Crohn’s Disease | Case Study | Assignment

Running head: CASE STUDY
Case Study
Name of the Student
Name of the University
Author Note

CASE STUDY1
ANSWER NO.1.
Crohn’s disease is a kind of inflammatory bowel disease that disturbs the numerous
sectors of the gastrointestinal tract. The disease is categorized by several severe symptoms
such as abdominal pain, weight loss and fever. It is generally caused due to environmental
factors, viruses and also due to genetic disorders (Ha & Khalil, 2015). Different conditions
and factors interplays over time and results in the development of chronic inflammatory state.
It is also regarded as an autoimmune disease. The genetic factors also contributes to the
development of this condition such as higher level of AIEC results in resistant of phagocytic
mechanism of the body resulting in inflammation. The luminal antigens are secreted in large
amount resulting in production of cytokines such as tumour necrosis and interleukin-2
resulting in systemic and local inflammation (Ellinghaus et al., 2015). The condition affects
the ileum which is around 60 per cent, the duodenum and the stomach is affected 5 per cent
and the most severely affected part is the perianal which results up to 75 per cent. The disease
be begins with a vault inflammation and swellings which progresses into tiny focal aphthous
ulcer which is basically the breakage of intestinal lining due to inflammation. The disease
shows cobblestone appearance in the colon. The histopathological features that is observed in
the small intestine is large deposition of mesenteric fat. The microscopic study also suggest
that the disease lead to epithelioid granulosa. The identification is also based upon superficial
ulceration in the granulation tissue spreading to sub mucosa, along with the presence of
goblet cells. The neutrophils and lymphoids are aggregated. The ulcer progresses with time
and results in more swelling of the tissue in the intestine and ultimately leading to scarring
condition along with narrowing and stiffness of the area (Azer & Sun, 2019). Patients
suffering from this experience a drastic weight loss condition the reason can be loss of
appetite. The disease also affects the ability of digestion along with poor absorption of
nutrients. It also affects the elimination of the waste materials from the body. The disease

CASE STUDY2
affects the gut and the ileum. Crohns disease also results in fistula in the body. The loss of
nutrition leads to the development of intestinal bleeding or diarrhoea. The patient in this case
had severe abdominal pain, nausea, fistula and abdominal sepsis. The calorie intake is less
due to defective breakdown of food leading resulting in rapid weight loss. The disease affects
both physiological and psychological state of the body (Feuerstein & Cheifetz, 2017).
ANSWER NO.2
The pain is a combination of both emotional and sensational feeling that gives an
unpleasant response to the body. It is generally associated with potential damage of the tissue.
The pain can be of many types such as prickling pain, thermal pain, sharp pain, aching pain.
The sensation can originate from different part of the body such as visceral, somatic,
neuropathic and sharp pain. It can be chronic or acute. The pathway consists of three different
types of receptors such as first order neuron, second order neuron and third order neuron. The
first order neuron are consists of dorsal root ganglion within which the cell bodies are
present. The branch is divided into two one is central branch and the other is peripheral
branch. The second order neuron consists of cranial nerves present in the brain stem. The
third order neuron in present within the ventral posterolateral nucleus area of the brain
thalamus. The first order neuron encompasses of noiceptor receptor located at the nerve
ending of primary afferent neuron. These receptors gets activated due to threshold stimulus
like thermal, chemical and mechanical. The signals are transmitted in the brain thereby
causing the sensation (Kendroud & Hanna, 2019).
Morphine belongs to the class of opioid analgesic. The drug has a high affinity
towards receptors such as mu opioid, delta and kappa. The drug binds to the mu receptors and
shows its analgesic effects within the peripheral and central nervous system. The drug
activates the downward inhibitory pathway of pain in the central nervous system along with