Nursing Case Study on Crohn's Disease and Diverticulitis

Running head: NURSING CASE STUDY
Nursing Case Study
Name of the student
Name of the university
Author note

1NURSING CASE STUDY
Answer to question 1.
The patient Mr Bob Jackson is a 55 year old married man who have
two children. He lives in Patersons Plains of Melbourne and is a sheep
farmer. He has been admitted to the ED due to experiencing nausea,
malaise, diarrhoea and increasing Left Lower Quadrant (LLQ) abdominal
pain since one week. His surgical history and medical records points out
that the most likely chronic disease that fits Mr Jackson’s symptoms is
Crohn’s disease.
Aetiology:
Crohn’s disease is a chronic digestive tract inflammation that
spreads into the deeper layers of the gut tissues and affects the normal
digestion and bowel of the individuals. There are three major causes of
Crohn’s disease, which are as follows:
 Infection: Several environmental agents can cause this disease,
although it is not transmissible.
 Immuno-response: There are also chances of occurrence of the
disease due to an immune responses generated against any
antigens present in the gut. These are usually hypersensitive
response to the gut microflora (Cleynen et al., 2016). Changes in
these gut microbiome may result in Crohn’s disease.
 Vasculitis: There are also evidences of the gut mucosal ulceration
which results from the ischaemic condition generated due to
vasculitis of the submucosal vessels of the gut (Ishida, Iwai,
Yoshida, Kagotani & Okabe, 2013).
Several other theories are also hypothesized but the exact
pathogenesis of Crohn’s disease is yet to be known.
In Australia, the prevalence of Crohn’s disease or other inflammatory
bowel diseases are the highest among the world. More than five million
people suffer from the disease worldwide, out of which 75,000 are from
Australia (De Cruz et al., 2015). The number of people affected is

2NURSING CASE STUDY
increasing at such an alarming rate, it is assumed that within ten years
the number of reported cases of Crohn’s disease will be 100,000 in
Australia. This is not a contagious disease. Although medication improves
the inflammation, often surgery is required to eliminate the affected
portions of the intestine.
The symptoms of the disease include diarrhoea, abdominal pain,
nausea, vomiting: all of which are similar to the symptoms of Mr Jackson.
Even though the reason behind this inflammatory bowel disease is still
not known, it is thought that generation of an immune response due to
invasion of a virus or bacteria can lead to the inflammation. Mr Jackson is
a sheep farmer. Parasites that infect sheep, could have infected Mr
Jackson and resulted in all the symptoms of Crohn’s disease (Laass,
Roggenbuck & Conrad, 2014). Also, He has medical history of suffering
from depression. But he is currently not on any anti-depressant
medication. That is probably one of the reason behind his current
malaise.
Pathophysiology:
This is considered as an autoimmune disease and is known to
mostly affect individuals with genetic susceptibility. The inflammation
mostly occurs in the small intestine and the colon of the GI tract. The
disease may affect any part of the gastro-intestinal (GI) tract, but is
mostly reported to appear in the terminal portion of the ileum and colon.
The disease starts with inflammation of the crypts and formation of
abscesses which are developed into small mucosal lesions or ulcers
(Gecse et al., 2014). The spread of this inflammation thickens the walls of
the bowel and develops lymphedema. Excessive inflammation results in
fibrosis, and stricture formation, leading to obstructions in bowel.
According to the phenotypic characteristics, CD can be divided into
three subtypes:
 Inflammatory: Inflammation of the GI tract (Neurath, 2014)