1. Digestive Disorders

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

3. 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

4. Endoscopy
Colonoscopy
visualizes the colon, from rectum to cecum

5. 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

6. 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.

7. 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

8. 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.

9. 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.

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

11. 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.

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

13. 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

14. 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.

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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.

21. 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

22. 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

23. 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

24. 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

25. 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