(^322) Medical-Surgical Nursing Demystified
Ulcerative Colitis
WHAT WENT WRONG?
An inflammatory disease of the large intestine that affects the mucosal layer begin-
ning in the rectum and colon and spreading into the adjacent tissue. There are ulcer-
ations in the mucosal layer of the intestinal wall, and inflammation and abscess
formation occur. Bloody diarrhea with mucous is the primary symptom. There are
periods of exacerbations and remissions. Symptom severity may vary from mild to
severe. The exact cause is unknown, but there is increased incidence in people with
northern European, North American, or Ashkenazi Jewish origins. The peak inci-
dences are from mid-teen to mid-twenties and again from mid-fifties to mid-sixties.PROGNOSIS
Patients with ulcerative colitis may have an increase in symptoms with each flare-
up of the disease. Malabsorption of nutrients can cause weight loss and health
problems. Some patients will need surgery to resect the affected area of the large
intestine, resulting in a colostomy, ileal reservoir, ileoanal anastomosis, or ileoanal
reservoir. There is an increased risk of colon cancer in patients with ulcerative coli-
tis. The patient is also at risk for developing toxic megacolon or perforating the
area of ulceration.HALLMARK SIGNS AND SYMPTOMS
- Weight loss
- Abdominal pain
- Chronic bloody diarrhea with pus due to ulceration
- Electrolyte imbalance due to diarrhea
- Tenesmus—spasms involving the anal sphincter; persistent desire to empty
bowel
INTERPRETING TEST RESULTS
- Anemia—low hemoglobin and hematocrit due to blood loss and chronic
disease.
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