The nurse is reviewing the record of a client with Crohn’s disease. Which of the following stool characteristics would the nurse expect to note documented on the client’s record?
A. Chronic constipation
B. Diarrhea
C. Constipation alternating with diarrhea.
D. Stool constantly oozes from the rectum.
Correct Answer: B. Diarrhea
Crohn’s disease is characterized by nonbloody diarrhea of usually not more than four to five stools daily. Over time, the diarrhea episodes increase in frequency, duration, and severity. In CD, the inflammation extends through the entire thickness of the bowel wall from the mucosa to the serosa. The disease runs a relapsing and remitting course. The other options are not associated with diarrhea.
Option A: Patients with flare-ups of Crohn’s disease typically present with abdominal pain (right lower quadrant), flatulence/bloating, diarrhea (can include mucus and blood), fever, weight loss, anemia. In severe cases, perianal abscess, perianal Crohn’s disease, and cutaneous fistulas can be seen.
Option C: When the small bowel is involved, it may present with diarrhea, malabsorption, weight loss, abdominal pain, and anorexia. Enterovesical fistulae may present with pneumaturia, recurrent urinary tract infections, and feculent vaginal discharge.
Option D: Granuloma formation is very common in Crohn’s disease but their absence does not exclude the diagnosis. The ongoing inflammation and scarring lead to bowel obstruction and stricture formation. Crohn’s disease is also associated with enterovesical, enteroenteral, enterocutaneous, and enterovaginal fistulas.
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