1. The Digestive System Lesson 2: Pathology of the Digestive System30
The Digestive System
Lesson 2:
Pathology of the Digestive System

2. Lesson Objectives
Upon completion of this lesson, students should be able to …
Define and spell the terms to learn for this chapter.
Briefly explain common disorders associated with the digestive system.

3. Overview of Digestive Disorders
Can be minor or serious
Symptoms may be subtle
Causes can vary
Diagnosis:
Medical history
Physical exam
Laboratory tests
Endoscopic procedures
Imaging techniques 3

4. Critical Thinking Question
What are some causes of digestive system disorders? 4

5. Appendicitis Inflammation of the appendix Symptoms:
Acute pain at the McBirney point on the abdomen
Treatment is surgical removal of the appendix
Complication:
Appendix can burst, causing infection and even death
The appendix is a pouch extending off the cecum of the large intestine. Bacteria can collect in the pouch, causing infection. 5

6. McBurney’s Point

7. Cirrhosis Damage to the liver caused by fibrosis
Chronic inflammation of the liver prevents normal liver function
Numerous causes
Symptoms include:
Edema and ascites
Fatigue and jaundice
Itching and bleeding
Weight and muscle loss
Abdominal pain 7

8. Treatment of Cirrhosis
Avoiding substances harmful to the liver
Dietary modifications
Medications and surgery to prevent and treat complications
Liver transplant in extreme cases 8

9. Colitis Inflammation of the large intestine Many causes and types
Symptoms:
Abdominal pain
Diarrhea and bloating
Dehydration
Bloody stools 9

10. Colitis
Treatment:
Directed at underlying cause–infection, inflammation, lack of blood flow, or another cause 10

11. Critical Thinking Question
What does the term “colitis” tell about the disorder? 11

12. Colorectal Cancer Begins as benign polyps
Because the polyps are small and produce few, if any, symptoms, regular screening tests are important to help prevent end-stage cancer
If signs and symptoms of cancer do appear, they may include a change in bowel habits, bloody stools, persistent cramping, gas, or abdominal pain 12

13. Colorectal Cancer
Screening tests and a few simple changes in diet and lifestyle can dramatically reduce a person’s overall risk of developing colon cancer
Treatment options:
Surgery
Chemotherapy
Radiation 13

14. Critical Thinking Question
What are some ways to prevent colon cancer? 14

15. Constipation Occurs when:
Person has less than 2 bowel movements a week, or 2 of the following problems 25 percent of time:
Straining to eliminate
Feeling that bowels are not emptied
Hard or pellet-like stools 15

16. Constipation Causes: Lack of dietary fiber Dehydration
Lack of exercise
Lifestyle changes 16

17. Critical Thinking Question
What is the relationship between diet, constipation, and colon cancer prevention? 17

18. Constipation Additional Symptoms: Treatment: Cramping Bloating Nausea
Exercise
Good nutritional habits
Scheduling a certain time each day for bowel movements
Laxatives may be useful 18

19. Crohn’s Disease Chronic inflammation of the intestines
Related to ulcerative colitis
Cause unknown, but may be bacterial
Common Symptoms:
Abdominal pain
Diarrhea
Weight loss 19

20. Crohn’s Disease Course of remissions and exacerbations Treatment:
No cure
Medications
Mild cases may not need treatment 20

21. Critical Thinking Question
What do “remissions and exacerbations” mean? 21

22. Diarrhea Frequency or looseness of stool Types: Causes:
Acute–a few days to a week
Chronic–lasts more than 3 weeks
Causes:
Depends on type
Usually bacterial, viral, or parasitic infection
Side effects of medication 22

23. Diarrhea Treatment: Absorbents to absorb excess water
Antimotility medication to relax muscles 23

24. Diverticulitis
Inflammation of a diverticulum in the walls of the colon (can follow diverticulosis)
Cause unknown
May be result of stool in a diverticulum
Symptoms:
Pain and cramping
Fever
Chills
Bloating
Constipation or diarrhea
Treatment depends on severity of condition 24

25. Diverticulosis Out-pouchings (diverticula) from the colon
Caused by pressure on and weakening of intestinal wall
Higher incidence in the elderly
Mild symptoms:
Bloating
Cramping 25

26. Diverticulosis
Sets stage for inflammation and infection of the diverticula (diverticulitis)
Prevention:
High fiber diet 26

27. Critical Thinking Question
Why is there a higher incidence of diverticulosis in the elderly? 27

28. Colon with diverticulosis.28

29. Gastroesophageal Reflux Disease (GERD)
Back flow of gastric fluids into the esophagus
Lower esophageal sphincter doesn’t close
Symptoms:
Heartburn
Sore throat
Hoarseness
Bad taste in mouth
Belching
Regurgitation
May be symptom-free 29

