Treatments for Ulcerative colitis
Treatments for Ulcerative colitis:
There is currently no cure for ulcerative colitis. The good news is that major medical advances in the last decade have made big strides in expanding and improving treatment for ulcerative colitis. The overall treatment goal for people living with ulcerative colitis is to control symptoms to a degree that allows them to feel better and live the most normal, healthy, and active life as possible. This includes inducing and maintaining the longest possible periods of remission (the absence of active disease). It is possible to achieve remissions of months or even years, although symptoms do tend to recur. Treating ulcerative colitis and achieving remission involves controlling colon inflammation, ensuring good nutrition and hydration, and relieving and treating symptoms, such as abdominal pain and bloody diarrhea. For the best outcome for your individual case of ulcerative colitis, it is important to get a referral to a qualified gastroenterologist who is experienced in treating people with ulcerative colitis. In conjunction with this specialist, you will develop an individualized treatment plan that best fits your type and severity of ulcerative colitis, your goals, and your life style. The plan will also be based on your complete medical history, severity of the disease, coexisting complications, such as bleeding, and your response to prior treatments.
The most effect treatment plans include a multifaceted approach. One facet of treatment is the use of medications. After a complete evaluation, your health care provider will decide what medication or combination of medications will work best for you. Prescribed medications commonly include aminosalicylates, drugs that contain 5-aminosalicyclic acid (5-ASA). These medications help control inflammation and may be given orally, through an enema, or in a suppository, depending on the location of the inflammation in the colon. 5-ASAs are usually first prescribed to people with mild or moderate ulcerative colitis, and they are also used when ulcerative colitis symptoms recur. Ulcerative colitis may also be treated with corticosteroids, including prednisone. Corticosteroids are very effective in reducing inflammation and controlling symptoms, but can have serious side effects, such as increased susceptibility to infection. They are generally used for short-term treatment in people who have moderate to severe ulcerative colitis or for those who do not respond to 5-ASA medications. For patients whose symptoms do not respond to 5-ASAs medications or corticosteroids, immunomodulators such as azathioprine and 6-mercapto-purine (6-MP) may be used. These drugs also reduce inflammation. There are serious potential side effects and complications that are associated with these drugs, including pancreatitis, hepatitis, and an increased risk of infection. Immunomodulators are slow acting and patients need close medical monitoring while taking these medications.
It is very important that any medications for ulcerative colitis be taken exactly as directed, that you immediately notify your gastroenterologist or health care provider if you experience any side effects, and that you ensure that all your health care providers, including the dentist, are aware of your diagnosis of ulcerative colitis and all your medications.
Treatment may also include medications that have an anti-diarrheal effect, relieve pain, and treat infections that can develop in the colon and elsewhere. If symptoms become severe, hospitalization may be necessary. This may be due to bleeding, colon rupture, or diarrhea that is severe enough to cause dehydration and electrolyte imbalances. Intravenous rehydration and electrolyte replacement therapy may be needed. Many people with ulcerative colitis also need surgery at some point in their lives. About 25%-40% of people with ulcerative colitis eventually have their colons surgically removed because of these serious life-threatening complications, including colon rupture and hemorrhage (massive bleeding). The complete removal of the large intestine is called a colectomy, which may also be performed in some cases when other treatments have failed or if side effects of medications are not tolerable or become dangerous. Depending on the individual case, surgery may include removing the colon and rectum, (proctocolectomy). In this case, the surgeon will make a small opening in the abdomen (a stoma) for waste to leave the body. This is called an ileostomy. With an ileostomy, stool will then be caught in a pouch worn over the stoma. In another procedure, the lowest portion of rectum is left intact when the colon and upper portion of the rectum is removed. Then the lower part of the small intestine is attached to the rectum, where waste products will leave the body. This is called an ileoanal anastomosis. This surgery allows for elimination through the anus, although stool may be more loose and occur more often than normal. The decision and type of surgery should be a decision you make in conjunction with your health care team, including your primary care provider, gastroenterologist, and nurses who specialize in enterostomal therapy. It will be based on you particular case and presentation of ulcerative colitis, your needs, and lifestyle.
