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NURS 6501 PATHO WK 8 DISCUSSION

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Pathophysiology of Inflammatory Bowel Disease Inflammatory bowel disease (IBD) is a term given to chronic and recurring conditions that affect the gastrointestinal tract (Centers for Disease Contro ... l & Prevention (CDC), 2017). Irritable bowel syndrome (IBS) is a condition that affects the movement of the intestine (CDC, 2017). Ulcerative colitis and Crohn’s disease are the two most common IBD. In ulcerative colitis lesions are mostly contained in the large intestine especially on the left side. With ulcerative colitis, the crypt of Lieberkuhn in the large bowel becomes infiltrated with T cells that damage the epithelium. Immunoglublin E and G, along with B cells and plasma cells increase at the site of inflammation and goblet cells release mucus (Basson, 2017). Ulceration occurs in the mucosa with rare narrowing of the lumen of the large intestine; polyps form throughout the large intestine (Dudley-Brown & Huether, 2012). Crohn disease lesions may range from the mouth to the anus called skip lesions. The inflammation of Crohn disease is thought to be triggered by cell-mediated response and increased levels of interferon-gamma and tumor necrosis factor alpha. In IBD, Crohn disease, the increase in interferon-gamma and tumor necrosis factor- alpha, along with stimulation of Th1 cells, produces inflammation throughout the small and large intestine mucosa and serosa layers. Injury to bowel tissue occurs as neutrophils and macrophages infiltrate the site of inflammation. Granuloma ulcerations occur in some areas of the bowel and skip other areas (Dudley-Brown & Huether, 2012). Pathophysiology of Irritable Bowel Syndrome Irritable bowel syndrome is a functional gastrointestinal bowel disorder causing increased contractions of the colon. IBS is diagnosed by characteristic cluster of symptoms without detectable structural abnormalities. The pathophysiology of IBS is complex and involves a number of factors. Hypersensitivity to pain in the visceral gut occurs by either malfunctioning of the central nervous system or receptors in the wall of the gut; known as the brain-gut axis. Malfunction of the brain-gut axis can increase gastrointestinal motility causing diarrhea or decease gastrointestinal motility causing constipation. A decreased transit time is, also, associated with normal intestinal flora overgrowth. Individuals with IBS have minimal intestinal inflammation, permeability alterations, and decreased immune response in the gut. Intolerance or allergy to certain foods stimulate an immune response in the mucosa, change the normal gut [Show More]

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