...The Honourable Leona Aglukkaq, P.C., M.P. Health Canada Brooke Claxton Building, Tunney's Pasture Postal Locator: 0906C Ottawa, Ontario K1A 0K9 Re: Expansion of private healthcare services offered in Canada: The use of Capsule Endoscopy as a patient purchased diagnostic test for evaluation of gastrointestinal problems Dear Ms. Aglukkaq: I would like to propose a change in the manner in which specialized gastrointestinal diagnostic services are offered in the public Canadian healthcare system. Gastroenterology and evaluation of digestive disease/problems is one of the most heavily utilized sectors in the healthcare system. It is critical to improve patient care by minimizing patient waiting times and to reduce the burden on physicians to provide timely and accurate patient diagnosis and care. As Canada is expanding the offering of some privately offered health services such as ct scans, mris and x-ray studies in terms of diagnostic procedures used to diagnose gastrointestinal problems1, I would like to propose that Capsule Endoscopy be made available as a privately purchased outpatient diagnostic procedure. Currently, this extremely valuable but expensive diagnostic test is only available to a narrowly selected group of patients seeking care from a gastroenterology specialist1. This test has the ability to be used as a timely, accurate, low risk and easily administered diagnostic tool for patients presenting with several different types of gastrointestinal dysfunctions...
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...Patient Education Plan: Crohn’s Disease NUR/427 Health and Chronic Disease Management Patient Education Plan: Crohn’s Disease Patient Case History The patient is a 24-year-old, Caucasian, female who was recently diagnosed with Crohn’s Disease. She is single and currently lives alone in Philadelphia, Pennsylvania. The patient admits to eating a poor/unbalanced diet; she cites her busy schedule as the main factor contributing to her poor nutrition. She is not a smoker. Her father’s sister also has Crohn’s Disease but no one else in the immediate family, at least no one that she knows of, has the disease. She was diagnosed after coming to the emergency room with blood in her stool; she has also experienced bouts of diarrhea off and on for the past several weeks. She takes Advil for headaches daily and complains of constant fatigue, which she attributes to stress. Stress can be attributed to her lifestyle; she is a college graduate who is currently enrolled in a Masters program working toward her MBA. She also works as a teller at a local bank. The field is extremely competitive and between the demand of her job and her schoolwork she has limited time left for a social life. She goes on occasional dates and goes out with girlfriends fewer than two nights a week. Because she is a full-time student she spends a large portion of her time on the computer; she is extremely comfortable using the Internet. The patient has a very busy life and a very full...
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...Impact Paper Regardless of which definition of chronic illness you subscribe to, be it Feldman, Cluff, or Curtin & Lublin, they all share common themes. They all describe a condition that is long lasting and persistent, requiring some medical oversight/treatment and personal retraining. Once a diagnosis is applied, specific treatments are started but the training of the individual is just that, individual. Each person has their own unique learning style. The following describes this process experienced by one patient afflicted with Crohn’s disease (CD). CD is an inflammatory bowel disease affecting the gastrointestinal (GI) tract anywhere from the mouth to the anus. Sometimes confused with ulcerative colitis, CD usually confines itself to the distal small bowel (ileum), large intestine (colon), rectum, and anus. Where colitis only affects the lining of the colon and rectum. The exact cause of CD is not known. It is thought to be an autoimmune disease with a genetic component as this condition tends to run in families. The most common symptoms of CD are cramps like abdominal pain, fever, fatigue, poor appetite, painful bowel movements, persistent diarrhea, and unintentional weight loss. More advanced symptoms include: constipation, eye irritation, rectal fistulas, joint pain, mouth ulcers, bloody stool, rectal bleeding, skin lumps/sores, and swollen gums. CD sufferers are also at greater risk of small bowel and colon cancer. The patient The patient is a 37 year old, Caucasian...
