Ulcerative Colitis Presentation 11 (2).pptx

Ulcerative Colitis

1. Welcome To Our Case Study Presentation Presentation on Ulcerative Colitis

2. Ulcerative colitis Subject: Medical and Surgical Nursing -1 Paper -1: Medical and Surgical Nursing Presented by-- Group: TheCaregivers (Group B) BSc In Nursing 2nd Year College of Nursing Sher-e-Bangla Nagar Dhaka-1207 Presented to- Sharmishtha Shill Nursing Instructor ( CoNSBN )

3. Patient Information: Patient Name          : Rupom Islam Age                            : 21 years Sex                             : male Profession                : student Reg No                      : 2023012007 Date of admission  : 7-12-2023 Diagnosis                  :   ulcerative Colitis disease Ward no                    : 412 Bed no                       : 07 Marital status           : Unmarried Educational Level     : HSC Patient address         : Shymoli Permanent address  : Sylhet

4. Patient’s illness history Chief complaints: Rectal bleeding Frequent stools and mucous discharge from the rectum. Abdominal Pain History of Present illness : According to patient statement – Patient was apparently normal before 6 months . He developed abdominal pain, high fever with chill and loss of appetite and taken to a hospital where he was diagnosed having chronic constipation. On admission his BP=130/90, Pulse rate=72/min. He was treated for fever and abdominal pain and shifted to ward. After reducing fever and abdominal pain he was discharged after 2 days. Past Medical History: 1. Over the last few months he noticed his        bowel habits had become more erratic. 2. He had episodes of diarrhoea. 3. He noticed bright red blood in his stools, pains also noted on defecation. 4. He also faced weight loss.

5. Patient’s illness history cont... Family History: He lives in a joint family. No family history of diabetes mellitus, hypertension, epilepsy, asthma etc. Diet History:   Low fiber food intake. Less water intake Addicted to spicy food  Patient’s Habit:    Chain Smoker Alcohol

6. General Examination Vital Signs: 1. Temperature     : 102 degree. F 2.   Blood Pressure : 90/130 mmHg 3.   Pulse                  : 71 bits per minute 4.   Respiration       : 17 breath per minute  General appearance: Nourishment   : Malnourished Body build       : Weak Skin color        : Pale Activity             : Less physical activity Consciousness: Conscious Movement      : pain during movement Weight             : 72 kg Height         : 167 cm     

7. Systemic Examination Gastrointestinal System Inspection          : Bloating of abdomen Palpation            : Abdominal tenderness Percussion          : Tapping the body to elicit sound Auscultation       : Hypoactive bowel sounds Abdominal girth : Enlarged Pain                      : Present in abdomen Nausea                : Absent Diarrhea               : Present Constipation       : Absent Vomiting              : Absent

8. Systemic Examination Neurological system Mental status             : Stressful Sensation of pain       : Severe pain Tremors or seizures   : Absent Dizziness                     : Absent

9. Introduction Ulcerative colitis is a disease in which the lining of the colon (the large intestine) becomes inflamed and develops sores (ulcers), leading to bleeding and diarrhea . The inflammation almost always affects the rectum and lower part of the colon, but it can affect the entire colon. Ulcerative colitis is most common in North America and Western Europe.The mean standardised incidence of ulcerative colitis in Bangladesh (3 cases/year) was marginally lower than in Europeans (62 cases/year ). Although ulcerative colitis cannot be cured without removing the colon, it can usually be controlled. Most people with ulcerative colitis are able to live active lives.

10. What is ulcerative colitis?   Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in the lining of the digestive tract(specially in colon and rectum) • The inflammation usually begins in the rectum and spreads upwards to involve all or part of the large intestine (colon). • Ulcerative colitis can cause a variety of symptoms, including abdominal pain, diarrhea , rectal bleeding, and fatigue.

11. Types of ulcerative colitis  1. Ulcerative colitis :  Inflammation is confined to the area closest to the anus (rectum) and rectal bleeding may be the only sign of the disease  2. Proctosigmoiditis : Inflammation involves the rectum and sigmoid colon the lower end of the colon. Signs and Symptoms include bloody diarrhea , abdominal cramps and pain and an inability to move the bowels in spite of the urge to do so.  3. Left sided colitis : Inflammation extends from the rectum up throw the sigmoid and descending colon. Sign and symptoms include bloody diarrhea , abdominal cramping and pain on the left side, and urgency to defecate.  4. Pan-colitis : This type often affects the entire colon and causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, Fatigue, and significant weight loss.

