and centrally based strategies can be made through lifestyle modifications by the patient. However, lifestyle modifications take time and often require a lot of trial and error in terms of figuring out what works for the patient. There is no single diet or lifestyle change that works for every person with IBS, as each patient is different and has unique challenges. In addition, there are a number of alternative and complementary treatment options that are often used by patients with IBS.

The treatment goal for IBS is the management of symptoms, and treatment strategy is determined by assessing two factors: the severity of symptoms and the dominant symptom. The severity of symptoms is determined by:

• The intensity of the symptoms, how much they bother the patient
• Whether or how much the patient is utilizing medication to manage the symptoms
• The rate of absenteeism (missing school or work)
• The frequency of doctor visits and other health care utilization
• Any mood disorders the patient may have, such as depression, anxiety or bipolar disorder
• The quality of life ¹

The dominant symptom in IBS is generally in one of two categories: transit time, meaning the speed of which the digestion occurs, and perceptive symptoms, referring to those symptoms the patient reports feeling, such as abdominal pain or bloating. Transit time in IBS is either diarrhea (IBS with predominant diarrhea, IBS-D) or constipation (IBS with predominant constipation, IBS-C), or a patient may have a combination of both diarrhea and constipation (IBS-M for mixed bowel transit times).

The underlying reasons for IBS isn’t completely understood. However, IBS is mostly likely caused by various factors, including environmental and psychological, that might work independently or in combination.

NURS 6501 – Inflammatory Bowel Disorder

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