30. Gastroesophageal Reflux Disease (GERD)
Treatment:
Medications
Positioning
Fundoplication (surgery to tighten the cardiac sphincter) 30

31. Gastroesophageal Reflux Disease (GERD)
Complications:
Reflux esophagitis (inflammation of the esophagus)
Barrett’s esophagitis (precancerous condition)
Perforation of the esophagus
Esophageal cancer
Esophageal stricture
Esophageal ulcers 31

32. Mechanisms of GERD

33. Hemorrhoids Dilated vein in the walls of the anus
Associated with constipation or chronic diarrhea
Symptoms:
Bleeding after defecation
Protrusion of hemorrhoids from anus (severe)
Treatment:
Dietary changes
Topical medication
Surgery (severe) 33

34. Critical Thinking Question
How can increasing fiber intake help to control hemorrhoids? 34

35. Internal and External Hemorrhoids

36. Hiatal Hernia
Upper stomach protrudes into chest through an esophageal hiatus
Causes:
Obesity and smoking
Poor seated posture
Frequent coughing
Straining with constipation
Heavy and frequent lifting
Heredity
Congenital defects 36

37. Critical Thinking Question
What other serious condition has symptoms of chest pain and/or pressure? 37

38. Symptoms of a Hiatal Hernia
Chest pain and/or pressure
Heartburn
Difficulty swallowing
Coughing, belching, and hiccups
Can be associated with GERD 38

39. Hiatal Hernia 39

40. Inguinal Hernia
Intestine pushes through the abdominal wall in the groin area causing a bulge
Causes:
Weakness in abdominal wall
Heavy lifting
Straining resulting from coughing, or bending, straining, or even laughing 40

41. Symptoms and Treatment for an Inguinal Hernia
Bulge in groin, scrotum, or labia
Pain and discomfort, worsening with bending or lifting
Nausea and vomiting
Heaviness, swelling, and a tugging or burning sensation in the area
Only treatment is surgery 41

42. Inguinal Hernia

43. Irritable Bowel Syndrome (IBS)
Common intestinal condition
Causes:
Largely unknown
May be stress-related
Treatment:
Dietary modifications
Medication
Psychotherapy (for stress) 43

44. Symptoms of Irritable Bowel Syndrome (IBS)
Abdominal cramping and pain
Changes in bowel movements
Uncontrollable urgency to defecate
Gassiness and bloating
Nausea
Passing of mucus during bowel movements
Feeling that bowels are not emptied 44

45. Oral Cancer Can start anywhere in the mouth Risk factors:
Age and gender
Smoking and use of chewing tobacco
Excessive sun exposure 45

46. Oral Cancer
Symptoms:
Sore, irritation, or swelling in the mouth or lump on the neck lasting more than 2 weeks
Red or white patches in mouth
Sore, wart-like patch or lump on the lip
Persistent sore throat
Difficulty chewing, swallowing, or speaking 46

47. Treatment of Oral Cancer
Surgery
Radiation
Chemotherapy 47

48. Pancreatic Cancer Types: Symptoms: Adenocarcinoma of the pancreas
Pancreatic neuroendocrine carcinoma (rare)
Symptoms:
Easily attributed to other disorders
Abdominal and/or back pain
Weight loss
Bloating
Diarrhea or fatty bowel movements
Jaundice 48

49. Treatment for Pancreatic Cancer
Complete surgical removal of the cancer
Radiation
Chemotherapy
High mortality rate 49

50. Peptic Ulcer Disease (PUD)
Lesion in the lining of the stomach, esophagus, or duodenum
Duodenal ulcers most common
Ulcers in the stomach are also common
Caused by imbalance in stomach acids
Can be aggravated by bacterial infection
The most common location for PUD is the duodenum. 50

51. Peptic Ulcer Disease (PUD)
Symptoms
Abdominal pain
Nausea and vomiting
Weight loss
Heartburn and chest pain 51

52. Peptic Ulcer Disease (PUD)
Symptoms of Stomach ulcers
Pain and/or burning sensation in upper abdomen when stomach is empty
Difficulty swallowing and/or regurgitation
Bloating, retching, feeling ill after eating
Nausea and vomiting
Loss of appetite and weight 52

53. Development of a Peptic Ulcer53

54. Treatment of PUD Treatment: Medication change
Avoidance of tobacco and alcohol
Medications to protect the stomach by stopping the secretion of stomach acids
Antibiotics to treat H. pylori infections
Occasionally surgery may be required 54

55. Once pyloric stenosis is surgically corrected, it does not recur.
Occurs in infants, usually before 5 months of age
Pyloric sphincter swells and thickens
Symptoms:
Vomiting of increasing severity
Dehydration
Fussiness
Treatment:
Surgery
Once pyloric stenosis is surgically corrected, it does not recur. 55

56. Questions? 56