12. Clinical features/ Signs and symptoms of ulcerative colitis The most common symptoms of ulcerative colitis include:  Abdominal pain  Diarrhea   Rectal bleeding Fatigue Weight loss  Fever  Night sweats  Joint pain  Skin lesions Abdominal pain Urgency to have a bowel movement Tenesmus (a feeling of incomplete bowel emptying)

13. Causes of ulcerative colitis   The exact cause of ulcerative colitis is unknown. It is thought to be caused by a combination of genetic and environmental factors.  People with a family history of IBD are more likely to develop ulcerative colitis.  Ulcerative colitis may also be triggered by certain infections or medications.  Risk factors for ulcerative colitis:  There are several factors that can increase your risk of developing ulcerative colitis, including:  Age: Ulcerative colitis is most common in people between the ages of 15 and 35.    Family history: People with a family history of ulcerative colitis or Crohn's disease are at increased risk of developing the disease.    Race: Ulcerative colitis is more common in people of Ashkenazi Jewish descent. Smoking: Smoking increases the risk of developing ulcerative colitis and makes it more difficult to treat.

14. Complications of ulcerative colitis  The complications of ulcerative colitis are classified into two types , they are-  1.Intestinal  2. Extraintestinal  Intestinal complications of ulcerative colitis are- Hemorrage , Strictures perforation, toxic megacolon and colonic dilation.  Extraintestinal complications of ulcerative colitis are those that occur outside the gastrointestinal tract. These include anemia , mouth sores, inflammation of the eyes or joints (arthritis), osteoporosis, skin conditions, liver conditions, and cancer.

15. Pathophysiology of ulcerative colitis   To begin with multiple ulcers, with proctitis and colitis     These ulcers extend into the deeper layer                     Spasm of the bowel                    Stricture of the colon              Permanently contracted colon  In between ulcers, epithelial thickening occurs which appears like polyps.                          Pseudopolyposis

16. Diagnosis of ulcerative colitis Some tests that may be helpful in diagnosing ulcerative colitis include:   • Stool tests: These tests can check for blood, mucus, or pus in your stool.   • Colonoscopy: This is a procedure that allows your doctor to see the inside of your colon and rectum. Sigmoidoscopy: This is a procedure that allows your doctor to see the inside of your lower colon and rectum. Biopsy: This is a procedure that removes a small sample of tissue from your colon and rectum so that it can be tested for ulcerative colitis. 

17. And some Imaging scans make the gut regions visible to identify inflammation. These are- Magnetic Resonance  Enterography  (MRE) . ​ CT scan of the abdomen may be carried out if ulcerative colitis is suspected and can differentiate UC from Crohn’s disease.  ​ Plain X-rays rule out significant complications such as a megacolon or a perforated colon and are useful as a first-line imaging modality. ​ Double-contrast barium enema can detect early mucosal changes.​

18. Treatment of ulcerative colitis   There is no cure for ulcerative colitis, but there are a number of treatments that can help to control the symptoms and prevent complications. The type of treatment will vary depending on the severity of the symptoms.  Mild to moderate ulcerative colitis may be treated with medication, such as:  Anti-inflammatory drugs  Immunosuppressants  Antibiotics  •Probiotics 

19. Medication  There are several types of medication that can be used to treat ulcerative colitis. These medications work by reducing inflammation in the colon and rectum. Some of the most common types of medication used to treat ulcerative colitis including- Aminosalicylates : These medications are available in oral and topical forms. They work by reducing inflammation in the colon and rectum. Corticosteroids: These medications are available in oral and rectal forms. They work by reducing inflammation in the colon and rectum.  Immunomodulators: These medications work by suppressing the immune system. They are typically used to treat people who have not responded to other medications.  Biologics: These medications are a newer type of treatment that work by targeting specific proteins in the body that are involved in inflammation.

20. Treatment for Severe ulcerative colitis  Severe ulcerative colitis may require more aggressive treatment, such as:  • Hospitalization  • Intravenous medication  • Surgery  Surgery  Surgery may be recommended for patients who have stopped responding to their medication. Other patients choose to undergo surgery to improve their quality of life. Some patients become dangerously ill and require emergency surgery.

21. Ulcerative Colitis Surgical Procedure The standard surgical procedure to treat ulcerative colitis is a proctocolectomy. This surgery removes both your colon and your rectum (collectively called the large intestine).  There are two types of proctocolectomy procedures used to treat ulcerative colitis. 1. Proctocolectomy with ileal pouch-anal anastomosis : Removal of the colon and rectum, and creation of an internal pouch that eliminates the need for a permanent external ostomy. 2. Proctocolectomy with end ileostomy: Removal of the colon, rectum, and anus and creation of an external ostomy.

