CASE #7 R.G. Presents with Inflammatory Bowel Disease Description: R.G. was a co

Question

CASE #7

R.G. Presents with Inflammatory Bowel Disease Description: R.G. was a colicky baby, even though she was breastfed. Her mother decided to continue to breast feed up to 8 months because she was accepting very few solids. As a toddler and preschooler, RG would fuss and refuse to eat some days for no apparent reason. She often complained of abdominal pains and cramps as she grew up and her parents tried to identify the reason for her pain. They thought she was lactose intolerant like some close relatives. By avoiding milk products, RGs products in her diet. They also gave her a low fiber diet by limiting whole grain breads and cereals. Although she had no appetite and was rater thin, she was still growing normally. Her parents were Jewish and both were tall and thin. Her intermittent abdominal pain and diarrhea continued into her teens and her doctor diagnosed her with irritable bowel syndrome and lactose intolerance and she was treated for iron and vitamin B12 deficiency anemia. In high school, she began to have sporadic diarrhea when she ate fatty foods and was stressed during examination periods. She began to develop joint pain and very fatigued which led her to drop ballet and become isolated from friends. She became sad and her school performance dropped. The next year she had more frequent episodes of diarrhea, lost more weight and felt depressed. It worsened to include skin rash, mouth ulcers, periodontal disease, and fever. She almost stopped eating as not to trigger bouts of pain. She mostly had soup and gingerale, with occasional plain white pasta or rice. Upon complaining of unbearable appendicitis like abdominal pain she went to the emergency room.

Question: 1. Why do you think R.G. developed iron and vitamin B12 deficiency anemia? Please Explain.

Explanation / Answer

INFLAMMATORY BOWEL DISEASE:- Inflammatory bowel disease is an auto immune disorder in which ones own immune system attacks the same individual like digestive system.It is 2 types crohn's disease and the other is ulcerative colitis.Crohn's disease mainly affect any part of the gastrointestinal tract that is from mouth to anus.Where as ulcerative colitis it mainly affects to the colon and rectum.

SIGNS AND SYMPTOMS:- Abdominal pain,vomitigs ,diarrohea,rectal bleeding severe internal cramps in the region of pelvic,weight loss , anemia,arthritis, cholangitis

Based on the case scenario R.G develoed iron and vitamin B12 deficiency anemia as a result of loss of blood by rectal bleeding .due to disease condition there is poor absorption of the intestines and R.G has reduced the intake of food which results in decreased vitamin supplement .because of these two reasons R.G has developed iron and vitamin B12 deficiency.

because of this vitamin B12 deficiency only we are seeing the symptoms in R.G like depression, irritability, inflammation of the tongue which results in decreased sense of taste.

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