Crohn's disease is a type of inflammatory bowel disease
which refers to the intermittent episodes of abdominal cramping and diarrhea.
It causes inflammation in the digestive tract and often leads to weight loss
fatigue and vomiting and nausea. In the current case, Jordan is a 25 years old
male diagnosed with Crohn's Disease.
Structural and Functional Changes
The structural and functional wellbeing of digestive tracts is crucial for the health of the individual. The structural abnormalities often leads to functional decline, as a result human experience unhealthy life. The structural changes in inflammatory bowel disease mainly occur due to issue in digestive tract. Hence the distal ileum is the most prevalent issue in IBD. Furthermore, the inflammation or thickness of the intestine wall is also one of the kind of inflammatory bowel disease. In the current case, Jordan was experiencing diarrhea, abdominal cramp, and weight loss and diagnosed with Crohn's disease.
The complete medical assessment of the
Jorden’s reports suggest multiple changes in the structure of digestive tracts,
which further leads to the weight loss. The structure changes of inflammatory
disease were large patches of inflamed mucosa and submosca throughout his small
bowel and colon. He was also diagnosed with the bowel obstruction in his
terminal ileum. The dry and pale skin were the other symptoms due to the
structural issues. The structural abnormalities were inhibiting the organs to
function well. The relationship between structural and functions are
consistent. The structural wellbeing of the digestive system promotes better
functioning. In contrast, the structural abnormalities disturb the functional
system as well (Nair et al., 2016).
The functional changes which have been observed in
Jordan’s case were dysfunction of food consumption and water intake. The
digestive system was not processing appropriately to absorb the food. As a
result, Jordan was experiencing nausea and vomiting. The inflamed digestive
tract was not properly performing its function. Diarrhea or lack of food
consumption and vomiting were reducing the weight of the Jordan. Due to Crohn's
disease, the sleep cycle was also disturbed. Furthermore, Jordan was not able
to appropriately walk and perform daily activities. The work-life was also
reported to be disturbed. Apart from these, Jordan was experiencing multiple
pain.
The functions of the entire body were disturbed due to
structural issues. All these structural abnormalities were contributing to
weight loss in Jordan’s case. Literature suggests that structural abnormalities
in the digestive system not merely affect the function of that particular
organ, but also disturbs the entire body functions (Nair et al., 2016).
Role of Morphine in determining the Pathways to alter the
Conscious Perception of Pain
Morphine is a very effective painkiller for reducing pain
in multiple body areas. In particular, it is effective in blocking the pain due
to Crohn's disease. Morphine found to be more effective painkiller in
contemporary medicines. The recent data suggested the effectivity of morphine
in pain reduction and led to a better condition of the patients. It is
effective because it directly effects on opioid receptors (GCPR), which
regulates pain in the nervous system. Opioid receptors are widely distributed
in the brain, spinal cord, digestive tract. These receptors respond to
encephala, which control body pain.
Morphine mimics the compound to artificially block pain. Morphine binds the opioid receptors that generate the series of events, and GCPR activates g-protein. It also triggers more conduction through potassium channels and minimizes the conduction through calcium channels and adenylate cyclase. In this way, the nervous system controls the body’s signalling system that transmits pain. The robust evidence-based studies have been carried out on patients with Crohn's disease (Morrone et al., 2017).
The results of the
studies recommended the morphine three most effective medicine for blocking
pain. A few contradictory studies also reported that morphine as a least
effective painkiller due to its side effect (Long, Barnes, Herfarth,
&Drossman, 2012), but the ratio of such studies were very limited.
Therefore, it can be concluded that morphine is an effective medicine for
relieving abdominal pain.
The Clinical Manifestation indicates the deterioration of
Jordan’s Condition
The clinical manifestation that deteriorates the Jordan
Crohns or inflammatory bowel is comprised of a cluster of symptoms. Such as
diarrhea, abdominal pain, weight loss, nausea or billing vomiting, fatigue,
mails, tenderness, abdominal gurgling & rumbling, and dark colour urine.
The medical examination showed right lower abdominal quadrant and audible bowl
sound, pale and dry skin, cool extremities, capillary and flat neck veins.
Medical Officer reported bowel obstruction in terminal inflamed mucosa &
submucosa throughout his small bowel and colon. The above symptoms have a
history of gradual development.
This early sign
and symptoms of the Crohn's disease were observed in the age of 17. Currently,
Jordan is 25 years old and still suffering from acute pain and Crohn's disease.
Unfortunately, the lack of proper treatment by medical officers and surgeon
lead to deteriorating the condition of Jordan. The issues needed medical
attention but tried to manage by consulting doctors and nutrients. No
improvement in Jordan's condition has been observed despite having invasive
treatments. According to recent studies, the timely treatment for an early sign
and symptoms for Crohn's disease must be taken (Ha, & Khalil, 2015). In
some other studies, the delayed treatment and inappropriate treatments worsen
the condition of the patients.
Characteristics of Intravenous Fluid and Rational for Administration
The intravenous fluid is a liquid substance used to
fulfil the water, sugar and salt (Barkas, Liberopoulos, Kei &Elisaf, 2013).
The intravenous fluid injected through a vein to those patients who cannot
consume oral food. Intravenous food is available in many types and forms. In
Jordan’s case, the 100 ml Hartman compound sodium was used to fulfil diet
deficiency. The Hartman solution is a mixture of sodium lactate, sodium
chloride, potassium, calcium and chloride. It is used for multiple purposes
such as relapsing electrolytes & fluids among patients with low blood
pressure, low blood volume and metabolic acidosis (Kammermeier, 2016). The
fluid is injected through veins.
In the current case as Jorden was suffering from weight
loss. He was not consuming many diets due to diarrhea and vomiting, as his
intestine and bowel tract was not functioning correctly. To fulfil the diet
deficiency, 100 ml Hartman compound solution was injected in his body. The
literature is enriched with the evidence-based studies reflects the
effectivities of intravenous fluid for the management of Crohn's disease
affects (Barkas, Liberopoulos, Kei &Elisaf, 2013). The robust studies also
indicate the effectiveness of intravenous fluid in weight gain among the
patients of Crohn's disease (Kammermeier, 2016).