NURSING 101Crohns Disease - Nursing Care Plan/ECPI University

Crohn’s Disease Nursing Care Plan




Crohn’s disease is named for Dr. Burrill Bernard Crohn (1884–1983) who, with his colleagues, first
described the disease in 1932. Crohn’s disease can affect any part of the digestive system;
however, it develops most often in the section of the small intestine just before the large intestine
begins. This region is called the ileum, and Crohn’s disease that develops there is sometimes called
ileitis. The other common site for Crohn’s disease is in the colon or large
intestine. Crohn’s disease is one of several inflammatory bowel diseases.



Epidemiology

In the United States, it is currently estimated that about 1 –1.3 million people suffer from IBD. 1, 2 The
cause of IBD is unknown, and until we understand more, prevention or a cure will not be possible.

We do understand that IBD affects some subpopulations more than others.

Sex: Ulcerative colitis is slightly more common in males, while Crohn’s disease is more frequent in
women.

Ethnicity: IBD occurs more in people of Caucasian and Ashkenazic Jewish origin than in other racial
and ethnic subgroups. Previously noted racial and ethnic differences seem to be narrowing though.2
In spite of incomplete data on certain subgroups including racial and ethnic minorities and
geographic regions, reported rates remain in similar ranges.

We still do not have a precise understanding of how many people experience Crohn’s disease and
ulcerative colitis because we lack standard criteria for diagnosing IBD. Identifying cases of IBD is
often inconsistent or the disease may be classified as another condition.



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, Crohn’s Disease Nursing Care Plan




Prevalence (number of existing cases per 100,000 population)

Crohn's disease Ulcerative colitis
26 to 199 cases per 100,000 persons 2
37 to 246 cases per 100,000 persons 2




201 per 100,000 adults 1
238 per 100,000 adults 1




Incidence Rate (number of newly diagnosed cases per 100,000 person­years

Crohn's disease Ulcerative colitis
3.1 to 14.6 cases per 100,000 person-years 2
2.2 to 14.3 cases per 100,000 person-years 2




Risk Factors

Environmental


Ulcerative colitis is more common among ex­smokers and nonsmokers, while Crohn’s disease is
more common among smokers.


IBD is more common in developed countries. There is north­ to­ south variation and is more
common in urban communities compared with rural areas. These observations suggest that
urbanization is a potential contributing factor. It is believed that this is the result of “westernization” of

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lifestyle, such as changes in diet, smoking, differences in exposure to sunlight, pollution, and
industrial chemicals.3


Socioeconomic


Three studies outside of the United States have examined the relationship between socioeconomic
factors and IBD. One study found both ulcerative colitis and Crohn’s disease are more prevalent in
white­collar occupations.4 Another study found Crohn's disease and ulcerative colitis were less
common in groups with higher education and income. A third study found a minor association
between specific occupations and IBD.6


Other factors


Diet, oral contraceptives, perinatal and childhood infections, or atypical mycobacterial infections
have been suggested, but not proven, to play a role in developing IBD.7



In 2015, an estimated 1.3% of US adults (3 million) reported being diagnosed with IBD (either
Crohn’s disease or ulcerative colitis). This was a large increase from 1999 (0.9% or 2 million adults).
Some people were more likely to report having IBD, including those:
 Aged 45 years or older.
 Hispanic or non­Hispanic white.
 With less than a high school level of education.
 Not currently employed.
 Born in the United States (compared with adults born outside of the United States).

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