Crohn vs UC
Crohn: transmural, any GI tract, skip lesions, fistulas, strictures. UC: mucosal, continuous from rectum, limited to colon, bloody diarrhea. Both: remission/exacerbation. Increased colon cancer risk.
Pharmacotherapy
Mild-moderate: 5-ASA (mesalamine). Moderate-severe: corticosteroids, immunomodulators (azathioprine), biologics (infliximab, adalimumab). Antibiotics for Crohn. Anti-diarrheals (avoid in severe flare — toxic megacolon risk).
Nursing Care
Nutrition: high-calorie, high-protein, low-residue during flares. Monitor dehydration/electrolytes. Teach med adherence and immunosuppression risks. Screen for depression. Surgery: colectomy curative for UC. Ostomy education.
Important Notes
- Toxic megacolon is life-threatening — watch for abdominal distension, fever, tachycardia.
- Anti-diarrheals contraindicated in severe UC flares — can precipitate toxic megacolon.
Clinical Tips
- Stress and diet can trigger flares — teach patients to identify triggers.
- Biologic therapy requires TB screening before initiation — reactivation is a risk.
Summary
IBD management combines anti-inflammatory/immunosuppressive medications, nutritional support, and surgical intervention for complications.
