Ulcerative Colitis: Functional and Structural Changes

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

1NURSING
Answer 1
Ulcerative colitis (UC), an inflammatory disease caused due to the formation of sores
and irritation in the inner-lining of the large intestine (National Institute of Diabetes and
Digestive and Kidney Diseases [NIDDK], 2019). In UC, the main functional change includes
generation of inflammatory response in the mucosal lining of the small intestine during the
initial stage of the disease prognosis. This type 1 hypersensitivity reaction is followed by the
formation of edema. This results in the structural changes in the intestinal lining spreading up
to the colon (Conrad, Roggenbuck & Laass, 2014). The structural changes is characterised by
the formation of haemorrhage along the length of the colon. This haemorrhage in the lower
part of the gastro-intestinal tract is responsible for the heightened cell death, this can be
regarded as another functional change in UC. During the later part of the disease progression,
as the disease progress to more chronic state there occurs distortion of the mucosal glands
along with decrease in goblet cells due to cellular extravasations from polymorphonuclear
leucocyte. This sudden depletion of the goblet cells associated with the inflammation in the
lower inner lining of the gastro-intestinal tract leads to further cell death. This heightened
increase in the cell death results in drastic weight loss. This is the reason why the weight loss
scenario for Eleanor Brown is not pronounced during the initial stage of the disease in
comparison to the later stages of the disease prognosis (Rogler, 2014).
The structural change in the gastro-intestinal tract along with chronic inflammation
hampers the peristalsis movement of the stomach. The functional change in the mechanism of
stomach, leads to cramping in the muscles located in the lower portion of the stomach. This
functional change attributes to indigestion and subsequent development of diarrhoea (Conrad,
Roggenbuck & Laass, 2014). Vomiting causes loss of fluid and electrolyte balance in the
body, further promoting drastic weight loss in Eleanor Brown. Another functional aspect that

2NURSING
can be highlighted in this stage is, generalised state of inflammation generates a metabolic
state in the body leading to the rapid breakdown of the muscles cells, leading to loss of
protein and weight loss. Another functional aspect of UC is it increases the energy
expenditure of the body leading to the generation of fatigue and problem in executing daily
living activities as highlighted in the case of Eleanor Brown. Moreover, the catabolic
hormones like adiponectic, leptin and ghrelin are secreted in an unregulated manner leading
to further weight loss (Rogler, 2014).
Answer 2
The pain sensation in the body is mediated by two sensory neurons, afferent neurons
and efferent neurons. Afferent neurons work by receiving the pain signals from the sensory
organs and transmitting the signals to the brain through the spinal dorsal horn of the central
nervous system (CNS). The efferent neurons work opposite to afferent neurons. They receive
the pain impulses from the CNS and transmit the signal through the spinal dorsal horn to the
limbs or the other organs of the body (Gilron et al., 2015). Morphine, an opium analgesic is
alkaloid in nature and helps in the effect management of conscious perception of pain. It
mainly works as an antagonist of afferent neurons. Morphine binds to kappa, delta and mu
receptors and thereby helping to inhibit the downstream signal transduction through
nociceptive neurotransmitter. This hamper the progression of the pain impulses from the
sensory organs to the brain and thus reducing the sensation of pain. The action of morphine is
exhibited within 6 to 30 minutes of administration. Over use of morphine or long-term use of
morphine leads to the generation of morphine addiction (Gilron et al., 2015).
Answer 3
The main clinical manifestation in Eleanor Brown that reflects deterioration is rectal
bleeding arising out of pseudopolyps in the colon. The formation of pseudopolyps in the