Crohn Disease Basics

Crohn disease is a chronic inflammatory bowel disease with inflammation that can involve the full thickness of the bowel wall. It can affect different gastrointestinal locations and may leave unaffected bowel between involved areas. Transmural inflammation helps explain the major structural complications: a narrowed segment can obstruct flow, penetrating disease can form a fistula, and infection can collect as an abscess. Crohn disease can recur even when symptoms have settled, so symptom relief alone does not prove that inflammation has resolved. [1,2] Common findings include abdominal pain, diarrhea, bowel urgency, fatigue, reduced appetite, weight loss, nausea or vomiting, fever, and blood in stool. Perianal pain, swelling, drainage, fissures, or fistulas may be part of the presentation. Joint, skin, or eye symptoms can occur outside the bowel. The pattern varies with disease location and behaviour; no single symptom confirms Crohn disease. [2,3] The practical-nursing mental model is: assess the present symptom pattern, compare it with the client’s baseline, look for complications and treatment harm, and connect symptoms with objective findings. Record stool frequency and character, pain, nausea or vomiting, oral intake,...