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...General Surgery is a surgical specialty that focuses on abdominal contents including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland (depending on the availability of head and neck surgery specialists). They also deal with diseases involving the skin, breast, soft tissue, and hernias. Services Offered : Trauma surgery – Often they are the first port of call to critically ill or gravely injured patients, and must perform a variety of procedures to stabilize such patients, such as intubation, burr hole, cricothyroidotomy, and emergency laparotomy or thoracotomy to stanch bleeding. Laparoscopic surgery – This is a relatively new specialty dealing with minimal access techniques using cameras and small instruments inserted through 0.3 to 1 cm incisions. Robotic General surgeons that are trained today are expected to be proficient in laparoscopic procedures. Colorectal surgery – General surgeons treat a wide variety of major and minor colon and rectal diseases including inflammatory bowel diseases (such as ulcerative colitis or Crohn's disease), diverticulitis, colon and rectal cancer, gastrointestinal bleeding and hemorrhoids. Breast surgery – General surgeons perform a majority of all non-cosmetic breast surgery from lumpectomy to mastectomy, especially pertaining to the evaluation and diagnosis, of breast cancer. Vascular surgery – General surgeons can perform vascular surgery if they receive special training...
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...Barbara is suffering from Regional Enteritis which is also referred as Crohn’s disease. Crohn’s disease is an inflammatory bowel disease that can affect any area of the digestive tract from the mouth to the anus. Since there has not been any diagnosis made, the diagnosis that I would offer is to request lab tests and x rays to determine if the disease seems to appear in Barbara’s body. The types of test that I would run are barium x rays and other x rays for showing where and how severe Crohn's disease is. It’s helpful for finding any problems in parts of the small intestine that can't be easily viewed by other techniques. CT scans for usage of computer-aided X-ray techniques to produce more detailed images of the abdomen and pelvis than can be seen in traditional X-rays, colonoscopy or sigmoidoscopy to allow for to directly viewing the large intestine, which is the lower part of the digestive tract , and a video capsule endoscopy in which Barbara will swallow a small capsule or pill that holds a miniature video camera. As it travels through her small intestine, it sends images of the lining to a receiver in which she will wear a belt around her waist. The images are downloaded and reviewed at a computer. The images can provide detailed information about early, mild problems associated with Crohn's disease. When Crohn’s disease is diagnosed after the tests are completed being that there is no cure for Crohns disease, I have various ways to treat it such as prescribing medications...
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...#110 Disease of the Digestive System Crohn’s Disease Dr. Juliet Durant Cameron Palmer March 3rd, 2011 Lab Instructors Ashley Simpson Crohn’s disease is an ongoing disorder that causes inflammation of the digestive tract, also referred to as the gastrointestinal (GI) tract. Crohn’s disease can affect any area of the GI tract, but it most commonly the ileum of the small intestine. The swelling extends deep into the lining of the affected organ and can cause pain; in addition to making the intestines empty frequently, resulting in diarrhea. Crohn’s disease (also referred to as ileitis or enteritis) is an inflammatory bowel disease, the general name for diseases that cause swelling in the intestines. Because the symptoms of Crohn’s disease are similar to other intestinal disorders, such as irritable bowel syndrome and ulcerative colitis, it can be difficult to diagnose. Ulcerative colitis causes inflammation and ulcers in the top layer of the lining of the large intestine. In Crohn’s disease, all layers of the intestine may be involved, and normal healthy bowel can be found between sections of diseased bowel. Crohn’s disease affects men and women equally and seems to run in some families. Crohn’s disease can occur in people of all ages but is more often diagnosed in people between the ages of 20 and 30. People of Caucasian decent have an increased risk of developing Crohn’s disease, and African Americans are at decreased risk for developing Crohn’s disease. Several...
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...at home with her spouse and has a few friends she sees on a regular basis. The patient states she has never smoked, nor has she ever drunk alcohol and no one in the house does either. She does consume 3-4 diet pops a day that contain caffeine. The patient states she has no medical training or knowledge other than the conditions, which she has a history of. She seems to have memory deficits of unknown etiology and very high anxiety issues with very high dependency or separation issues (needing someone near her at all times and demanding). The patient’s medical history consists of kidney stones, urinary tract infection (UTI), high cholesterol, irritable bowel syndrome, diabetes mellitus (Type 1), acid reflux, allergic rhinitis, addison’s disease, osteoporosis, osteopenia, anxiety, and depression. She has a surgical history of: cholecystectomy, colonoscopy, liver biopsy, and hysterectomy. After asking the patient how she learns best, she states “I learn better with a hard copy and someone going over the information me and my husband.” Also assessed were her needs. The acute stage she needs IV access, pain meds, a strict diet of nothing by mouth or minimum, sips of water, IV fluids for dehydration, glucose control, urine sample, stool sample. The next stage of care would most likely consist of a gastroenterologist consult, x-ray (abdomen), CT scan (abdomen), colonoscopy, gastroscopy, and eventually a...
