Mechanisms Inflammatory Bowel Disease And Irritable Bowel Syndrome

Week 8: Gastrointestinal System
During examinations, patients often present with various symptoms. Often, these symptoms overlap multiple disorders within body systems—especially gastrointestinal (GI) disorders—further increasing the difficulty in diagnosing and treating patients. Consider a patient who presents with severe abdominal pain that has persisted for months. At first review, it might be inflammatory bowel disease or irritable bowel syndrome, but upon closer inspection and testing, gastric cancer is found. As this case outlines, it is important that you, as an advanced practice nurse, are able to identify alterations of GI disorders in order to properly diagnose patients or refer them for specialized care when necessary.
This week you examine the pathophysiology of gastrointestinal disorders. You also explore common treatments and the impact of patient factors on these disorders.
Learning Objectives
Students will:
Compare the pathophysiology of inflammatory bowel disorder and irritable bowel syndrome
Analyze treatments for digestive disorders
Evaluate the impact of patient factors on digestive disorders
Analyze the pathophysiology of gastric acid stimulation and production
Evaluate the impact of patient factors on gastrointestinal disorders
Evaluate clinical considerations of gastrointestinal disorders
Understand and apply key terms, concepts, and principles related to alterations of the gastrointestinal system
Photo Credit: Keith Brofsky/Photodisc/Getty Images
Learning Resources
Note: To access this week's required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Chapter 35, “Structure and Function of the Digestive System”

This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.

Chapter 36, “Alterations of Digestive Function”

This chapter presents information relating to disorders of the gastrointestinal tract and accessory organs of digestion. It also covers the pathogenesis, clinical manifestations, evaluation, and treatment of gastroesophageal reflux disease, gastritis, peptic ulcer disease, inflammatory bowel disease, and irritable bowel syndrome.

Chapter 37, “Alterations of Digestive Function in Children”

This chapter presents information relating to disorders of the gastrointestinal tract and liver that affect children. It focuses on congenital impairment, inflammatory disorders, metabolic disorders, as well as the impairment of digestion, absorption, and nutrition.
Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Chapter 13, “Gastrointestinal Disease”

This chapter provides a foundation for exploring gastrointestinal disorders by reviewing the structure and function of the GI tract. It also describes mechanisms of regulation of GI tract disorders such as acid-peptic disease, inflammatory bowel disease, and irritable bowel syndrome.

Chapter 14, “Liver Disease”

This chapter reviews the structure and function of the liver. It then explores the clinical presentation, etiology, pathogenesis, pathology, and clinical manifestations of three liver disorders: acute hepatitis, chronic hepatitis, and cirrhosis.

Chapter 15, “Disorders of the Exocrine Pancreas”

This chapter begins by reviewing the anatomy, histology, and physiology of the exocrine pancreas. It then examines the clinical presentation, etiology, pathology, pathogenesis, and clinical manifestations of acute and chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer.
de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787
Required Media
Laureate Education, Inc. (Executive Producer). (2012c). The gastrointestinal system. Baltimore, MD: Author.

This media presentation outlines the pathophysiology of the gastrointestinal system and associated alterations.
Optional Resources
American Liver Foundation (2016). Retrieved from http://www(dot)liverfoundation(dot)org/
National Digestive Diseases Information Clearinghouse. (2016). Retrieved from http://digestive(dot)niddk(dot)nih(dot)gov/index.aspx
Discussion: Digestive Disorders
Many patient symptoms can be tied to multiple disorders, which may lead to misdiagnoses. For instance, consider two digestive disorders of the gastrointestinal tract—inflammatory bowel disease and irritable bowel syndrome. These two disorders are commonly confused because they present similar symptoms. As an advanced practice nurse, you must know the differences to properly diagnose and treat the disorders. How does the pathophysiology of inflammatory bowel disease compare to the pathophysiology of irritable bowel syndrome? How do treatments for the two disorders compare?
To Prepare
Review Chapter 36 in the Huether and McCance text and Chapter 13 in the McPhee and Hammer text.
Identify the pathophysiological mechanisms of inflammatory bowel disease and irritable bowel syndrome. Think about similarities and differences between the disorders.
Consider common treatments for inflammatory bowel disease and irritable bowel syndrome. Reflect on whether treatments for one disorder would work for the other disorder.
Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor you selected might impact the pathophysiology of and treatments for each disorder.
By Day 3
Post an explanation of the pathophysiological mechanisms of inflammatory bowel disorder and irritable bowel syndrome, including similarities and differences. Then describe common treatments, addressing whether treatments for one disorder would work for the other disorder. Finally, explain how the patient factor you selected might impact the pathophysiology of and treatments for each disorder.