22. Nursing Process and Management of Ulcerative Colitis ​

23. Nursing Management of Ulcerative Colitis  A Holistic Approach Nursing plays a crucial role in supporting patients with Ulcerative Colitis (UC) , a chronic inflammatory bowel disease affecting the colon. Here's an overview of nursing management for UC ,   1. Assessment:  Medical history: Gather details about symptom onset, severity, flares, past surgeries, medications, allergies, and family history of IBD. Physical examination: Assess vital signs, abdominal pain/tenderness, stool characteristics (frequency, consistency, blood, mucus), and signs of dehydration or malnutrition. Psychosocial assessment: Evaluate the emotional impact of UC, coping mechanisms, support systems, ability to manage daily activities, and concerns about body image and intimacy. Diagnostic tests: Stool tests, blood tests, colonoscopy, and biopsies may be needed to confirm diagnosis and assess disease severity. 

24. 2. Nursing Diagnoses:  Based on the assessment, common nursing diagnoses for UC patients might include:  Acute pain related to inflammation.  Impaired elimination ( diarrhea ) related to colonic inflammation.   Activity intolerance related to fatigue and malnutrition .  Deficient knowledge about UC and its management.  Anxiety related to the unpredictable disease course and potential complications.

25. Care Planning and Implementation:   The care plan should address the identified diagnoses and focus on:  Pain management: Medications and non-pharmacological interventions like heat therapy or massage.  Symptoms management Diarrhea management: Antidiarrheal medications and dietary modifications.  Nutritional support: Ensuring adequate calorie and fluid intake through dietary counseling or enteral/parenteral nutrition.  Education:   Providing clear information about UC, medications , disease managemen t strategies, and potential complications .  Encouraging self-monitoring of symptoms and triggers. Teaching coping mechanisms for stress and anxiety

26. Psychosocial support:   Connecting patients with support groups or individual therapy.  Addressing concerns about body image and intimacy.  Promoting adherence to treatment and fostering a positive outlook. 4. Monitoring and Evaluation:  Regularly monitor the patient's response to treatment and any changes in symptoms, including:  Pain control and medication effectiveness.  Stool frequency and consistency.  Nutritional status and hydration.  Adherence to medication and dietary recommendations.  Potential complications like dehydration, electrolyte imbalances, and anemia .

27. Preventive measures of ulcerative colitis  There is no specific diet that can cure ulcerative colitis. However, there are some foods that may trigger symptoms, so it is important to identify and avoid these foods. Some common triggers include: Spicy foods  Fatty foods Dairy products  Alcohol Carbonated Drinks  Lifestyle changes  There are several lifestyle changes that can help to manage the symptoms of ulcerative colitis and prevent complications. These changes include:   Getting enough rest  Managing stress   Quitting smoking  Exercising regularly

28. Not drinking carbonated drinks. Not eating high fiber foods. Such as pop corn , vegetable skin and nuts. Drinking more liquids.  Eating more frequent, smaller meals Keeping a food diary that identities foods that cause symptoms.  Ulcerative colitis is a serious but manageable condition. With the right treatment and lifestyle changes, most people with ulcerative colitis can live long and healthy lives.

29. Conclusion Nurses work closely with physicians, dietitians, and other healthcare professionals to provide comprehensive care for UC patients.  Remember:  Each UC patient is unique, and the nursing approach should be individualized based on their specific needs and circumstances. Building trust and rapport with the patient is essential for effective communication and adherence to treatment plans.  Compassion, empathy, and active listening are crucial in supporting patients through the challenges of living with UC.  By providing holistic care that addresses physical, emotional, and social needs, nurses can significantly improve the quality of life for people living with Ulcerative Colitis.

30. References https://en.wikipedia.org/wiki/Ulcerative_colitis https://www.uptodate.com/contents/ulcerative-colitis-beyond-the-basics https://www.wikidoc.org/index.php/Ulcerative_colitis_history_and_symptoms Download/ A_Child_with_Ulcerative_Colitis_case study https://www.cureus.com/articles/160367-quality-of-life-of-patients-with-inflammatory-bowel-disease-in-bangladesh#!/ https://bard.google.com/chat/1b7a1cf952e6beff Copilot with GPT-4 (bing.com)

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