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...probably heard about a digestive disease called Crohn's disease. It is a chronic inflammatory disease primarily of the bowel, but can affect any part of the GI tract. Some signs and symptoms of the disease include persistent diarrhea, rectal bleeding, abdominal cramps and pain, constipation, fever, loss of appetite, fatigue, and night sweats are just some of the many symptoms. If you have one or more of these signs, please go and see your doctor as soon as possible for a possible cause and treatment. It is a chronic disease, so this means patients will likely experience periods when the disease flares up and causes symptoms, followed by periods of remission when patients may not notice any symptoms at all. The...
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... Colorectal Cancer Colorectal cancer is a genetic disorder. Colorectal cancer may cause one or more of the symptoms below: • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days • A feeling that you need to have a bowel movement that is not relieved by doing so • Rectal bleeding, dark stools, or blood in the stool (often, though, the stool will look normal) • Cramping or abdominal (belly) pain • Weakness and fatigue • Unintended weight loss Most of these symptoms are more often caused by conditions other than colorectal cancer, such as infection, hemorrhoids, or inflammatory bowel disease. Still, if you have any of these problems, it's important to see your doctor right away so the cause can be found and treated, if needed. (“FITWAY,” 2013) Colorectal cancer would be diagnosed after having a colonoscopy that would hopefully reveal the cause of the bleeding, change in bowels, etc. If there is colon polyps the surgeons will remove the polyps during the procedure. If the polyps and/or mass are too big to remove during the colonoscopy the surgeons will schedule patient for an abdominal procedure to remove it. Men and women both can equally be affected by colorectal cancer as they increase in age. This type of cancer occurs more often in people age 50 and over but is not limited to these ages. . The U.S....
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...Crohn’s disease is a very serious and underrated disease. There is not much awareness about this disease; however it affects thousands of people a year. Crohn’s disease is an inflammatory bowel disease, (IBD), named after an American gastroenterologist, Dr. Burill B. Crohn. This debilitating disease was further investigated by Dr. Crohn when an Italian physician Giovanni Battista Morgagni in 1969 diagnosed a young man with chronic diarrhea. Because of its symptoms, Crohn’s disease is often misdiagnosed, and conditions for patients only become worse. In 1913, Scottish physician T. Kennedy Dalziel reported nine cases in which patients were suffering from intestinal obstructions. This physician closely examined the patients inflamed bowel and found a characteristic of Crohn’s as describe by Dr. Crohn. The bowel had transmural inflammation with abdominal cramps, fever, diarrhea, and weight loss. This disease was affecting typical young adults in the 1920’s and 1930’s. After several other findings reportedly being documented, Dr Crohn and his colleagues presented a paper on terminal ileitis describing the symptoms and findings of Crohn’s disease to the American Medical Association on May 13, 1932. The findings were given significant recognition, making it the fist time this condition was familiarized with the public in a widely-read journal. Crohn’s disease, also known as granulomatous enteritis and colitis, is an inflammatory disease that can affect any part of the gastrointestinal...
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...Crohn’s Disease Crohn's disease is named after the physician who described the disease in a paper written in 1972. It is also called Morbus Crohn's, Granulomatous enteritis, Regional enteritis, or Terminal ileitis. The disease is usually chronic, with recurrent periods, and also periods of remission. The spread of Crohn s disease into the world is getting worse, and there is still no cure or prevention known to the disease. Crohn's disease is an inflammatory bowel disease ,IBD, the general name for diseases that cause inflammation in the intestines. Crohn's disease can be difficult to diagnose because its symptoms are similar to other intestinal disorders such as irritable bowel syndrome and to another type of IBD called ulcerative colitis. Crohn's disease may also be called ileitis or enteritis. Ulcerative colitis causes inflammation and ulcers in the top layer of the lining of the large intestine. Crohn's disease affects men and women equally and seems to run in some families. About 20 percent of people with Crohn's disease have a blood relative with some form of IBD, most often a brother or sister and sometimes a parent or child. The most common complication is blockage of the intestine. Blockage occurs because the disease tends to thicken the intestinal wall with swelling and scar tissue, narrowing the passage. Crohn's disease may also cause sores, or ulcers, that tunnel through the affected area into surrounding tissues such as the bladder, vagina, or skin. The areas...
