1. Ulcerative Colitis A disease only of the colon
2. Inflammatory bowel disease (IBD) the mucosal surface of the colon is in-
flamed-most often occurs in the rec-
tosigmoid areas, must may involve the
entire colon
3. Inflammatory bowel disease (IBD) Occurs in the rectum and sigmoid colon
4. Inflammatory bowel disease (IBD) Results in friability, erosions, and bleed-
ing
5. Inflammatory bowel disease (IBD) Characterized by bloody and purulent di-
arrhea
6. Inflammatory bowel disease (IBD) While it is not the first treatment choice,
total colectomy is a treatment option that
can completely resolve this problem
7. Diverticulitis Patients with diverticulitis may present
with bleeding not associated with pain or
discomfort.
8. Diverticulitis Is associated with obesity-these patients
are at higher risk
9. Diverticulitis When the diverticula become inflamed,
there are usual signs and symptoms
of infection-fever, chills, and tachycardia,
painless bloody stools
10. Diverticulitis Patients typically present with localized
pain and tenderness in the LLQ of the
, abdomen with associated anorexia, nau-
sea and vomiting
11. Diverticulitis CT scan with contrast may sometimes be
done to r/o if the gynecologic etiology
(such as ovarian cyst or tumor) as well
as bowel pathology such as abdominal
abscess
12. Diverticulitis High-fiber diet is best management
13. Clostridium Difficile Infection of the large intestine
14. Clostridium Difficile Exists in air, water, soil, processed food
and human feces
15. Clostridium Difficile Causes profuse, watery, mucoid diarrhea
16. Clostridium difficile (C. diff) Certain types can be dangerous or
life-threatening if not treated
17. Clostridium Difficile Risk factors *Working in healthcare facility
*Long duration hospitalization
*Long-term use of antibiotics attects
normal GI flora
*Long-term use of medications that re-
duce GI acidity, *Consumption of conta-
minated food or water *Touching infect-
ed soil, objects and surfaces
*Older adult will become dehydrated
quickly
18. Clostridium Difficile
, *Patient may be asymptomatic
*Generally profuse, watery, mucoid diar-
rhea
19. Clostridium Difficile: Mild to moderate infec- Watery diarrhea three or more
tion times/day for two or more days
20. Clostridium Difficile: Mild to moderate infec- Mild abdominal cramping and tender-
tion ness
21. Clostridium Difficile Severe infection: Watery diarrhea (10-15 stools/day)
22. Clostridium Difficile Severe infection: Strong foul odor
23. Clostridium Difficile Severe infection: Acute abdomen secondary to toxic
megacolon with perforation
24. Clostridium Difficile Severe infection: Abdominal distention
25. Clostridium Difficile Severe infection: Fever
26. Clostridium Difficile Severe infection: Nausea/vomiting/dehydration requir-
ing hospitalization
27. Clostridium Difficile Severe infection: Blood or pus in the stools (severe cases)
28. Clostridium Difficile: Diagnosis Complete blood count (CBC): elevated
WBC count
29. Clostridium Difficile: Diagnosis Enzyme-linked immunodeficiency assay
(ELISA): identifies toxins that produce C.
ditt bacteria
30. Clostridium Difficile: Diagnosis Cell cytotoxicity assay: identifies the ef-
fects of bacterial toxins on human cells
, 31. Clostridium Difficile: Diagnosis Polymerase chain reaction (PCR): detects
bacterial genes
32. Clostridium Difficile: Diagnosis Endoscopy: if the patient is unresponsive
to treatment; will show pseudomem-
branes that suggest c-ditt infection
33. Clostridium Difficile: Treatment Metronidazole
34. Clostridium Difficile: Treatment Probiotics- to restore the healthy growth
of normal GI bacteria
35. Clostridium Difficile: Treatment Colectomy in severe cases
36. Clostridium Difficile: Treatment Maintain fluids, Clear liquid diet
37. Clostridium Difficile: Treatment Eat starchy foods to prevent diarrhea,
Avoid catteine, spicy foods, milk and
greasy foods
38. Clostridium Difficile: Treatment May require a GI consult
39. Gastroesophageal Reflux Disease (GERD) *Symptoms occur at night with regur-
gitation; heartburn is classic for GERD
(mild to severe).
*Dysphagia is frequently a prominent
symptom of GERD. It is usually as-
sociated with other symptoms, includ-
ing regurgitation, water brash (reflex
salivation), sour taste in the mouth
in the morning, odynophagia, belch-
ing, coughing, hoarseness, or wheezing,
usually at night.