POST # 1 ELIZABETH
Note: In your reply consider elaborating on the statement — The potential to develop anemia from vitamin B-12 and iron malabsorption can be an issue for patients fighting Crohn disease (Mayo Clinic, 2020).
Case Study D: Crohn Disease
This case study includes patient Mr. P.T., a nineteen-year-old male that has been experiencing symptoms of Crohn’s disease for five years. The case study mentions that this patient has a family history of this disease. The purpose of this case study is to examine the pathophysiologic components of Crohn’s disease, its exacerbating factors, and any nutritional deficits that may contribute to this disease process.
● Describe the pathophysiology of Crohn disease.
According to VanMeter & Hubert (2014), Cronh’s disease is an inflammatory bowel disease that affects the digestive tract and occurs typically in the small intestine. From a pathophysiological perspective, the terminal ileum and ascending colon are most impacted by Cronh’s disease (VanMeter & Hubert, 2014). Creating an inflammatory response in the digestive tract, the effects of this disease spreads into the deep layers of the bowel (Mayo Clinic, 2020). This disease begins as a lesion that infiltrates an intestinal crypt, creating an ulceration that moves from the superficial mucosa into the deep layers of the bowel (Ranasinghe & Hsu, 2020). With continued inflammation, granulomas form within all intestinal wall layers (Ranasinghe & Hsu, 2020). The cobblestone appearance is commonly found through visualization via colonoscopy, flexible sigmoidoscopy, and imaging scans (Johns Hopkins, 2020). Scarring occurs on the intestinal walls where inflammation has resolved (Ranasinghe & Hsu, 2020). The cause of Crohn’s disease is not clearly known, but healthcare providers who have suspected stress and diet to be a trigger for the body’s response, now attribute heredity and a malfunctioning immune system as components of this disease process (Mayo Clinic, 2020). The body’s immune system recognizes the microorganism, begins to attack it, and inflammation occurs (Mayo Clinic, 2020). Heredity is a factor contributing to Crohn’s, making a person with this genetic component more susceptible to the disease (Mayo Clinic, 2020).
● Suggest several possible exacerbating factors for Crohn disease.
This multifactorial disease has exacerbating factors that include cramping, diarrhea, and abdominal pain (VanMeter & Hubert, 2014). Tenderness and pain are typically felt in the right lower and center portion of the abdomen (VanMeter & Hubert, 2014). Additional risk factors include age, ethnicity, smoking, and nonsteroidal anti-inflammatory medications (Mayo Clinic, 2020). Although NSAIDs are not a direct cause of Crohn disease, the inflammatory process that can occur with these medications exacerbates this condition (Mayo Clinic, 2020).
● Explain how nutritional deﬁcits may occur with Crohn disease.
Patients with Crohn’s disease may suffer from complications of malnutrition and malabsorption resulting in fatigue, anemia, weight loss, decreased appetite, and anorexia (Mayo Clinic, 2020). Damage to the wall of the intestinal tract reduces the body’s ability to absorb and digest food (VanMeter & Hubert, 2014). Abscesses can form due to the malabsorption issues related to Crohn disease (VanMeter & Hubert, 2014). The potential to develop anemia from vitamin B-12 and iron malabsorption can be an issue for patients fighting Crohn disease (Mayo Clinic, 2020).
Johns Hopkins. (2020). Crohn’s Disease. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/crohns-disease
Mayo Clinic. (2020). Crohn’s disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304
Ranasinghe, I. R. & Hsu, R. (2020). Crohn Disease. In StatPearls. StatPearls Publishing.
VanMeter, K. C. & Hubert, R. J. (2014). Gould’s pathophysiology for the health professions. St. Louis, MO: Elsevier Saunders. ISBN 13-978-1455754113