Crohn’s Disease and Ulcerative Colitis Essay

Crohn’s Disease and Ulcerative Colitis Essay

Problem Description

Crohn’s disease and Ulcerative colitis (Inflammatory Bowel Disease) are both considered to be diseases with a high relapse and remittance rate, a period in which the inflammation of the mucus membranes tends to vary from normal to severe ulceration. According to the World Health Organization, the prevalence of IBD has gradually increased in the recent past decades to approximately 360 per 100000 persons in well developed nations. Research has revealed that stress increases the risk of relapse in IBD, an important finding that should be integrated into therapeutic interventions to benefit patients as well as improve the clinical understanding on the pathology of IBD. As stated by Woodward et al., (2016), failure to do so, it is certain that we shall continue to witness high complication rates, hospital readmissions, poor healthcare quality and poor health outcomes. Crohn’s Disease and Ulcerative Colitis Essay


Setting/Context Where the Issue Can Be Observed

Patients with stress suffering from IBD can either be adults or children and are found in inpatient or outpatient primary care settings, pediatric units, psychiatric units or long term care facilities. Recent studies have indicated that stress among these patients increases the risk of relapse resulting to a series of symptoms which can either be acute, severe or chronic. Depending on the degree of severity, this is what contributes to frequent visits to primary care providers and hospital readmissions. It is also worth knowing that, other patients with stress and suffering from IBD can also be found in community settings most of whom are influenced by culture to use traditional medicine for symptom relief.

High Level Detail Regarding the Issue

Research has revealed that the aetiology of both conditions encompasses a multifaceted interaction between the environment and genes. A lot of progress has been made in identifying the specific genes which predispose an individual to IBD. However, the environmental factors that trigger the first presentation, subsequent relapse and their mode of action are not well understood (Woodward et al., 2016). Stress has been identified as a potential environmental factor that has been reported to have a strong relationship with IBD. In this case, stress involves acute stress and chronic stress where patients experience adverse life events, both of which suppress the immune system hence reduce the number of NK cells, macrophages and CD8+ lymphocytes that are present in blood. Besides, has also been evidenced to increase the severity of inflammation in patients with IBD.

Impact of the Problem on the Quality of Care Provided By Staff and Patient Outcomes

Patients with IBD experience extremely severe physical symptoms which are associated a wide range of comorbidities. Up to 60% experience stress which increases the risk of relapse, which can persist during remission resulting to frequent visits to primary care providers, specialists and even hospital readmissions. Frequent hospital readmissions have undeniably been identified as a metric that is associated with poor healthcare quality in the United States with poor health outcomes (Barnes et al., 2017).

Significance of the Issue and Implications to Nursing

            Stress causes leukocytosis, which lowers the immune status of patients with IBD and this predisposes one to infectious diseases and hospital readmissions.  The current trends regarding this issue are of public health importance for taxpayers as well as patients since it is associated with increased medical costs, poor quality of life and poor health outcomes (Barnes et al., 2017). Crohn’s Disease and Ulcerative Colitis Essay

When patients do not recover as expected or develop more complications, nurses become stressed, discouraged or even frustrated and this lowers the satisfaction rates which can in turn negatively impact the care provided to other patients (Barnes et al., 2017).

Proposed Solution

Research clearly reveals that stress is a factor that influences the pathology of IBD and reduces the quality of life of these patients. In order to improve the quality of life and health outcomes of patients with IBD, Selinger et al., (2017) highly recommend that these patients are educated on the significance of reducing stress and anxiety and how this may positively impact their health. This can also be achieved through stress reduction therapy which has been proven to be of great therapeutic significance.


Barnes, E. L., Kochar, B., Long, M. D., Martin, C. F., Crockett, S. D., Korzenik, J. R., & Kappelman, M. D. (2017). The burden of hospital readmissions among pediatric patients with inflammatory bowel disease. The Journal of pediatrics, 191, 184-189.

Selinger, C. P., Carbery, I., Warren, V., Rehman, A. F., Williams, C. J., Mumtaz, S., & Ford, A. C. (2017). The relationship between different information sources and disease‐related patient knowledge and anxiety in patients with inflammatory bowel disease. Alimentary pharmacology & therapeutics, 45(1), 63-74.

Woodward, S., Dibley, L., Combes, S., Bellamy, A., Clark, C., Czuber-Dochan, W., & Norton, C. (2016). Identifying disease-specific distress in patients with inflammatory bowel disease. British Journal of Nursing, 25(12), 649-660.

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Crohn’s Disease and Ulcerative Colitis Essay


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