CHAPTER 7 Gastrointestinal System^295
HALLMARK SIGNS AND SYMPTOMS
- Fever
- Right lower quadrant pain
- Diarrhea (non-bloody)
- Abdominal mass
- Weight loss (unintentional)
- Fatigue
- Bloating after meals (postprandial)
- Abdominal cramping due to spasm
- Borborygmi (loud, frequent bowel sounds)
- Fistula formation (bowel-bowel, bowel-stomach, bowel-bladder, bowel-skin,
bowel-vagina) - Aphthous ulcers (oral ulcerations)
- Nephrolithiasis
INTERPRETING TEST RESULTS
- Erythrocyte sedimentation rate will be elevated during exacerbations.
- Anemia—due to both vitamin B 12 and folic acid deficiency.
- Albumin level will be low.
- Electrolytes may be abnormal due to loss from diarrhea and malabsorption.
- Barium studies will show “apple core” in area of stricture formation, narrow-
ing due to inflammation, and fistula formation. Not performed if bowel per-
foration is a concern. - CT scan shows abscess formation and thickening of bowel wall due to in-
flammation. - Sigmoidoscopy or colonoscopy for direct visualization of lower GI tract or
for biopsy.
TREATMENT
- Dietary restriction.
- Nutritional supplementation.