Case Study: Analysis of Crohn's Disease Symptoms and Treatment

This case study examines Crohn's disease, an inflammatory bowel disease affecting the gastrointestinal tract. The study details the disease's symptoms, including abdominal pain, weight loss, and fever, and explores its causes, such as genetic factors and autoimmune responses. The patient's condition is analyzed, focusing on the impact of Crohn's disease on the digestive system, leading to malabsorption and related complications. The study also addresses pain pathways and the use of medications like morphine. Furthermore, the case study discusses clinical observations, including hypotension, elevated pulse, and respiratory rate, as well as laboratory findings such as anemia and pyelonephritis. Finally, the treatment plan involving Hartmann's solution and methylprednisolone is explained, highlighting their roles in restoring electrolytes, reducing inflammation, and managing symptoms. The document provides a comprehensive overview of the disease, its diagnosis, and treatment approaches.

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

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Answer No. 1
Crohn’s disease disrupts the structure and functions of different parts of the
gastrointestinal tract. It is a kind of inflammatory bowel disease (Ha & Khalil, 2015). The
disease has many signs and symptoms such as fever, loss of weight in the body and severe
abdominal pain. Crohn’s disease can be caused due to several factors such as environmental
issues, genetic factors and viral infections. It is also regarded as an autoimmune disorder
where the factors triggers that inflammatory state of the body resulting to the development of
chronic symptoms. The genetic factor that is responsible for the development of this disease
is AIEC, which rises in level and develops a resistant mechanism of the body towards
phagocytic responses and results in inflammation (Boyapati, Satsangi & Ho, 2015). The
systemic and local inflammation happens due to the production of cytokines like interleukin-
2 and tumour necrosis (Lee, Kwon & Cho, 2018). The inflammatory state of the body affects
the ileum severely and damages the portion about 60 per cent, the next portion that is affected
due to this chronic disease is the perianal portion of the body and the last part that is affected
due to this is the duodenum and the stomach which is 5 per cent. The condition begins with
the swelling and vault which further gives rise to focal aphthous ulcer, it is a condition where
the stomach lining breaks due to the chronic inflammation. The small intestine is composed
of large amount of mesenteric fat that is clearly observed during the histopathological study.
The structural changes further involves that state of granulation in tissues that spreads till the
sub mucosal layer with the appearance of goblet cells. The ulcer that occurs due to this state
gives rise to more swelling in the tissues of the intestine leading to the development of
stiffness and narrowing of the area (Langner et al. 2014). The patient in the case study had an
indication of less appetite which resulted in a severe weight loss in the body. The patient is
developing the condition of crohn’s disease again which is affecting the digestive system of

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the body resulting in malabsorption of food in the small intestine along with defective
elimination of waste materials from the body. The condition this malfunction developed due
to the structural changes in the body which in turn affects the functional capacity. The loss of
nutrition also lead to the development of diarrhoea or intestinal bleeding. The fails to restore
the calorie that is needed by the body in maintaining the growth and metabolism resulting in
severe weight loss.
Answer No. 2
The pain is a sensational pathways which combines with emotions as well giving an
unpleasant response to the body. The pain occurs when the body experiences a potential
damage in the tissue. The receptors of pain mechanism are present throughout the body.
These receptors promote sensation in the body through somatic path, neuropathic path and
visceral path. Pain can be of chronic or acute depending upon the pain threshold. The
threshold can be of chemical, mechanical and thermal which initiates the stimulus and is
transmitted in the brain for the response (Chen & Sehdev, 2019). The pathway has three
different forms of neuron that carries the impulse into the brain and helps in origin of pain
(Yam et al., 2018). These are first order neuron, second order neuron and third order neuron.
The first order neuron are comprises of dorsal root ganglion within which the cell bodies are
located. The branch is divided into two, one is peripheral branch and the other is central
branch. The second order neuron comprises of cranial nerves present in the brain stem. The
third order neuron in present within the ventral posterolateral nucleus area of the brain
thalamus.
Morphine belongs to the class of opioid analgesic drug. It has a high affinity towards
few receptors like kappa, delta and opioid. The drug primarily binds to the mu receptor and
begins its analgesic effect within the central and peripheral nervous system. The drug initiates

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the descending inhibitory pathway of pain in the central nervous system along with inhibition
of afferent neurons in the peripheral nervous system thus decreasing the overall transmission
(Pasternak, 2014).
Answer No. 3.
The bowel obstruction causes gurgling, vomiting, nausea and abdominal pain. The
shrinking of the scars promotes restriction in the pathway. The obstruction can be managed
with the help of surgical therapy. The patient developed the condition of high fever due to the
pus formation around the bowel wall during the inflammation. Fever is a symptom of any
chronic infections (Evans, Repasky & Fisher, 2015). The clinical observation report states
that the patient had hypotension or lower blood pressure which was 92/52mm/Hg. The cause
of this lower blood pressure can be malabsorption of food in the body. It also made the body
weak and fatigue. The patient had a high level of pulse rate which was 112bpm, which can be
the reason for developing coronary artery diseases developed due to stiffness of the artery due
to clotting. The respiratory rate was elevated due to the severe abdominal pain which can in
turn give rise to pleural disease. The patient’s oxygen saturation rate was normal. The main
cause of weight loss is due to diarrhoea. The urine report and the dark colour suggested that
the patient had a symptom of pyelonephritis which is sign of renal infection (Belyayeva &
Jeong, 2019). The patient also had a severe symptom of anaemia along with C-reactive
protein which is found from the blood report.
Answer No. 4.
The patient was prescribed intravenous fluid named Hartmann’s solution and
methylprednisolone. The other name of Hartmann’s solution is Ringer’s lactate solution. It is
a mixture of potassium chloride, sodium chloride, calcium chloride and sodium lactate along

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with water. It is normally recommended to patient with poorer blood pressure for exchanging
the electrolytes and fluids in the body (Hoorn, 2017). It is helpful in curing of metabolic
acidosis as it is linked to renal failure chiefly with the sign of dehydration. The solution is
very high in bicarbonates, which helps in preserving the fluid balance of the body. The
patient in the case study was given this fluid to restore the electrolytes of the body as he was
suffering from severe abdominal pain due to dehydration.
The patient was also recommended for methylprednisolone intravenously. The drug is
useful in treating the inflammation of the body. It is also called as anti-inflammatory agent as
it belongs to corticosteroid (Puckett, Gabbar & Bokhari, 2019). The drug cures the diarrhoea
state by lowering the immune function of the body resolving the inflammatory state of the
digestive tract. The drug shows its effect very fast just after consuming of taking. It is also
useful in treating ulcerative colitis and also resolving infection.

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References
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Evans, S. S., Repasky, E. A., & Fisher, D. T. (2015). Fever and the thermal regulation of
immunity: the immune system feels the heat. Nature reviews. Immunology, 15(6),
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Ha, F., & Khalil, H. (2015). Crohn's disease: a clinical update. Therapeutic advances
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