Treatments for Ulcerative colitis
The list of treatments mentioned in various sources
for Ulcerative colitis
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Lifestyle changes
- Oral anti-inflammatory medications
- Anti-inflammatory medications by enema
- 5-ASA agents
- Corticosteroids
- Pain relief medications
- Anti-diarrheal medications
- Iron supplements - for anemia
- Sulphasalazine
- Azathioprine
- Treatments for severe attacks:
- Surgery
- Temporary colostomy
- Proctocolectomy with Brooke ileostomy
- Proctocolectomy with continent ileostomy
- Ileoanal anastomosis
- Surgical removal of large bowel
- TNF-inhibitors - Infliximab
- 5-aminosalicylic acid derivative - sulfasalazine
- Balsalazide
- Total colectomy
- Standard treatment for ulcerative colitis depends on extent of involvement and disease severity. The goal is to induce remission initially with medications, followed by the administration of maintenance medications to prevent a relapse of the disease. The concept of induction of remission and maintenance of remission is very important. The medications used to induce and maintain a remission somewhat overlap, but the treatments are different. Physicians first direct treatment to inducing a remission which involves relief of symptoms and mucosal healing of the lining of the colon and then longer term treatment to maintain the remission
Ulcerative colitis: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Ulcerative colitis may include:
Hidden causes of Ulcerative colitis may be incorrectly diagnosed:
Ulcerative colitis: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for Ulcerative colitis:
Curable Types of Ulcerative colitis
Possibly curable types of Ulcerative colitis may include:
Ulcerative colitis: Research Doctors & Specialists
Research all specialists including ratings, affiliations, and sanctions.
Drugs and Medications used to treat Ulcerative colitis:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Ulcerative colitis include:
- Mesalamine
- Asacol
- Mesasal
- Pentasa
- Quintasa
- Rowasa
- Salofalk
- Methylprednisolone
- A-Methapred
- Depmedalone-40
- Depmedalone-80
- Depo-Medrol
- Enpak Refill
- Mar-Pred 40
- Medrol
- Medrol Acne Lotion
- Medrol Enpak
- Medrol Veriderm Cream
- Meprolone
- Neo-Medrol Acne Lotion
- Neo-Medrol Veriderm
- Rep-Pred 80
- Solu-Medrol
- Olsalazine
- Dipentum
- Prednisolone
- A&D w/Prednisolone
- Cortalone
- Delta-Cortef
- Duapred
- Fernisonone-P
- Hydelta-TBA
- Hydeltrasol
- Inflamase
- Inflamase Forte
- Key-Pred
- Meticortelone
- Meti-Derm
- Metreton
- Minims Prednisolone
- Mydrapred
- Niscort
- Nor-Pred
- Nova-Pred
- Novoprednisolone
- Optimyd
- Otobione
- Peidaject
- Pediapred
- Polypred
- Predcor
- Pred Forte
- Pred-G
- Pred Mild
- Prelone
- PSP-IV
- Savacort
- Sterane
- TBA Pred
- Prednisone
- Apo-Prednisone
- Aspred-C
- Deltasone
- Liquid Pred
- Meticorten
- Novoprednisone
- Orasone
- Panasol-S
- Paracort
- Prednicen-M
- Prednisone Intensol
- SK-Prednisone
- Sterapred
- Sterapred-DS
- Winpred
- Sulfasalazine
- Alti-Sulfasalazine
- Azaline
- Azulfidine
- Azulfidine EN-Tabs
- PMS Sulfasalazine
- PMS Sulfasalazine E.C
- Salazopyrin
- Salazopyrin EN
- SAS-Enema
- SAS Enteric-500
- SAS-500
- Sulfazine EC
- Balsalazide
- Colazal
- Hydrocortisone (rectal)
- Anucort HC
- Anusol-HC Suppository
- Colocort
- Cortifoam
- Cortizone-10
- Hemril HC
- Preparation H Hydrocortisone
- Proctocort Rectal
- ProctoCream HC
- ProctoCream HC Cream
- Proctosol-HC
- Cortenema
- Emo-Cort
- Hydrocortisone (systemic)
- A-HydroCort
- Cortef
- Hocrocortone Phosphate
- Solu-Cortef
- Auanil HC
- CaldeCORT
- Cetacprt
- Cortagel Maximum Strength
- Cortaid Intensive Therapy
- Cortaid Maximum Strength
- Cortaid Sensitive Skin With Aloe
- Corticool
- Cortizone-5
- Cortizone-10 Maximum Strength
- Cortizone-10 Plus Maximum Strength
- Cortizone 10 Quick Shot
- Cortizone for Kids
- Dermarest Dri-Cort
- Dermtex HC
- Hytone
- LactiCare-HC
- Locoid
- Nupercainal Hydrocortisone Cream
- Nutracort
- Pandel
- Post Peel Heeling Balm
- Samol-HC
- Summer's Eve SpecialCare Medicated Anti-Itch Cream
- Texacort
- Theracort
- Westcort
- Hydrocortisone (topical)
Unlabeled Drugs and Medications to treat Ulcerative colitis:
Unlabelled alternative drug treatments for Ulcerative colitis include:
Hospital statistics for Ulcerative colitis:
These medical statistics relate to hospitals, hospitalization and Ulcerative colitis:
- 0.19% (23,735) of hospital consultant episodes were for ulcerative colitis in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 82% of hospital consultant episodes for ulcerative colitis required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 52% of hospital consultant episodes for ulcerative colitis were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 48% of hospital consultant episodes for ulcerative colitis were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 23% of hospital consultant episodes for ulcerative colitis required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Hospitals & Medical Clinics: Ulcerative colitis
Research quality ratings and patient incidents/safety measures
for hospitals and medical facilities in specialties related to Ulcerative colitis:
Hospital & Clinic quality ratings » »
Choosing the Best Treatment Hospital:
More general information, not necessarily in relation to Ulcerative colitis,
on hospital and medical facility performance and surgical care quality:
Discussion of treatments for Ulcerative colitis:
Ulcerative Colitis: NIDDK (Excerpt)
Treatment for ulcerative colitis depends on the
seriousness of the disease. Most people are treated with medication. In
severe cases, a patient may need surgery to remove the diseased colon.
Surgery is the only cure for ulcerative colitis.
Some people whose symptoms are triggered by certain foods are able to
control the symptoms by avoiding foods that upset their intestines, like
highly seasoned foods or milk sugar (lactose). Each person may experience
ulcerative colitis differently, so treatment is adjusted for each
individual. Emotional and psychological support is important.
Some people have remissions--periods when the symptoms go away--that
last for months or even years. However, most patients' symptoms eventually
return. This changing pattern of the disease means one cannot always tell
when a treatment has helped.
Someone with ulcerative colitis may need medical care for some time,
with regular doctor visits to monitor the condition.
Drug Therapy
Most patients with mild or moderate disease are
first treated with 5-ASA agents, a combination of the drugs sulfonamide,
sulfapyridine, and salicylate that helps control inflammation.
Sulfasalazine is the most commonly used of these drugs. Sulfasalazine can
be used for as long as needed and can be given along with other drugs.
Patients who do not do well on sulfasalazine may respond to newer 5-ASA
agents. Possible side effects of 5-ASA preparations include nausea,
vomiting, heartburn, diarrhea, and headache.
People with severe disease and those who do not respond to mesalamine
preparations may be treated with corticosteroids. Prednisone and
hydrocortisone are two corticosteroids used to reduce inflammation. They
can be given orally, intravenously, through an enema, or in a suppository,
depending on the location of the inflammation. Corticosteroids can cause
side effects such as weight gain, acne, facial hair, hypertension, mood
swings, and increased risk of infection, so doctors carefully watch
patients taking these drugs.
Other drugs may be given to relax the patient or to relieve pain,
diarrhea, or infection.
Occasionally, symptoms are severe enough that the person must be
hospitalized. For example, a person may have severe bleeding or severe
diarrhea that causes dehydration. In such cases the doctor will try to
stop diarrhea and loss of blood, fluids, and mineral salts. The patient
may need a special diet, feeding through a vein, medications, or sometimes
surgery.
Surgery
About 25 percent to 40 percent of ulcerative colitis
patients must eventually have their colons removed because of massive
bleeding, severe illness, rupture of the colon, or risk of cancer.
Sometimes the doctor will recommend removing the colon if medical
treatment fails or if the side effects of corticosteroids or other drugs
threaten the patient's health.
One of several surgeries may be done. The most common surgery is a
proctocolectomy with ileostomy, which is done in two stages. In the
proctocolectomy, the surgeon removes the colon and rectum. In the
ileostomy, the surgeon creates a small opening in the abdomen, called a
stoma, and attaches the end of the small intestine, called the ileum, to
it. This type of ileostomy is called a Brooke ileostomy. Waste will travel
through the small intestine and exit the body through the stoma. The stoma
is about the size of a quarter and is usually located in the lower right
part of the abdomen near the beltline. A pouch is worn over the opening to
collect waste, and the patient empties the pouch as needed.
An alternative to the Brooke ileostomy is the continent ileostomy. In
this operation, the surgeon uses the ileum to create a pouch inside the
lower abdomen. Waste empties into this pouch, and the patient drains the
pouch by inserting a tube into it through a small, leakproof opening in
his or her side. The patient must wear an external pouch for only the
first few months after the operation. Possible complications of the
continent ileostomy include malfunction of the leakproof opening, which
requires surgical repair, and inflammation of the pouch (pouchitis), which
is treated with antibiotics.
An ileoanal anastomosis, or pull-through operation, allows the patient
to have normal bowel movements because it preserves part of the rectum.
This procedure is becoming increasingly common for ulcerative colitis. In
this operation, the surgeon removes the diseased part of the colon and the
inside of the rectum, leaving the outer muscles of the rectum. The surgeon
then attaches the ileum to the inside of the rectum and the anus, creating
a pouch. Waste is stored in the pouch and passed through the anus in the
usual manner. Bowel movements may be more frequent and watery than usual.
Pouchitis is a possible complication of this procedure.
Not every operation is appropriate for every person. Which surgery to
have depends on the severity of the disease and the patient's needs,
expectations, and lifestyle. People faced with this decision should get as
much information as possible by talking to their doctors, to nurses who
work with colon surgery patients (enterostomal therapists), and to other
colon surgery patients. Patient advocacy organizations can direct people
to support groups and other information resources. (See Resources
for the names of such organizations.)
Most people with ulcerative colitis will never need to have surgery. If
surgery ever does become necessary, however, some people find comfort in
knowing that after the surgery, the colitis is cured and most people go on
to live normal, active lives.
(Source: excerpt from Ulcerative Colitis: NIDDK)
Ileostomy, Colostomy, and Ileoanal Reservoir Surgery: NIDDK (Excerpt)
Sometimes treatment for Crohn's disease,
ulcerative colitis, and familial adenomatous polyposis involves removing
all or part of the intestines. When the intestines are removed, the body
needs a new way for stool to leave the body, so the surgeon creates an
opening in the abdomen for stool to pass through. The surgery to create
the new opening is called ostomy. The opening is called a stoma.
(Source: excerpt from Ileostomy, Colostomy, and Ileoanal Reservoir Surgery: NIDDK)
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Bowel sounds, hyperactive:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
After detecting hyperactive bowel sounds, quickly check the patient's vital signs and ask him about associated symptoms, such as abdominal pain, vomiting, and diarrhea. If he reports cramping abdominal pain or vomiting, continue to auscultate for bowel sounds. If bowel sounds stop abruptly, suspect complete bowel obstruction. Prepare to assist with GI suction and decompression, to give I.V. fluids and electrolytes, and prepare the patient for surgery.
If he has diarrhea, record its frequency, amount, color, and consistency. If you detect excessive watery diarrhea or bleeding, prepare to administer an antidiarrheal, I.V. fluids and electrolytes and, possibly, blood transfusions.
GENDER CUE:Homosexual males who report acute diarrhea and who have negative fecal ova and parasite cultures may be infected with chlamydial proctitis not associated with lymphogranuloma venereum. Because rectal cultures will probably be negative, treatment with tetracycline is appropriate.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Intestinal obstruction:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Surgery, nasogastric tube, total parenteral nutrition, supportive care (I.V. fluids, bed rest)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Ulcerative colitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The goals of treatment are to control inflammation, replace nutritional losses and blood volume, and prevent complications. Supportive treatment includes bed rest, I.V. fluid replacement, and a clear-liquid diet. For patients awaiting surgery or showing signs of dehydration and debilitation from excessive diarrhea, total parenteral nutrition (TPN) rests the intestinal tract, decreases stool volume, and restores positive nitrogen balance. Blood transfusions or iron supplements may be needed to correct anemia.
Immunomodulators or 5-aminosalicylates may be used to decrease the frequency of attacks. Drug therapy to control inflammation includes steroids. Antispasmodics and antidiarrheals are used only in patients whose ulcerative colitis is under control but who have frequent, loose stools.
Alert Antispasmodics and antidiarrheals may precipitate massive dilation of the colon (toxic megacolon) and are generally contraindicated.
Surgery is the last resort if the patient has toxic megacolon, fails to respond to drugs and supportive measures, or finds symptoms unbearable. A common surgical technique is proctocolectomy with ileostomy. Another procedure, the ileoanal pull-through, is being performed in more cases. This procedure entails performing a total proctocolectomy and mucosal stripping, creating a pouch from the terminal ileum, and anastomosing the pouch to the anal canal. A temporary ileostomy is created to divert stool and allow the rectal anastomosis to heal. The ileostomy is closed in 2 to 3 months, and the patient can then evacuate stool rectally. This procedure removes all the potentially malignant epithelia of the rectum and colon. Total colectomy and ileorectal anastomosis isn’t as common because of its mortality rate (2% to 5%). This procedure removes the entire colon and anastomoses the terminal ileum to the rectum; it requires observation of the remaining rectal stump for any signs of cancer or colitis.
Pouch ileostomy (Kock pouch or continent ileostomy), in which the surgeon creates a pouch from a small loop of the terminal ileum and a nipple valve from the distal ileum, may be an option. The resulting stoma opens just above the pubic hairline and the pouch is emptied periodically through a catheter inserted in the stoma. In ulcerative colitis, a colectomy may be performed after 10 years of active disease because of the increased incidence of colon cancer in these cases. Performing a partial colectomy to prevent colon cancer is controversial.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Bowel sounds, hyperactive:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
After detecting hyperactive bowel sounds, quickly check vital signs and ask the patient about associated symptoms, such as abdominal pain, vomiting, and diarrhea. If he reports cramping abdominal pain or vomiting, continue to auscultate for bowel sounds. If bowel sounds stop abruptly, suspect complete bowel obstruction. Prepare to assist with GI suction and decompression and to give I.V. fluids and electrolytes, and prepare the patient for surgery.
If the patient has diarrhea, record its frequency, amount, color, and consistency. If you detect excessive watery diarrhea or bleeding, prepare to administer an antidiarrheal, I.V. fluids and electrolytes and, possibly, blood transfusions.
Gender Cue: Homosexual males who report acute diarrhea and who have negative fecal ova and parasite cultures may be infected with chlamydial proctitis not associated with lymphogranuloma venereum. Because rectal cultures will probably be negative, treatment with tetracycline is appropriate.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Intestinal obstruction:
Treatment
(Handbook of Diseases)
Initial therapy involves correcting fluid and electrolyte imbalances, resting the bowel by decompressing it to relieve vomiting and distention, maintaining nothing by mouth status, and treating shock and peritonitis. A strangulated obstruction usually necessitates blood replacement as well as I.V. fluid administration. Nasogastric tube suction is necessary to relieve vomiting and abdominal distention.
Close monitoring of the patient’s condition determines the duration of treatment; if the patient fails to improve or if his condition deteriorates, surgery is necessary. Surgery is performed on all patients with large-bowel obstruction.
Total parenteral nutrition may be appropriate if the patient suffers a protein deficit from chronic obstruction, postoperative or paralytic ileus, or infection.
Drug therapy includes an analgesic and a sedative. An antibiotic is given for peritonitis due to bowel strangulation or infarction. A broad-spectrum antibiotic should be given to provide anaerobic and gram-negative coverage.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Ulcerative colitis:
Treatment
(Handbook of Diseases)
The goals of treatment are to relieve symptoms of the acute attack and prevent recurrent attacks, to replace nutritional losses and blood volume, and to prevent complications.
Supportive treatment includes I.V. fluid replacement and a clear-liquid diet. For patients awaiting surgery or showing signs of dehydration and debilitation from excessive diarrhea, total parenteral nutrition rests the intestinal tract, decreases stool volume, and restores positive nitrogen balance. Blood transfusions or iron supplements may be necessary to correct anemia.
Drug therapy
Medications to control inflammation include corticotropin and adrenal corticosteroids, such as prednisone, prednisolone, and hydrocortisone; sulfasalazine, which has antiinflammatory and antimicrobial properties, may also be used. Options to decrease attacks include 5-aminosalicylates such as mesalamine and immunomodulators such as azathioprine, 6-mercaptopurine.
UNDER STUDY: Dehydroepiandrosterone is a steroid hormone that’s marketed as an over-the-counter drug in the United States. In pilot studies, it was proven safe to use in patients with ulcerative colitis. Dosage adjustments may further improve treatment outcomes.
