Digestive Disorders

Assessment Techniques Physical exam: Visualization Auscultation Percussion Palpatation Gastric analysis: hemoccult, pH Fecal analysis: hemoccult, cultures, O&P

Radiography Abdominal CT Scan Abdominal ultrasound Radiographic procedure Detailed cross sectional view within the abdomen (detects tumors and obstruction) Abdominal ultrasound Noninvasive procedure using sound waves Upper GI Series/Barium Swallow Lower GI Series/Barium Enema

Endoscopy Colonoscopy visualizes the colon, from rectum to cecum

Endoscopy (continued) Gastrointestinal endoscopy visualizes esophagus, stomach and duodenum Protoscopy Visualizes rectum and anus Sigmoidoscopy Visualizes the entire rectum, sigmoid colon, and possibly a portion of the descending colon

Pathology of the Digestive System Examples of symptoms: Anorexia - lack of appetite Eructation - gas expelled from the stomach through the mouth Steatorrhea - fat in the feces; frothy, foul-smelling fecal matter Ascites - abnormal accumulation of fluid in the abdomen Flatus – gas expelled through the rectum Discuss symptoms such as ascites, borborygmus, constipation, diarrhea, dysphagia, flatus, hematochezia, jaundice, melena, and nausea. Based on your knowledge of the functions of the liver, how might cirrhosis cause ascites? Copyright © 2005 by Elsevier Inc. All rights reserved.

Disorders of the Digestive System Alactasia Also called “lactose intolerance.” Not enough of the enzyme lactase is produced. The unabsorbed lactose ferments in the intestines leading to gas, cramps, and diarrhea Anorexia Lack of appetite Anorexia nervosa Compulsive dieting and excessive exercise Can become emaciated and have electrolyte/cardiac disorders

Pathological Conditions (cont’d.) Upper Gastrointestinal Tract achalasia - failure of the lower esophagus sphincter (LES) muscle to relax What kind of diet do physicians recommend to relieve symptoms of achalasia? Copyright © 2005 by Elsevier Inc. All rights reserved.

Disorders of the Digestive System (continued) Anal fistula almost always the result of a previous abscess a small tunnel connecting the anal gland from which the abscess arose to the skin of the buttocks outside the anus.

Disorders of the Digestive System (continued) Appendicitis Inflammation of the appendix; Can rupture and cause peritonitis Tx: Appendectomy Bulemia nervosa

Disorders of the Digestive System (continued) Cleft Lip and Cleft Palate Incomplete closure or fusion of the embryotic structure, specifically the maxillary processes and the nasal elevation during the second month of gestation.

Disorders of the Digestive System (continued) Cholelithiasis Chole = bile or Gall; lithiasis – means presence of stones

Disorders of the Digestive System (continued) Cholecystitis Inflammation of the gallbladder Cirrhosis A chronic degenerative condition of the liver accompanied by the formation of scar tissue Colitis Inflammation of the colon Colon cancer An abnormal growth in the large intestine Constipation The inability to defecate

Disorders of the Digestive System (continued) Celiac disease; usually symptoms develop 2 to 4 months after solid foods are introduced. Children are unable to digest gliadin, which is a component of gluten – a protein found in wheat, rye, barely, and oats. Thought to be related to IgA deficiency and early introduction of protein solids. Crohn’s disease Inflammation and ulceration, usually affecting the ileum and colon, or both Symptoms include chronic diarrhea, abdominal pain, fever, anorexia, wt. loss, FTT, enlarged regional lymph nodes, RLQ mass or fullness.

Disorders of the Digestive System (continued) Diverticulitis The weakening of the colon wall, leading to formation of a pouch causing infection or abscesses if fecal material trapped

Disorders of the Digestive System (continued) Gastroenteritis – vomiting (emesis) and diarrhea Acute caused by: Infections (bacterial, viruses) - Rotavirus Toxins Antibiotic therapy Diet conditions Chronic caused by: Malabsorption disorders (such as Chrons, celiac) Structural defects Allergic disorders

Disorders of the Digestive System (continued) Food Poisoning Botulism Characterized by paralysis and is often fatal E. Coli Watery bloody diarrhea that is often accompanied by a high fever Salmonella Severe diarrhea, nausea and vomiting accompanied by a high fever

Disorders of the Digestive System (continued) Gastritis Inflammation of the stomach lining Gastroesophageal reflux disease Frequent heartburn or chest pain, bitter taste in the mouth, difficulty swallowing, frequent hoarseness or coughing due to regurgitation Halitosis Or bad breath, is caused by anaerobic bacteria

Disorders of the Digestive System (continued) Heartburn A painful burning sensation in the esophagus caused by the backflow of acidic chyme from the stomach Hemorrhoid A painful dilated vein in the lower rectum or anus Hepatitis A viral infection of the liver Jaundice (icterus) – yellow discoloration of skin caused by excessive bilirubin in the blood

Hepatitis Hepatitis A Hepatitis B passed by fecal-oral route, most commonly by poor sanitation or poor hand washing in day-care centers symptoms generally mild Hepatitis B transmitted via blood and body fluids as well as vertically from mother to fetus Can result in long-term sequelae of cirrhosis, liver cancer, fulminating hepatitis, and hepatocellular carcinoma.

Hepatitis continued Hepatitis C Hepatitis D Hepatitis E Hepatitis G – transmitted through the blood -predominantly parenterally spread; often thru blood transfusion Most cases are subclinical but can lead to cirrhosis and hepatocellular carcinoma Hepatitis D only occurs in children infected with HBV Hepatitis E waterborne and is responsible for outbreaks in developing countries. Infection may be severe but it does not become chronic. Hepatitis G – relatively new virus transmitted through blood. individuals with HGB may be asymptomatic, and most infections are chronic

Disorders of the Digestive System (continued) Ileus Temporary stoppage of intestinal peristalsis Intestinal obstruction (bowel obstruction) Complete stoppage to the passage of intestinal contents Intussusception Telescoping of the bowel onto itself Inguinal hernia Protrusion of a small loop of bowel thru a weak place in lower abdominal wall or groin

Disorders of the Digestive System (continued) Pancreatitis A mild acute or chronic condition resulting from gallbladder stone blockage, disease, injury, or alcoholism Peptic ulcer Ulcer of the stomach Peritonitis An inflammation of the abdominal cavity caused by bacteria

Disorders of the Digestive System (continued) Phenylketonuria Inherited disease that can lead to mental retardation if untreated Pyloric stenosis A birth defect in which a constricted pyloric sphincter does not allow food to pass easily into the small intestine

Disorders of the Digestive System (continued) Tay-Sachs A recessive genetic disorder in which fat cells accumulate in the body and cause damage to normal cells Ulcer An open sore on the lining of the digestive tract