Affects the entire thickness of the intestinal wall — Crohn's Disease
♠️ Crohn's disease causes transmural inflammation, meaning inflammation can extend through the entire thickness of the intestinal wall.
♠️ Transmural involvement distinguishes Crohn's disease from ulcerative colitis, which primarily involves the mucosa and submucosa.
♠️ Deep inflammation can produce fissures, strictures, fistulas, and abscesses.
♠️ The inflammation may occur anywhere from the mouth to the anus, although the terminal ileum and colon are frequently affected.
♠️ Chronic transmural inflammation can cause bowel-wall thickening and narrowing of the intestinal lumen.
♠️ Progressive narrowing can eventually contribute to intestinal obstruction.
♠️ The deeper tissue involvement also explains why penetrating complications occur more frequently with Crohn's disease.
♠️ Full-thickness intestinal inflammation is therefore a hallmark characteristic of Crohn's disease.
Toxic megacolon is a common complication — Ulcerative Colitis
♠️ Toxic megacolon is a serious complication strongly associated with severe ulcerative colitis.
♠️ Extensive colonic inflammation can cause the colon to become markedly dilated and unable to contract effectively.
♠️ Clients may develop abdominal distention, tenderness, fever, tachycardia, and systemic toxicity.
♠️ Severe inflammation increases the risk for colonic perforation, peritonitis, sepsis, and shock.
♠️ Toxic megacolon represents an acute medical emergency requiring immediate recognition and treatment.
♠️ The complication is particularly concerning during a severe or fulminant ulcerative colitis exacerbation.
♠️ The nurse should closely monitor for increasing abdominal distention, worsening pain, fever, and changes in bowel activity.
♠️ The strong association between severe colonic inflammation and toxic megacolon makes this characteristic most consistent with ulcerative colitis.
Nutritional deficiencies occur frequently — Crohn's Disease
♠️ Nutritional deficiencies are common in Crohn's disease because inflammation frequently involves the small intestine, where many nutrients are absorbed.
♠️ Inflammation of the terminal ileum can interfere with absorption of vitamin B12 and bile salts.
♠️ Chronic diarrhea can further contribute to losses of fluids, electrolytes, and nutrients.
♠️ Abdominal pain may cause clients to reduce food intake because eating can worsen gastrointestinal symptoms.
♠️ Malabsorption may contribute to deficiencies in iron, folate, calcium, vitamin D, and other nutrients.
♠️ Repeated intestinal inflammation or surgical resection can further reduce the available absorptive surface.
♠️ Persistent nutritional deficiencies may lead to anemia, weakness, impaired healing, and weight loss.
♠️ Frequent malabsorption and nutritional deficiencies are therefore more characteristic of Crohn's disease.
Healthy tissue is interspersed with areas of inflammation — Crohn's Disease
♠️ Crohn's disease characteristically produces skip lesions, in which inflamed intestinal segments are separated by areas of normal tissue.
♠️ The inflammatory process is therefore discontinuous rather than involving one uninterrupted segment of bowel.
♠️ Skip lesions can occur at multiple locations throughout the gastrointestinal tract.
♠️ Crohn's disease can affect any portion of the digestive tract from the mouth to the anus.
♠️ The terminal ileum and proximal colon are particularly common sites of involvement.
♠️ Endoscopic examination may reveal alternating regions of healthy and inflamed tissue.
♠️ Ulcerative colitis differs because its inflammation generally progresses continuously from the rectum proximally through the colon.
♠️ Interspersed healthy and inflamed intestinal tissue therefore strongly indicates Crohn's disease.
Can often cause severe weight loss — Crohn's Disease
♠️ Significant weight loss frequently occurs in Crohn's disease because chronic intestinal inflammation interferes with digestion and nutrient absorption.
♠️ Small-intestinal involvement can produce malabsorption, reducing the amount of nutrients available to the body.
♠️ Chronic diarrhea can cause additional loss of nutrients, fluids, and electrolytes.
♠️ Abdominal pain and cramping may cause clients to intentionally decrease their food intake.
♠️ Persistent inflammation can increase metabolic demands while simultaneously reducing nutritional intake.
♠️ Strictures or other intestinal complications may further interfere with adequate nutritional intake and absorption.
♠️ These combined effects can result in malnutrition and substantial unintended weight loss.
♠️ Severe weight loss is therefore particularly consistent with Crohn's disease.
Fistulas and perianal abscesses are rare — Ulcerative Colitis
♠️ Fistulas and perianal abscesses are rare in ulcerative colitis because inflammation is generally limited to the superficial layers of the colon.
♠️ Ulcerative colitis primarily affects the mucosa and submucosa rather than extending through the entire intestinal wall.
♠️ Fistula formation usually requires deeper inflammation that penetrates through the bowel wall.
♠️ Crohn's disease, in contrast, produces transmural inflammation that can create abnormal connections between the bowel and surrounding structures.
♠️ Crohn's disease can consequently produce enterocutaneous, enteroenteric, enterovesical, and other types of fistulas.
♠️ Perianal disease, including abscesses and fistulas, is also strongly associated with Crohn's disease.
♠️ Their relative absence therefore supports ulcerative colitis rather than Crohn's disease.
♠️ Rare fistulas and perianal abscesses are therefore most consistent with ulcerative colitis.