Ulcerative Colitis: Causes and Symptoms

Running head: NURSING
Name of the Student
Ashma Gyawali Kharel
Name of the University
Western Sydney University

1
NURSING
Answer 1
Ulcerative colitis (UC) is a chronic disease that leads to inflammation or irritation and
sores (commonly known as ulcers) in the inner lining of the large intestine. It is classified
under the chronic inflammatory disease of the gastro-intestinal (GI) tract, known as
inflammatory bowel disease (IBD). UC has slow prognosis initially and during the course of
time it becomes worse (National Institute of Diabetes and Digestive and Kidney Diseases
[NIDDK], 2019).
Weight-loss is one of the common sign and symptom of UC, and is mainly driven by
the morphologic and inflammatory changes in the colon. During the initial stages of the UC,
the inflammation is limited to mucosa and mainly consists of constant involvement of the
differing severity of ulceration, edema and haemorrhage along the length of the colon. Thus,
weigh loss is not drastic at the initial stage. However, as the disease progresses there occurs
distortion of the mucosal glands and depletion of the goblet cells due to infiltration of the
colon area by the polymorphonuclear leukocytes and mono-nuclear cells leading to the
development of chronic inflammation (Conrad, Roggenbuck & Laass, 2014). Elsherif,
Alexakis and Mendall (2014) stated that inflammatory nature results in the generalised
catabolic resulting in drastic weight loss. Moreover, the resting energy expenditure is found
to increase gradually during the acute flares of the UC and heightened release of the pro-
inflammatory cytokines exert an anorexic effect leading to further loss in the bio-mass.
Elsherif, Alexakis and Mendall (2014) further highlighted that the inflammatory state of the
UC is also associated with the changes in the level of numerous metabolic hormones
secretion like leptin, ghrelin and adiponectin. Dis-equilibrium in hormonal secretion leads to
hamper in the balance of the satiety leading to weight loss.

2
NURSING
One of the consistent features of UC is presence of mucus and blood mixed with stool
along with cramping in the lower part of the abdomen. This cramping is more intense during
the passage of the bowel movements. This discharge of the blood promotes weight loss.
Moreover, abdominal cramping and inflammation prevent absorption of the micro-nutrient
and macro-nutrient leading to further weight loss due to nutritional deficiency (Conrad,
Roggenbuck & Laass, 2014). Eleanor Brown has been suffering from UC for the past 17
years. This prolong prognosis of the disease is the reason behind her weight loss. Moreover,
in relation to the above mentioned literature, it can be said that Eleanor Brown has 14
episodes of diarrhoea with excretion of blood and pus along with several pain in the lower
portion of the abdomen. Excretion of pus in stool indicates the presence of chronic internal
inflammation leading to weight-loss. Eleanor Brown is also experiencing abdominal bloating
and cramping, decreasing her willingness to have food. Feeling ill to consume food and drink
can be considered as another reason behind her drastic weight loss.
Answer 2
There are two types of neurons, afferent neurons and efferent neurons, which are used
as pain receptors. The neurons that receive information from the sensory organs like the skin
and the eye and transmit the pain response to the along the spinal dorsal horn of the central
nervous system are known as afferent neurons. Neurons that send impulses from the central
nervous system through the spinal dorsal horn to the limbs and the other organs are known as
efferent neurons. Morphine is opioids that attenuate the excitability of the peripheral terminal
of the neurons and thereby preventing the transmission of the action impulses and reducing
the sensation of pain. The action of morphine is exerted both in the brainstem nuclei and
opirat receptors and thus preventing generation of conscious pain (Jagla et al., 2013).
Morphine also inhibits the vasodilation generated by the entidromic electrical stimulation of