Nurse Practitioners Raising Crohn’s and Colitis Awareness
Learn more about these common gastrointestinal conditions — and what you can do to aid patients living with them.
Across the United States, it is estimated that 2.4 to 3.1 million people are living with inflammatory bowel disease (IBD). As explained in the Journal for Nurse Practitioners (JNP), “IBD is a term collectively used to refer to conditions that cause inflammation of the bowel. The two most common disorders included in this term are ulcerative colitis and Crohn disease.” Crohn’s and colitis are lifelong diseases, and the Centers for Disease Control and Prevention (CDC) estimates that the “2018 total overall costs for IBD-related care were $8.5 billion” — and are continuing to trend upward.
“Crohn's disease and ulcerative colitis, collectively known as IBD, come with pain, inflammation, fatigue and other symptoms that often go unspoken due to stigma,” states the Crohn’s and Colitis Foundation. The stigma surrounding Crohn’s disease and ulcerative colitis have long led to diagnostic delays — with the average diagnostic delay of IBD ranging anywhere from 2 months to 8 years. In observance of Crohn’s and Colitis Week, the American Association of Nurse Practitioners® (AANP) would like to take this opportunity to share IBD resources for nurse practitioners (NPs) supporting their patients with these conditions.
Combating Crohn’s Disease
According to the American Journal of Gastroenterology (AJG), “Crohn's disease is an idiopathic inflammatory disorder of unknown etiology with genetic, immunologic and environmental influences.” Though it largely shares many of the same symptoms as ulcerative colitis and other forms of IBD, Crohn’s differentiates itself with symptoms such as diarrhea which is not bloody, malnutrition and mouth sores. Complicating matters is the fact that Crohn’s disease may appear — and reappear — at any point in a patient’s lifespan. As the American Society of Colon & Rectal Surgeons (ASCRS) explains, “It is a chronic condition that can appear at any time, can go into remission without explanation and can recur without apparent cause. Unlike ulcerative colitis, there is no cure for Crohn's disease. However, medical and surgical management of Crohn’s disease often provides patients with long periods of clinical remission.”
“Crohn’s disease can be a devastating disease and difficult to diagnose. The advanced practice nurse (APRN) should be aware of the etiology, pathophysiology, diagnostic methods and current treatment options of this disorder,” states Brenda Ruthruff, MSN, APRN-BC, CWOCN. In a clinical review for the Journal of the American Association of Nurse Practitioners® (JAANP), Ruthruff goes on to stress that, “In collaboration with a gastroenterologist, APRNs can provide much needed information to the patient with Crohn’s disease. Practice recommendations include patient education, pain management and support for quality-of-life issues.” NPs can leverage the American College of Gastroenterology (ACG) clinical guidelines for the management of Crohn’s to aid in the diagnosis and treatment of this dangerous disease.
Understanding Ulcerative Colitis
Ulcerative colitis is known as the most common form of IBD. According to the AJG, “Nearly 1 million individuals each in the United States and Europe are affected by this condition and many more globally.” Remarking on how this illness impacts the digestive tract, the CDC explains “Inflammation from UC causes the walls of the colon to weaken. This wears away affected areas, creating open sores called ulcers.” The symptoms most unique to ulcerative colitis include stool with blood and mucus, stomach cramping and an urgent need to have a bowel movement.
Thankfully, the treatment of ulcerative colitis has seen advances to help address the growing incidence of this disease. The ACG states that “the management of disease has grown increasingly complex with availability of additional therapeutic classes. In addition, algorithms for initiating, optimizing and monitoring response to existing therapies have undergone considerable evolution.” NPs can positively impact patients with ulcerative colitis by implementing treat-to-target strategies for tackling IBD such as “providing a first-line assessment and diagnosis, prescribing treatment, encouraging greater patient–health care professional communication, expanding available clinical resources and acting as a first point of contact for advice and support.” For more information on tackling ulcerative colitis, Crohn’s disease and other gastrointestinal health issues, review the resources available to NPs in the AANP Gastroenterology resources page.
Engage, Learn, Network and Progress Practice in Gastroenterology
The Gastroenterology AANP Community offers a unique opportunity to interactively collaborate with colleagues who share an interest or clinical expertise in gastroenterology. As an AANP Community member, you’ll have access to a cutting-edge, online forum where you can engage in discussions, document sharing and knowledge exchange with fellow NPs. Come learn, share and help progress the development of theory and practice in gastroenterology.