Ulcerative colitis can be identified by recurrent episodes of inflammation that are confined to the mucosal layer of the colon
Assignment Details: Ulcerative colitis can be identified by recurrent episodes of inflammation that are confined to the mucosal layer of the colon. The condition frequently affects the rectum, while the small bowel remains unaffected (Peppercorn & Kane, 2023). According to the National Library of Medicine, renal involvement is a complication that can occur in patients with ulcerative colitis and typically presents as nephrolithiasis (Dincer et al., 2022).
Hematuria has been identified as a potential etiological factor in various medical disorders. The potential differential diagnosis for our patient includes sexually transmitted diseases, pyelonephritis, urethritis, cystitis, trauma, and urolithiasis (Dains, 2020). The selection of treatment modalities is contingent upon the specific diagnosis, encompassing a spectrum of interventions such as antibiotic therapy, administration of fluids, and pain management.
Health promotion activities for patients with ulcerative colitis focus on preventing complications and decreasing further episodic occurrences. Complications include colorectal cancer, dysplasia and strictures (Peppercorn, 2023). Cancer screening, osteoporosis screening, monitoring for anemia, and anxiety/depression surveillance are additional health promotion activities. Intriguingly, smokers diagnosed with ulcerative colitis after quitting have reported that their symptoms diminished or disappeared after resuming smoking (Peppercorn, 2023).
The assessment of therapy efficacy will play a crucial role in formulating the patient’s treatment strategy. Achieving mucosal healing and complete remission is the desired objective, as it helps minimize the need for future undesirable treatments, such as a colectomy. According to Peppercorn (2023), a substantial number of individuals diagnosed with ulcerative colitis, ranging from 20% to 30%, will require a colectomy as a result of their relentless disease.
The severity of the disease determines medication management. Mesalamine administered rectally is the first-line treatment for UC. If our patient is unable to tolerate rectal Mesalamine, then topical glucocorticoids are the next best alternative. Oral 5-ASA agents can be incorporated into the treatment plan if topical medications are not tolerated (Peppercorn, 2023).
References
Dains, J. E., Baumann, L. C., & Scheibel, P. (2020). Advanced health assessment and clinical diagnosis in primary care. Elsevier.
Dincer, M. T., Dincer, Z. T., Bakkaloglu, O. K., Yalin, S. F., Trabulus, S., Celik, A. F., Seyahi, N., & Altiparmak, M. R. (2022). Renal Manifestations in Inflammatory Bowel Disease: A Cohort Study During the Biologic Era. Medical science monitor : international medical journal of experimental and clinical research, 28, e936497. https://doi.org/10.12659/MSM.936497
Peppercorn M. & Kane S. Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults. In: UpToDate, Post TW (Ed), Wolters Kluwer. https://www.uptodate.com (Accessed on October 8, 2023.)
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