This NCLEX review will discuss Crohn’s Disease vs. Ulcerative Colitis.
As a nursing student, you must be familiar with the similarities and differences between Crohn’s Disease and ulcerative colitis along with their complications, major signs and symptoms, and treatments.
These type of questions may be found on NCLEX and definitely on nursing lecture exams.
Don’t forget to take the Crohn’s Disease vs Ulcerative Colits Quiz.
You will learn the following from this NCLEX review:
- Similarities between Crohn’s and Ulcerative Colitis
- Differences between Crohn’s and Ulcerative Colitis
Lecture on Crohn’s Disease vs. Ulcerative Colitis
NCLEX Review on Crohn’s vs. Ulcerative Colitis
Similarities
- Both are a form of IBD (inflammatory bowel disease)…not IBS (irritable bowel syndrome)
- Patient will have periods of flare-ups and remission
- Cause unknown but it may be due to a faulty immune system in OVERDRIVE that causes the gut to become inflamed…..may be triggered by the environment (foods…dairy, illness viral/bacterial, stress, NSAIDs)
- Causes inflammation and ulcer formation
- There are various types depending on location:
- Crohn’s Disease…ex: ileocolitis: inflammation in ileum and colon or Ulcerative Colitis…ex: pancolitis: inflammation of the entire large intestine
- Increased risk of colon cancer
- Diet Education:
- Watch foods that can cause a “flare-up” or should be avoided during a “flare-up”:
- High-fiber foods (they require a lot of digestion and the gut needs to rest)
- Food hard to digest like: nuts, raw vegetables or fruits (cooked are better)
- Allergen type foods: dairy or certain foods that the person may be intolerant too like wheat, fish and spicy avoid, high-fat foods, gluten, gas causing foods like onions, beans etc.
- Foods to eat during “flare-up” or to prevent one:
- Low fiber (easier on the gut to digest), high-protein and stay hydrated
- Watch foods that can cause a “flare-up” or should be avoided during a “flare-up”:
- Medications treatment tends to be the same:
- Anti-inflammatories: (5-aminosalicyates and corticosteroids)
- Immune suppressors (Azathioprine)/biologic type (Adalimumab or Inflixamib)
Differences
Crohn’s Disease
- Affects the whole GI tract from mouth the anus to the small/large intestine…most common is in the terminal ileum and start of the colon
- Affects ALL the bowel wall from mucosa to serosa (which is why you will see those unique complications)
- Found in scattered patches (not continuous fashion)…can find healthy lining among diseased lining…will give it a cobble-stone appearance when the patient is scoped
- No cure…managed with surgeries which helps increase the quality of life and decrease symptoms…bowel resection, or partial/total removal of the colon with ileostomy placement along with medications and diet
- Complications:
Abscessing Fistulas May Form Sepsis“
Abscesses
Fistulas
Malnourishment
Fissures (most commonly anal)
Strictures/obstructions
*other: ulcers in mouth, GI Tract, inflammation in the joints, eye, skin, and liver
Symptoms:
- diarrhea (may contain blood but more common with ulcerative colitis)
- abdominal cramping (common in the right lower side)
- ulcers in mouth along with other areas in GI tract
- anal fissures
- weight loss (more common in Crohn’s Disease than ulcerative colitis because the small intestine is inflamed and is responsible for absorbing the most nutrients)
Ulcerative Colitis
- Affects only the large intestine…very rarely the small intestine is involved
- Affects the inner layer of the intestinal lining (mucosa to submucosa)
- Starts in the rectum and migrates in a continuous fashion all through the colon…the more severe the disease, the more the disease will migrate throughout the large intestine until it affects it all
- Only cure is colectomy (complete removal of the large intestine/colon) with permanent ileostomy placement or Ileoanal anastomosis (J-pouch surgery): the colon and rectum are removed and a pouch is created that is attached to the ileum to allow stool to pass from the small intestine to the anus (so no outside ostomy is created)…also managed with medications and diet
- Complications:
- rupture of the bowel which leads to peritonitis
- toxic megacolon (dilation of the large intestine due to massive inflammation…it dilates and becomes paralyzed..can’t function…eventually ruptures)
- loss of form to haustra of the large intestine which will display as a lead pipe-sign on barium enema
- weight-loss and dehydration: patient can not absorb water or other nutrients because large intestine is inflamed
- anemia from bleeding ulcers
- immune system can also cause inflammation in the joints, eye, skin, and liver
- Symptoms
“Ulcers”
Urgent/frequent need to have bowel movements
Loss of weight due to constant diarrhea, Low red blood cells (anemia)
Cramps in abdomen (very painful)
Electrolyte imbalances, elevated temperature
Rectal bleeding
Severe diarrhea with pus, blood, mucous
More NCLEX Reviews
References:
- Ulcerative Colitis | NIDDK. (2014). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 8 March 2017, from https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis
- Crohn’s Disease | NIDDK. (2016, November). Retrieved March 08, 2017, from https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease