Inflammatory Bowel Disease (Crohn's vs UC): NCLEX Priorities
Crohn's vs ulcerative colitis: location, pattern, complications, treatments.
IBD comprises Crohn's and UC. NCLEX tests the distinguishing features and complications.
Crohn's
Mouth to anus, skip lesions, transmural. RLQ pain, weight loss, fistulas, strictures, perianal disease. Increased colon cancer risk.
Ulcerative colitis
Colon only, continuous, mucosal. Bloody diarrhea, LLQ pain, tenesmus. Toxic megacolon risk. Increased colon cancer risk.
Treatment
5-ASA (sulfasalazine, mesalamine), UC mainstay. Steroids for flares. Immunomodulators (azathioprine, methotrexate). Biologics (infliximab, adalimumab, ustekinumab, vedolizumab). Surgery curative for UC (colectomy).
Nutrition
Low residue during flare. B12 supplementation in terminal ileum disease. Iron for anemia.
Frequently asked
Toxic megacolon, manage how?
NPO, NG decompression, IV fluids, IV steroids, possible surgery. Don't barium enema (perforation risk).
Smoking and IBD?
Worsens Crohn's, may be protective for UC (don't recommend smoking).
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