1. GASTROINTESTINAL DISORDERS
BY: DENKENESH DOBBINS PHARMD CANDIDATE

2. PREVALENCE
Prevalence: 60 to 70 million people are affected by digestive diseases
Ambulatory care visits: million
Hospitalizations: 13.5 million
Mortality: 236,000 deaths

3. EPIDEMIOLOGY Gastroesophageal Reflux Disease Chronic constipation
Irritable Bowel Syndrome
Hernia
Hemorrhoids
Inflammatory Bowel Disease (Crohn’s Disease)
Ulcerative Colitis
Peptic Ulcer Disease
Viral Hepatitis
Pancreatitis

4. PATHOPHYSIOLOGY tube 25 to 32 feet in length oral cavity pharynx
esophagus
stomach
small intestine
large intestine
rectum
anus.
Organs that assist the function of the system
liver,
pancreas,
appendix
Gallbladder
produce and excrete digestive enzymes and acids.

5. PATHOPHYSIOLOGY POOR DIET AND NUTRITION
UNDERLYING CAUSES of GI disturbance include
microbes
toxins
physical damage to tissues
infections, inadequate or excessive levels of digestive acids (HCI) and enzymes,
stress,
poor levels of helpful bacteria, and
poorly functioning liver, pancreas or gallbladder
IMMUNE INCOMPETENCE OR  DYSFUNCTION
1. heavy in meat, starch, processed foods, preservatives, chemicals and other unhealthy additives. Diets should be altered to include more fiber, enzymes including digestive enzymes, appropriate oils like essential fatty acids and complex carbohydrates

6. SIGNS AND SYMPTOMS Unexplained weight loss Persistent, low-grade fever
Blood in the stool
Having a bowel movement that is black, tarry and foul smelling
Stomach pain
Flatulence (gas)
Bloated or swollen abdomen
Diarrhea, constipation or a combination of both
Whitish mucus in the stool

7. DIAGNOSIS Stool culture. Ultrasound Colonoscopy
Esophagogastroduode noscopy

8. NON PHARMALOGICAL THERAPY
EXERCISE
RELAXATION TECHNIQUES
HEALTHY DIET
HERBAL SUPPLEMENTS
GINGER
ALOE VERA WATER
LICORICE

9. PHARMALOGICAL TREATMENT proton pump inhibitors
DRUG
MOA
ADVERSE EFFECTS
MONITORING PAREMETER
Omeprazole
(Prilosec)
irreversibly block the the gastric proton pump of the gastric parietal cells. The proton pump is the terminal stage in gastric acid secretion
Headache
Diarrhea
Constipation
Abdominal pain
Nausea
Rash
Vitamin B12 levels
Ansoprazole
(Prevacid)
Rabeprazole
(Aciphex
Pantoprazole
(Protonix
Esomeprazole
(Nexium

10. PHARMALOGICAL TREATMENT Histamine H2-receptor antagonists
DRUG
MOA
ADVERSE EFFECT
MONITORING PARAMETERS
Cimetidine (Tagamet)
Suppress the normal secretion of acid by parietal cells and the meal-stimulated secretion of acid
Abnormal heartbeat
Confusion
Diarrhea
Difficulty breathing
Dilated pupils
Drowsiness
Flushing
Low blood pressure
Nausea
Blood pressure: may cause hypotension
Ranitidine (Zantac)
Famotidine (Pepcid)
Nizatidine (Axid)

11. SPECIAL POPULATIONS Pregnancy antacids sucralfate ranitidine
metoclopramide

12. PHARMACIST ROLE Educate patients drug use
Counsel patients on proper drug administration and possible side effects
Check for drug interactions
Counsel patient on importance of compliance

13. CLINICAL PEARLS
Avoid eating spicy foods, highly acidic and fatty foods
Avoid drinking alcohol
Take medication 30 minutes prior to meal

14. WORK CITED
National Digestive Diseases InformationClearinghousehttp://digestive.niddk.n ih.gov/statistics/statistics.aspx. September 2013
Natural Horizons Wellness Centers trointestinal-disorders/ September2013.
Histamine H2 Antagonist (Oral Route, Injection Route, Intravenous Route. information/DR September2013