The nurse can expect a 60-year old patient with ischemic bowel to report a history of:
A. Diabetes mellitus
B. Asthma
C. Addison's Disease
D. Cancer of the bowel
Correct Answer: A. Diabetes mellitus
Ischemic bowel occurs in patients over 50 with a history of diabetes mellitus. Diabetes mellitus is the most common endocrine disorder affecting multiple organs including the gastrointestinal (GI) tract where manifestations and/or complications relate to disordered gut motility possibly as a result of autonomic neuropathy.
Option B: Asthma is not related to an ischemic bowel. An increased prevalence of GI symptoms or complications has been documented in diabetic patients compared with nondiabetic control subjects including symptoms from both the upper and lower GI tract such as gastroparesis, anorexia, vomiting, early satiety, intestinal enteropathy, diarrhea, constipation, or fecal incontinence.
Option C: Addison disease is an acquired primary adrenal insufficiency. A primary adrenal insufficiency is termed Addison disease when an autoimmune process causes the condition. It is a rare but potentially life-threatening emergency condition. It results from bilateral adrenal cortex destruction leading to decreased adrenocortical hormones, which may include cortisol, aldosterone, and androgens.
Option D: Approximately 5% of patients with ischemic colitis have an obstructing lesion, usually in the distal colon. Half of these patients have colon cancer while the remainder has strictures caused by disorders such as diverticulitis, radiation, and previous surgery.
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