Paul is 26 years old; he lives with his fiancée and works for a computer company. Over the last two years he has been feeling tired, suffered from abdominal pain and diarrhoea. Three weeks ago he was diagnosed with Crohn’s disease. He has been shocked by the diagnosis and does not understand the disease or the prognosis.

Identify what information Paul will require regards the disease. Use the headings as a guide to plan your information

Overview of disease

• Long-term disease
• Ulceration along any part of GI tract
• Flare-ups and remission
• Abdominal pain, vomiting, diarrhoea, rectal bleeding, anaemia, weight-loss, fever and fatigue

Treatment

• Medication
• Dietary
• Psychological support
• Referral to IBD specialist nurse to provide ongoing patient centred care

Plan what assessment and health education Paul will require to enable him to cope and manage his Crohn’s disease. Use the headings as a guide

Nutrition and hydration

• Assess using MUST, Identify food triggers, food diary with symptoms, advise on eatwell guide, smaller meals
• Dehydration during exacerbation monitor fluid input, avoid caffeinated drinks

Bowel function

• Assess using Bristol stool chart, Bowel function chart risk diarrhoea and urgency know where toilets are, spare clothes and cleaning wipes

Pain and discomfort

• Pain assessment what causes pain, relieves pain, time of pain, quality onset, severity region of pain, analgesia, change of diet

Knowledge and understanding of IBD

• Establish understanding of condition, give reliable source of information, websites, leaflets

Lifestyle

• Id stress, cause of exacerbation, fatigue, causes and relieving methods coping strategies work informing employers

Psychological impact

• Self-esteem, coping strategies, how look, social impact, how he deals with this
• Meet other patients and support group counselling