Practicum Journal

Mary arrived at the healthcare with complaints of abdominal pain, persistent diarrhea, fatigue and occasional rectal bleeding.  Initial investigations pointed towards ulcerative colitis as Mary suggested that her pain began around the colon.  Mary was given pain relievers, and anti-inflammatory medication as further investigations and tests were conducted.  The ‘Aha' moment occurred when laboratory results (including endoscopy) indicated that she has ulcers in the intestinal tract and not the colon.  I realized that we could have misdiagnosed the patient for ulcerative colitis instead of Crohn's disease (Burns, & Blosser2013). 

Further investigations revealed that her small intestines were severely affected by the diseases and indicator that she could have been ignoring the symptoms for a while.  The small intestine had abscess and traces of intestinal bleeding.  Luckily, the treatment and management of Crohn's diseases are almost the same as that of ulcerative colitis.  Mary was already on anti-inflammatory drug Azulfidine.  The patient was also started on immunosuppressants such as cyclosporine to minimize the effects of the immune system causing inflammation.  Antibiotics were also prescribed to eradicate bacterial infection. Anti-diarrheal agents were also given to reduce the rate of diarrhea (Zonderman, & Vender, 2000).  The patient was also advised to increase her intake of fluids to reduce the risk of dehydration. The experience of handling Mary made me appreciate the importance of conducting in-depth investigations before making a diagnosis.  Diseases may have almost similar symptoms thus the need to consider and eliminate all potential disease before commencing treatment. Misdiagnosis can worsen the patient's condition especially if the patient commences with her or his medication.

References

Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., &Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.

Zonderman, J. & Vender, R. (2000). Understanding Crohn and ulcerative colitis. Univ. Press of Mississippi,

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