Biology of Disease

This essay focuses on the case study of Eleanor Brown, a 48-year-old lady suffering from severe ulcerative colitis. It discusses the causes, symptoms, and treatment options for ulcerative colitis.

Running head: BIOLOGY OF DISEASE
Biology of Disease
Name of the Student
Name of the University ‘
Author Note

1BIOLOGY OF DISEASE
This essay focuses on the case study of Eleanor Brown , a 48 years old lady, who is
suffering from severe ulcerative colitis since the age of 31. Now she is 48 and form last two
weeks, she is experiencing exacerbation of ulcerative colitis along with diarrhoea with pus
blood. In a last two weeks, she has lost 9 kilograms.
Question 1
The ulcerative colitis refers to the chronic gastrointestinal diseased condition in which
inflammation is observed due to the ulcer formation in the sigmoid colon and rectum,
specifically in the membrane of colon. In such conditions, lesion in the colon is observed due
to the pathogenic, inflammatory and genetic reason (Ananthkrhnan, 2015). The inflammation
occurs due to humoral immunity induced mechanism and T-lymphocyte induced cytotoxic
manifestations as a part of the pathogen associated immune response. The inflammation in
the large intestine mainly affects the base of the crypt of Lieberkuhn. As a results, formation
of minor erosions can be observed in the transverse colon, sigmoid colon and finally causes
ulcers and abscesses (Bressenot et al., 2015). However, if such condition is neglected, then,
it will result in more inflammated condition, cell necrosis, internal bleeding, pus
accumulation, thickening of the mucosal cells of that region as well. Hence it can be said that,
such changes in the structure in the structure of colon will also affect the functional
capabilities of colon. As a part of the functional changes, gastrointestinal bleeding, muscular
spasm and cramping, uncontrolled defecation may happen. Along with this, the loss of colon
surfaces due to the cell necrosis , formation of pus and blood release through the defecation.
Therefore, the loss of functioning of lumen of colon is also observed and it is associated with
the water reabsorption function of colon and as a result severe water loss and diarrhea take
place (Ren et al., 2015). In case of Eleanor Brown, it is observed that, the she is suffering
from the ulcerative colitis, bloody diarrhea, gastrointestinal pain and it can be said that this
patient may have the same changes in her GI tract. Due to the bleeding, loss of essential

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nutrients from the body takes place and it is the main reason of losing body weight and low
hemoglobin level of the patient. In addition, the loss of colonic lumen also reduce the
capacity of absorbing micronutrients and contributes to the loss of body weight loss of the
patient. Moreover, the high rate of inflammation will cause tissue catabolism and contribute
to the weight loss ( Lemberg & Day, 2015).
Question 2
The pain associated with this, ulcerative colitis is the visceral pain and it is assumed
that, the this pain is associated with inflammatory lesions of the GI tract of the system. As a
result, the activation of the sensory innervation occurs. Therefore it can be said that, the pain
sensation is occurred by the sensitization of the local sensory afferent neurons. This afferent
neurons transmits the signals to the CNS. CNS amplify those signals and finally transmits
the signals to the neurons of the central nervous system or CNS. In this case it is observed
that, the patient has been prescribed morphine for the management of pain. Morphine is a
widely used morphine that is used to treat inflammatory disease like UC. Morphine, mainly
causes hyperpolarization of the cells of the inflamed region and as a result the release of
presynaptic neurotransmitters are reduced. The increased efflux of potassium ions causes the
hyperpolarization of neurons and this results in reduced response to pain sensation. In
addition, the cessation of calcium ion influx helps in the reduced release of neurotransmitters
from the nerve endings which are located in the pain transmission pathways ( Bouwense et
al., 2015). By this mechanism morphine alters the concisions pain perception.
Question 3
From the observation of the Eleanor, it is observed that, the patient has low blood
pressure that is 90/50 mm hg. This is due to the exclusion of blood from the body of the
patient as she has diarrhoea along with blood and pus. The exclusion of bloods reduced the

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normal blood pressure of the patient. In addition, she also had increased pulse rate of 120
beats/ min That indicates that due to less amount of blood in the body, the work load of the
heart is enhanced to supply more oxygen. Due to the severe blood lose, the patient develops
anaemia that is less haemoglobin count in the body (86g/L that is far lower from the normal
range). The enhanced amount of WBC in the blood also suggests that the inflammation in the
colon is increasing day by day. Along with this, the routine blood tests of the patients it is
also noted that, the values of ESR and CRP tests are very high than that of the normal range
and that suggests worse condition of the inflammation (Crohn’s and Colitis Foundation of
America, 2019).
Question 4
The patient is ordered to give morphine 15mg (IM), Metoclopramide (IM) 10 mg,
Methylprednisolone 20 mg IVI and 1000mls Hartman’s solution over 6 hours. The morphine
is an opioid drugs that is used to decrease pain and this molecule exerts its function through
G-protein couple receptors. Main reason of giving all the drugs in an intravenous manner, in
order to avoid the first pass effect of the liver. By giving the drugs in an intravenous invasive
way, the drugs will be directly absorbed by the bloods and can exert its function in a more
specific way. The intravenous drug delivery will avoid the first pass effect that is metabolism
of drug by the hepatic cells and directly affect the target area after absorbing through the
blood in a more specific manner. The drug metoclopramide is used to treat nausea and
vomiting and it exerts its function mainly by blocking the neurotransmitters that transmits the
signals for vomiting. In addition, the rate of gastric emptying is enhanced and relaxation of
pyloric sphincter occurs and as a result vomiting ceases. The Methylprednisolone is used to
treat the inflammatory areas of the body by inhibiting the inflammatory cytokines’ pathways,
inhibiting the activation of t cells and also promotes the apoptosis of activated immune cells
(Petereit et al., 2018). The Hartman’s solution is prescribed for restore the amount of the

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sodium, calcium in the body as the patient has severe fluid loss due to diarrhoea (Rossen et
al.,2015) .

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