inflammatory%20bowel%20disease
INFLAMMATORY BOWEL DISEASE
Inflammatory bowel disease consists of ulcerative colitis and Crohn's disease.
Ulcerative colitis is a diffuse mucosal inflammation limited to the colon while Crohn's disease is a patchy, transmural inflammation that occurs in any part of the gastrointestinal tract.
The ileum and colon are the most frequently affected sites.

Supportive Therapy

Hospital Management for Severe Ulcerative Colitis
  • IV fluid and electrolyte replacement to correct and prevent dehydration or electrolyte imbalance, with blood transfusion to maintain a hemoglobin of >10 g/dL
  • Withdrawal of anticholinergics, antidiarrheal agents
  • Controlled trials failed to demonstrate therapeutic benefit of administering antibiotics; however, there are protocols that recommend administration of broad-spectrum antibiotics in patients with severe UC who have signs of toxicity or with worsening condition despite maximal medical therapy
  • SC Heparin may be given to reduce the risk of thromboembolism
  • Total parenteral nutrition is needed if patient is significantly malnourished

 

Supportive Therapy for Severe to Fulminant Crohn's Disease
  • If patient is unable to maintain nutritional requirements for 5-7 days, nutritional support via elemental feeding or parenteral hyperalimentation is indicated
  • Dehydrated patients should receive fluid and electrolytes as necessary
  • Transfusions may be necessary for anemia and active hemorrhage
  • Oral feeding should continue as tolerated in patients without evidence of intestinal obstruction
  • Severely ill patients or those with obstruction should have bowel rest and parenteral support
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