Analysis of Health Variation: Jordon Case Study, Crohn's Disease

This case study focuses on Jordan, a 25-year-old male admitted to the hospital with a five-day history of abdominal pain, bloating, nausea, and vomiting. Jordan, previously diagnosed with Crohn's disease at age 17, presents with symptoms including diarrhea, fatigue, and significant weight loss. The analysis explores the underlying causes of Jordan's condition, including the development of a stricture in the terminal ileum due to Crohn's disease, leading to small bowel obstruction and malnutrition. It details the structural and functional changes associated with Crohn's disease, such as inflammation, ulceration, and the impact on bowel movement, appetite, and hormonal levels (ghrelin and leptin). The study further examines the pain pathways involved and the effects of morphine. It also analyzes Jordan's clinical manifestations, including low hemoglobin, elevated ESR and CRP levels, and low albumin, indicating anemia, inflammation, and potential nutritional deficiencies. Finally, the need for intravenous fluids, including calcium chloride, potassium chloride, sodium chloride, and sodium lactate, to address malnutrition and electrolyte imbalances is discussed, highlighting the importance of nutritional support for Jordan's recovery.

Running head: HEALTH VARIATION
JORDON CASE STUDY
Name of the Student
Name of the University
Author note

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HEALTH VARIATION
Answer 1
Jordon is suffering from SBO (Small Bowel Obstruction) due to Crohn’s disease as in the
case study it was mentioned that he suffered from Crohn’s disease. Many structural and
functional changes occur due to this disease. He developed a stricture, which is causing
obstruction in the bowel movement through his terminal ileum. It is mentioned in the case study
that Jordan suffered from Crohn’s disease when he was 17 years old. In Crohn’s disease causes
this development of the stricture in the intestine leading to the narrowing of the intestinal wall
and therefore the passage of food becomes difficult (Craft, 2015). It develops a crypt
inflammation and abscesses that proceeds into tiny focal apthoid ulcer. The lesion developed in
the mucosa develops into transverse and longitudinal ulcer along with intervening musical edema
that creates a characteristics of cobblestone look to the bowel. Transmural inflammation spread
causes thickening of the bowel wall, causing extension of the mesenteric fat in to serosal of the
bowel. Due to this inflammation bowel movement does not occur. Along with this abscess and
fistula penetrates and extends towards the skin of the anterior flanks or abdomen. This leads to
improper movement of bowel leading to weight loss. As there is no bowel movement, the hunger
of the patient reduces, malabsorption occurs, diarrhoea leading to loss of nutrients and aversion
of foods. In Jordan’s case main cause of weight loss in loss of food appetite. The main reason
behind it is pain while eating, or hormonal inflammation also leads to weight loss. As the person
is not eating properly he undergoes nutrient deficiencies causing weight loss (Hill, Hall & Glew,
2017). When a person is suffering from improper bowel movement he faces a change in
hormonal level such as ghrelin and leptin. These are the two hormones that makes a human feel
full or hungry. As there is no bowel movement, increase in the inflammatory signals occurs like
TNF-α (Tumour necrosis factor) as well as interleukin. Both of these hormone is linked with

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improper nutritional status. All these factors together lead to the weight loss of Jordan. Even the
doctor mentioned that Jordan is having distended abdomen, audible bowel sound and tender
mass in the right lower abdomen portion. All these suggest a sign of developing Crohn’s disease
again in Jordan and hence requires faster treatment. The doctor also informed Jordan about his
inflammatory submucosa and mucosa. All the above functional and structural changes add up to
the cause of reduction of Jordan’s weight.
Answer 2
The pain in the abdomen signal is received by brain through motor cortex. The pain
pathway originates from somatosensory cortex that depends on thalamus as well as
hypothalamus. The thalamic neuron comes down towards midbrain and synapse in the medulla
of the brain in addition to spinal cord. It thereby inhibits the rising signals from nerves. The
signals of pain is generated by the autonomic nervous system, after they pass through medulla
the blood pressure and heart rate increases (Bullock & Manias, 2017). All the reaction outcome
depends pain intensity and it can be depressed at the centre of the brain inside the cortex along
the pathway. Sometimes extreme pain damages signalling pattern causing in the limitation of
signal pathways.
Morphine produces pain relief analgesia is produced causing relief from the development
of pain-relieving opiate neurotransmitters such as enkephalins, endorphins and dynorphins.
Regardless of the huge use of morphine plus associated to opioid agonists in clinic as well as
their influential analgesic effects, suppresses the analgesia effect.
Answer 3

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HEALTH VARIATION
The clinical manifestation that marks the deterioration of Jordan’s health lower level of
haemoglobin, erythrocytes sedimentation (ESR), c-reactive protein (CRP) and albumin.
Low haemoglobin is a might be sign of anemia however in Jordon’s case the level of
haemoglobin is slightly less (Torres et al., 2017). It is due to nutritional deficiency such as iron,
vitamin B-12. Patient, with improper bowel movement mainly suffer from iron deficiency and
improper iron absorption.
Erythrocyte sedimentation rate (ESR) as well as c-reactive protein (CRP) are used as a
marker for inflammation. High ESR means anemia and infection. High CRP means that the
person is suffering from inflammatory bowel disease, infection or lupus. Sometimes if the CRP
is not treated it might also lead to heart disease (Colombel et al., 2017). CRP can only be treated
twice a week. Jordan CRP is high that indicates that he is having some inflammation and also hid
ESR is high which is due to increase in the globulins, severe inflammation or due to arteritis.
Low albumin is an indication of undernutrition of protein causing decrease in the
synthesis of albumin, misdistribution amid extravascular and intravascular spaces as well as
excess loss of the intestine.
On other hand Haematocrit is 51% that means that Jordon is suffering from dehydration
due to diarrhea. High WBC (13.9 x109/L) indicates inflammation. As Crohn’s disease cause
improper and loss of diet causing malnutrition for vitamin B-12 leading to several blood cell
deficiency and increase in white blood cells (Crohn's & Colitis Australia, 2020).
Answer 4
As Jordon, was suffering from malnutrition because of his improper bowel movement he
needs IV for making nutritional balance. The IV that is ordered for Jordon contains calcium

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HEALTH VARIATION
chloride, potassium chloride, sodium chloride as well as sodium lactate (Burston & Corfee,
2017). All the required nutrients are present in sterile water.
As Jordan was suffering from nutrition such as vitamins, minerals, sodium and potassium
he needs to balance the nutrition in his body to reduce his suffering. Due to inflammation and
improper bowel movement his digestion capability decreased however to survive his body needs
food and there is decrease in RBC’s in his blood. Hence, he needs IV so that nutrition directly
reaches his blood and there is nutritional balance in his blood. Therefore, Jordan requires IV
treatment and need to have a proper balance of all the electrolytes and nutrition in blood (Berry,
2017). All the nutrients present in the IV fluid would make Jordan and maintain his weight. The
electrolyte would make Jordon strong so that he can cope up with his work schedules.

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