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...Anatomy: the abdominal cavity, right colon, cecum, the ascending colon, the hepatic flexure (where the ascending colon joins the transverse colon), the first one-third of the transverse colon, and part of the terminal ileum, along with fat and lymph nodes Indications: Indications for open right hemicolectomy include numerous benign and malignant conditions. The most common malignant condition is adenocarcinoma of the right colon; other malignant indications are malignant tumors of the appendix and cecum. The benign conditions include adenomatous polyps of the colon that cannot be removed endoscopically, carcinoids, irritable bowel syndrome (Crohn disease and sometimes ulcerative colitis), cecal volvulus, severe appendicitis with involvement of the cecum in the inflammatory process, and isolated right-side colonic diverticular disease (rare) Special considerations: In order to plan an operation for a patient with colon cancer, the surgeon must have a thorough understanding of the tumor's location in the bowel, the stage of the cancer, and the patient's physiologic status. ( answer those with pt. info) Pharmacology: Preop- 4 L of polyethylene glycol solution is given to the patient to be taken over 2-3 hours in the afternoon of the day before the procedure. A sodium phosphate enema is given on the night before the operation. Two doses of metronidazole and neomycin sulfate are given after the lavage preparation on the day before surgery. An intravenous (IV) second-generation cephalosporin...
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...Personal Impact Paper Addonica Jackson NUR/427 July 8, 2014 Debra Ayer Personal Impact Paper Crohn's disease (CD) is a chronic inflammatory bowel disease affecting any part of the gastrointestinal tract from the mouth to the anus, although the ileum, colon and perineum are most commonly involved (Hart, A. & Ng, S., 2011). CD is more widespread among adolescents and young adults between the ages of 15 - 35. According to Mayo Clinic Staff, "Researchers believed that a number of factors, such as heredity and a malfunctioning immune system, play a role in the development of Crohn's disease." In CD the patient develops inflammation to the wall of the bowel that causes scarring or the inflammation can penetrate through the wall of the bowel and causes a fistula. Some symptoms of CD are persistent diarrhea, abdominal pain and cramps, rectal bleeding, decrease appetite, weight loss and constipation. In order to protect the patient's privacy I will use the initial AJ. I obtained verbal permission from AJ and her mom to interview her. I chose CD because over the past 6 months I have seen the great financial, personal and social impact CD has on AJ and her family. This paper will also address AJ's learning process and educational experience regarding CD. It will also outline the change motivators AJ used and recommend theories of learning and motivation. AJ, a 21 year old nursing student was experiencing frequent bouts of abdominal pain, loose stool and hyperactive bowel...
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...REASON PROCEDURE: Colonoscopy. INDICATIONS Surveillance colonoscopy. Personal history of colonic polyps. Previous colonoscopy greater than three years ago. DESCRIPTION OF PROCEDURE Timeout was called. Consent signed. Perianal exam normal. Rectal exam normal. Preparation was adequate. The forward-viewing colonoscope was advanced to the cecum necessitating change in body position as well as abdominal wall pressure. In the right colon residual stool was present. FINDINGS Cecum and ascending colon: In the proximal ascending colon, along the medial wall I was lucky to find what appears to be a 1-2 cm carcinoma. This appears to be infiltrating, therefore, only biopsies were taken. The lesion was not removed. The area also was tattooed...
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...Crohn’s Disease is a condition suffered by many young men and women all around the world. Though more prevalent in Northern US and Canada, the disease has found its way to the farthest reaches across the globe. It is found more commonly in females and presents ages 20-30 years, though not strictly. The disease is a type of inflammatory bowel disease and can affect any part in the gastrointestinal tract. Once known as auto immune, it is now classified as immune deficiency. No cure has been found, but researchers work diligently to reduce the effects throughout a Crohn’s patient’s life. Crohn’s Disease was given its name in 1932 by gastroenterologist Dr. Burrill B. Crohn, whom it was respectively named after. Previous to this, many cases appeared and recorded as early as 1682 which was when the first description of the condition was made by the Italian physician Giovanni Battista Morgagni. It was described as “…a young man with a chronic, debilitating illness and diarrhea” (Bellany, 2005). Since then, more and more cases have arrived and continues to effect thousands of people worldwide. This condition falls under a medical category known as Inflammatory Bowel Diseases or IBD. The two main forms of IBD are Crohn’s Disease and ulcerative colitis. While very similar and often confused with one another, they have many different, as well as common symptoms. Less common forms are known as collagenous colitis, lymphocytic colitis and Behcet’s disease. Crohn’s Disease...
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