Patients with mild to moderate disease may eat a regular diet, excluding caffeinated beverages and gas-producing foods. Anticholinergics and a low-roughage diet without milk or milk products may be used to reduce bowel movement frequency. Fiber supplementation may be used to control diarrhea and rectal symptoms. Antidiarrheal agents should be used only in patients with mild symptoms, not in those with the acute phase of this illness.
Patients with disease primarily affecting the rectum or rectosigmoid should be managed with topical agents such as mesalamine. Topical steroids may be used, but they may be less effective.
Patients with mild to moderate disease extending above the sigmoid colon who fail to improve after 2 to 3 weeks on sulfasalazine or mesalamine should have a corticosteroid added to their regimen.
Severe colitis is usually managed with nothing-by-mouth status and parenteral alimentation. Volumizers and blood should be provided as needed. Surgical consultation should be obtained in all patients with severe disease.
Surgery
Surgery is recommended for patients who have toxic megacolon or who fail to respond to drugs and supportive measures.
The ileoanal restorative proctocolectomy with ileoanal pouch anastomosis is being performed more frequently. This procedure entails performing a total proctocolectomy, creating a pouch from the terminal ileum, and anastomosing the pouch to the anal canal. A temporary ileostomy is created to divert stools and allow the rectal anastomosis to heal. This technique is now more common than total proctocolectomy with ileostomy. The ileostomy is closed in 2 to 3 months.
Total proctocolectomy (with ileostomy) provides complete cure of disease. However, the patient’s self-image and social interactions may be affected by wearing an external appliance.
Pouch ileostomy (Kock pouch or continent ileostomy), in which the surgeon creates a pouch from a small loop of the terminal ileum and a nipple valve from the distal ileum, may be an option. The resulting stoma opens just above the pubic hairline, and the pouch empties periodically through a catheter inserted in the stoma. Patients may experience six or more bowel movements per day. A low-residue diet should be maintained to promote pouch adaptation. Patients may also need bulking agents or antidiarrheals to slow stool output. This procedure is performed less often now than in the past.
A colectomy may be performed after 10 years of active ulcerative colitis because of the increased incidence of colon cancer in these patients. Performing a partial colectomy to prevent colon cancer is controversial.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Bowel sounds, hyperactive:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Obtain the patient’s vital signs. Prepare him for diagnostic tests. These may include endoscopy to view a suspected lesion, barium X-rays, computed tomography scan, or stool analysis.
Monitor intake and output closely. If diarrhea is present, monitor for signs and symptoms of dehydration.
Patient teaching
Explain prescribed dietary changes to the patient. These may range from complete food and fluid restrictions to a liquid or bland diet. Because stress commonly precipitates or aggravates bowel hyperactivity, teach the patient relaxation techniques such as deep breathing. Encourage rest and restrict the patient’s physical activity.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Bowel sounds, hyperactive:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
After detecting hyperactive bowel sounds, quickly check the patient’s vital signs and ask him about associated symptoms, such as abdominal pain, vomiting, and diarrhea. If he reports cramping abdominal pain or vomiting, continue to auscultate for bowel sounds. If bowel sounds stop abruptly, suspect complete bowel obstruction. Prepare to assist with GI suction and decompression, to give I.V. fluids and electrolytes, and prepare the patient for surgery.
If he has diarrhea, record its frequency, amount, color, and consistency. If you detect excessive watery diarrhea or bleeding, prepare to administer an antidiarrheal, I.V. fluids and electrolytes and, possibly, blood transfusions.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Bowel sounds, hyperactive:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, such as laboratory studies, imaging studies, endoscopy, barium X-rays, or stool analysis.
▪ If the patient has diarrhea, administer I.V. fluids and electrolytes to replace losses.
▪ Restrict food and fluids to rest the GI tract, as indicated.
▪ If the patient has GI bleeding, restrict food and fluids and administer I.V. fluids, blood, and vasopressors.
Patient teaching
▪ Explain dietary changes, such as food and fluid restrictions, clear liquid diet, or bland diet.
▪ Teach stress reduction and relaxation techniques.
▪ Discuss any activity restrictions.
▪ Explain diagnostic tests and procedures.
▪ Teach the patient about the cause of hyperactive bowel sounds and the treatment plan after a diagnosis is established.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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