HEALTH ASSESSMENT OF A PATIENT WITH CROHNS DISEASECrohn’s disease is a chronic bowel inflammatory

HEALTH ASSESSMENT OF A PATIENT WITH CROHNS DISEASE

Crohn’s disease is a chronic bowel inflammatory disease. Some people may be symptom-free while others can have severe chronic symptoms. Crohn’s disease can sometimes cause life-threatening complications. Necessary information would need to be obtained from the patient through a health assessment and diagnostic tests. It is a chronic illness that does not have a cure and requires advanced care and ethical issues consideration. The information from the patient also plays a vital role in the management of Crohn’s disease.

Management of Crohn’s Disease requires an expert level of knowledge from a dedicated Nurse Specialist. The nurse should educate the patient to enhance confidence in the treatment plan. This increases drug persistence and adherence rates.  The nurse should advise the patient on the use of biosimilars to reduce the cost of treatment. Reassurance and ensuring patient comfort minimizes anxiety, enhances patient collaboration and promotes patient healing. Mental, emotional support in the form of empathy, showing care and giving a sense of security to this patient whose self-care is compromised.

Diagnosis of Crohn’s disease requires a comprehensive evaluation of biological, clinical, and psychosocial aspects of the disease. In a study by Lightner (2018) in the Bowel Inflammatory Diseases, the diagnosis of Crohn’s disease is often made after the completion of cross-sectional imaging. Laboratory tests are useful for diagnosing Crohn’s disease, assessing disease activity, monitoring response to therapy, and identifying complications. Symptoms of Crohn’s illness are fatigue, blood in the stool, anal drainage in the event of fistulas and abdominal pain. These symptoms, however, are not disease-specific.

There is no clear clinical feature that helps in the diagnosis of Crohn’s disease. The nurse should assess for complications/red-flag signs. These are bleeding, weight loss and anemia. The nurse should assess for diarrhea, fever, fatigue, abdominal pain and blood in the stool. The nurse assesses the skin, joints and eyes for extra-intestinal symptoms. The nurse also assesses the level of anxiety and depression. They are the most common psychosocial problems in Crohn’s disease.

Management of Crohn’s disease is a complex process. Complex diagnostic methods are required. This makes management expensive. It is a chronic illness requiring palliative care. Health care providers should pay attention to the psychosocial needs of the patient and consider the patient’s financial status when determining the method of management.

References

• Lightner, A. L. (2018). Duodenal Crohn’s disease. Inflammatory Bowel Diseases, 24(3), 546-551. https://academic.oup.com/ibdjournal/article-abstract/24/3/546/4863718
• Lichtenstein, G. R., Loftus, E. V., Isaacs, K. L., Regueiro, M. D., Gerson, L. B., & Sands, B. E. (2018). ACG Clinical Guideline: Management of Crohn’s disease in adults. American Journal of Gastroenterology, 113(4), 481-517. https://journals.lww.com/ajg/Fulltext/2018/04000/ACG_Clinical_Guideline__Management_of_Crohn_s.10.aspx?context=FeaturedArticles&collectionId=2
• Torres, J., Bonovas, S., Doherty, G., Kucharzik, T., Gisbert, J. P., Raine, T., … & Biancone, L. (2020). ECCO Guidelines on Therapeutics in Crohn’s Disease: medical treatment. Journal of Crohn’s and Colitis, 14(1), 4-22. https://academic.oup.com/ecco-jcc/article-abstract/14/1/4/5620479

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