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Aims. To consider a Patient's experience of IBDTo gain an appreciation of the complexities of IBD
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1. Inflammatory Bowel Disease Case Study Rachel Lees
Specialist Dietitian, HEFT
2. Aims To consider a Patients experience of IBD
To gain an appreciation of the complexities of IBD & how this can impact on Dietetic input
To reflect on the need to be flexible, there are often no absolutes with Dietetic Treatment!
To remember we need to deliver Patient centred care
3. Patient Profile NR, a female Asian patient born in 1976
Diagnosed with Crohns Disease in 1999
Thalassemia trait
Vegetarian
Avoids milk on cereal
Height 1.60m, usual weight around 60kg
4. History 1 OP between Nov 02 Dec 04
Weight 58.6kg, stable
Crohns active
Eating small vegetarian meals regularly +/- Fortisip 1 per day
Anaemic, started on Iron. Discussed good sources of Iron in a Vegetarian Diet
Advised to have a Colectomy, decided to delay this
Drug Rx Methotrexate, Prednisilone, Calcichew D3 Forte Methotrexate - antimetabolite alters immune functionMethotrexate - antimetabolite alters immune function
5. History 2 Jan 2005
Admitted 20/1 with L sided abdominal pain & vomiting. Weight 55kg
Diagnosis of Crohns Colitis +/- Perforation or Abcess
Recommenced on supplements
Theatre 30/1 for subtotal colectomy + Ileostomy. No evidence of small bowel Crohns seen in theatre
6. History 3 7/2/2005 Faecal peritonitis & sepsis Albumin 10, Mg 0.9 Re-laparotomy, abdominal drains ITU for Ventilation NG feeding commenced with Nutrison Protein Plus Complex Entero Cutaneous Fistulae Diagnosed