Nursing Management of Crohn's

Victor
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As we have discovered whilst reading the previous entries in this blog, Crohn's is a chronic, lifelong disease with which there is no cure.  The patient will need to modify lifestyle and routine, as well as develop coping strategies in order to adapt and manage the condition so as to ensure the highest quality of life that is possible.

The job of the nurse is to accompany the patient along various parts of the journey to discovering how to manage this chronic disease.  The nurse may be there at the beginning, during a flare-up, or providing pre- or post-surgical care following a procedure deemed necessary due to chronic damage and inflammation brought upon by the disease process.

Nurses, first and foremost, reinforce and support the medical care plan.  They provide education regarding various medications the patient will take to treat the disease, as well as associated side effects and time frame of expected action/results.  They will talk to the patient about situations which will increase the likelihood of a surgical procedure being required.  They'll strongly advocate for a balanced lifestyle and nutritious diet that has the following characteristics:


  • Avoid oily or spicy foods, sugar, high-fiber foods (need supplementation to replace lost nutrition), alcohol, caffeine, and foods high in sulfur - all of these foods can irritate the intestine and/or promote flare-ups 
  • Consider sensitivity to gluten and/or dairy (a gluten-free diet has shown to lessen the symptoms of Crohn's disease, so eat veggies, meat and fish)
  • Stay hydrated - drink plenty of fluids
  • Exercise to stay fit
Nurses will often incorporate additional tools into the plan of care, such as a website that helps a patient deal with Crohn's disease.  http://www.ibdetermined.org/ is such a website.  Sponsored by the Crohn's and Colitis Foundation of America (CCFA), it offers various tools to help a patient learn about Crohn's, but more specifically, to cope with this lifelong disease.  For instance, there's an app called "GI Buddy" that patients can either use on the site or download via a smartphone that does some really cool things.  A patient can track their symptoms, stay on top of their treatment, log food intake, monitor well-being, and generate reports that track trends in their disease (i.e. symptom progression/regression).  



The site also offers "tours" for the newly-diagnosed Crohn's patient, where they can explore options in disease management and hear from long-time and experienced Crohn's patients.  Tools such as this site, coupled with nursing education and care, can combine to form a powerful and effective team in guiding a Crohn's patient down the road to effective management and optimal quality of life.

References:

I'll Be Determined Exploration.(n.d.). Retrieved May 10, 2015, from http://www.ibdetermined.org/Default.aspx

Smith, C., & Harris, H. (2014, December 1). Crohn disease: Taking charge of a lifelong disorder. Nursing 2014, 37-38.

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