Comprehensive Case Study – Ulcerative Colitis (Essay Sample)

Comprehensive Case Study – Ulcerative Colitis Student's Name Institutional Affiliation Course Instructor's Name Date Introduction Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that causes ulcers and inflammation in the respiratory tract. It affects the internal linings of the colon and rectum, with symptoms gradually developing over time rather than suddenly (Henriksen et al., 2018). The main symptoms of UC include rectal bleeding, mucus passage, tenesmus, crampy pain in the abdomen, and diarrhea (Perler et al., 2019). The extent of the disease will determine how severe the disease presents itself. While ulcerative colitis can acutely present itself, the symptoms usually present for longer durations of weeks or months. It is worth noting that symptoms like diarrhea can be mild and intermittent that patients fail to seek medical assistance. Mahima and Prashanth (2017) present that diarrhea is the main symptom of UC. The researchers explain that this results from an abnormal response from the body's immune system. Various researchers have presented on the treatment and diagnostic process showing enhancements in UC management and treatment (Mahima & Prashanth, 2017; Ungaro et al., 2019). Various guidelines have been provided by research on the best practices regarding treatment. Hence, this analysis presents an overview of UC treatment based on two articles. Key Concepts Related to the Topic ‘A case study on ulcerative colitis’ by Mahima and Prashanth (2017) outlines a treatment procedure for ulcerative colitis. To put the extent of the disease damage into context, Mahima and Prashanth (2017) noted that UC has “an incidence of 1 to 20 cases per 1,00,000 individuals per year and a prevalence of 8 to 24 per 10,0002 (p. 1795). The extreme conditions of the disease are usually experienced between the age of 15 to 30. It is also reported that the illness has a second peak at ages 60 to 80. While the disease lacks any known cure, their research evidence suggests that the signs and symptoms can be significantly reduced through treatment. The researchers adopted Ayurveda as a separate treatment option for the illness, describing it as an alternative, convenient, and safe treatment. This treatment involves the use of Basti which offers a protective coating for the bowel to heal the wounds inside. ‘A treat-to-target update in ulcerative colitis: a systematic review’ by Ungaro et al. (2019) provides insights on UC treatment through therapy. The researchers present that a significant step towards UC treatment was made in 2015 with the proposal of Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) to shift the disease’s therapeutic focus to changing its natural history by monitoring the measurement objectives regularly and designing suitable treatment methods. This shift in the therapeutic approach had a positive reception among researchers leading to frequent references and citations. Nonetheless, since this EBM was initiated, new evidence of optimal treatment targets for ulcerative colitis has led to various viewpoints. The STRIDE proposal led to the treat-to-target approach for IBD, whose main objective was to shift the focus of treatment of ulcerative colitis to long-term prevention. It also proposed that the activity measurement for the disease be monitored objectively. These measurements may include the determination of endoscopic inflammation evidence. The T2T approach aimed to adjust therapy depending on the attainment of established treatment targets to realize disease remission. Viewpoints from Research EBM Guidelines There are various controversies surrounding UC treatment. However, the presentations from the two articles provide no compelling evidence that medication is better than therapy or vice versa. The general aim of UC treatment is to help medical practitioners develop reasonable practices in ensuring consistency in providing high-quality care and emphasizing the importance of offering support and advice to patients. According to Mahima and Prashanth (2017), UC requires a combination of internal and external treatment for appropriate treatment results to be realized. On the other hand, Ungaro et al. (2019) suggested that an increase in the histological and endoscopic targets and a decrease in the symptomatic or clinical targets presented a significant opportunity for this. Their focus was on promoting the prevention of the disease in addition to focusing on treatment through therapy. Treating or preventing the occurrence of UC conditions will rely on how best the selected methods or guidelines are implemented. For instance, the Basti method was successful because the treatment administration was adequately and properly conducted. The Merit of Evidence Found on the Topic Despite having no clear underlying etiology, some research evidence presents that inflammation is caused by the combination of compromised colonic epithelial integrity and changes in the intestinal microbiota. This leads to non-sterile contents of the intestines being exposed to the immunological tissue. Researchers also argue that dietary, environmental, and genetic factors play a significant role in the pathogenesis of ulcerative colitis (Ungaro et al., 2019; Perler et al., 2019). The disease has various risk factors, including a family history of inflammatory bowel diseases, NSAIDS, HLA-B27 positive, and smoking cessation, even though the overall benefits of smoking cessation are generally greater than the risks of ulcerative colitis (Jung et al., 2019). The clinical features of the disease could present in the form of historical symptoms as already identified. In contrast, others may be associated with extra-intestinal manifestations, such as renal, hematological, musculoskeletal, and ophthalmic symptoms. UC diagnosis predominantly happens based on the endoscopic findings and the clinical history of the disease. Clinical examinations look at the abdomen; the findings may include tenderness, pain, and distension in the lower abdomen. A digital rectal examination (DRE) may be necessary to screen for blood presence in anorectal pathology. A general examination of UC may also reveal other findings such as anemic features, uveitis, erythema nodosum, clubbing, and joint pain (Henriksen et al., 2018). The illness’s classification happens through various terms used in describing UC, depending on the location and extent of the illness. For instance, UC is classified as proctitis (rectum), pancolitis (rectum and entire colon), and protosigmoiditis (rectum and sigmoid colon). UC is also classified depending on the clinical severity, which can be mild, moderate, or severe. However, it also has other diagnoses with similar clinical features, including Crohn’s disease, infectious colitis, diverticulitis, radiation colitis, and vasculitis. UC Treatment Procedures In STRIDE therapy, UC treatment can be achieved by normalizing the bowel habit and resolving the rectal bleeding. Ungaro et al. (2019) present that it is important to take measures on inflammation to objectively manage the disease. However, some patients with histological and endoscopic remissions may experience continued symptoms. This is attributed to non-inflammatory mechanisms, including bacterial overgrowth in the small intestines, neurologic abnormalities, changes in the chronic fibers, and bile acid diarrhea. Stool frequency and rectal bleeding are important tools for measuring the extent of the disease. Mahima and Prashanth (2017) take a conventional approach to treatment approach with their recommendation of the Basti method. This is a procedure administered in the morning that requires patients to defecate before receiving a full body massage followed by a mild steam bath and then treatment. A barrier to practical acceptance of these treatment guidelines is caused by a lack of research evidence connecting the treatment targets to long-term outcomes. How the Evidence Would Impact Practice New treatment targets and methods will emerge as additional learning, and the body of research evidence continues to grow. This analysis suggests that future studies focus on determining the predictive value of treatment and prevention methods already in place. Additionally, there should be an evolution in the biomarker search owing to the frequent changes in disease activity, as explained by Ungaro et al. (2019). Studies must also design treatment and prevention strategies that explain the etiological characteristics of ulcerative colitis. For instance, Ungaro et al. (2019) proposed the development of a functional index for bowel damage from UC. As an emerging and seeming successful approach to the management and prevention of UC, the T2T paradigm must be widely embraced by various personnel in treating and caring for UC victims. Avoiding the long-term effects of UC require innovative intervention approaches based on EBP methods like the Basti treatment administered in Mahima and Prashanth’s (2017) case study. What Should Be Differently Based on Knowledge Gained? Even though the guidelines provided in the articles are comprehensive and based on research evidence, there are significant concepts related to culture, ...