1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 11 Digestive System Diseases and Disorders

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology Two main purposes: –Change foods into simpler substances –Eliminate waste products Alimentary canal –Continuous tube running from mouth to anus

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology Accessory organs: –Tongue –Teeth –Salivary glands –Gallbladder –Pancreas –Liver

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Digestion Animation

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Common Signs and Symptoms Related to hemorrhage, perforation, and altered motility Terms identifying bleeding: –Hematemesis –Hematochezia –Melena

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Common Signs and Symptoms Perforation in stomach or intestines causes peritonitis and septicemia Alteration in motility include diarrhea, vomiting, nausea, or constipation

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests X-ray Endoscopic exam –Esophagogastroduodenoscopy (EGD) GI series –Barium swallow and enema Occult blood Ova and parasites

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. EGD

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Mouth Dental caries –Disease of teeth due to bacteria on tooth surface Plaque Periodontal disease –Affects supporting structures of teeth/gums –Main cause of tooth loss in adults

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Mouth Periodontal disease –Causes: Poor oral hygiene Inadequate diet leading to gingivitis –Inflammation of gums –Prevention: Brushing and flossing Regular dental care Adequate diet

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Mouth Mouth cancer –Squamous cell carcinoma of lip Common oral cancer –Usually on lower lip from exposure to sunlight, chewing tobacco, or pipe/cigar smoking –Treatment: Radiation Surgical excision

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cancer of the Lip Photo courtesy Mark L. Kuss

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Throat and Esophagus Pharyngitis –Also known as sore throat –Viral or bacterial –Diagnosis by throat culture –If caused by strep, treated with antibiotics

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Throat and Esophagus Reflux esophagitis –Inflammation of tissue at end of esophagus –Caused by backflow of stomach acids through cardiac sphincter upward into esophagus

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Throat and Esophagus Reflux esophagitis –Symptoms: Heartburn Burning sensation in mid-chest or epigastric area –Long-term reflux can lead to bleeding, ulceration, and scarring of esophagus

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Throat and Esophagus Reflux esophagitis –Treatment: Reduce reflux Avoid large meals Avoid spicy foods, caffeine, and tight clothing Take stool softeners

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Throat and Esophagus Reflux esophagitis –Treatment: Take laxatives Take antacids or other drugs that tighten gastroesophageal sphincter Sleep with head of bed elevated

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Throat and Esophagus Hiatal hernia –Part of stomach sliding into chest cavity –Increases with age and weakness of cardiac sphincter –May be asymptomatic But can be related to reflux

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hiatal Hernia

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Throat and Esophagus Esophageal varices –Enlarged, tortuous veins of esophagus –Usually related to liver cirrhosis –Causes: Excessive alcohol consumption –Hemorrhage Life-threatening

21. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Stomach Gastritis –Inflammation of stomach –Symptoms: Epigastric pain Bloating Nausea

22. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Stomach Gastritis –Causes: Irritating agents –E.g., aspirin, alcohol, coffee, tobacco, bacterial-laden foods Helicobacter gastritis caused by small bacteria in stomach lining

23. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Stomach Gastritis –Diagnosis of helicobacter gastritis by biopsy –Treatment: Pepto-Bismol Flagyl Amoxicillin

24. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Stomach Peptic ulcer –Found in stomach and duodenum –Caused in part by action of pepsin –Also known as gastric ulcers

25. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Stomach Peptic ulcer –Treatment: Reduction of contributory factors Antacids Surgery in severe cases

26. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Stomach Stomach cancer –Affects more males than females –Often goes undiagnosed until metastasizes –Symptoms: Loss of appetite General stomach distress Heartburn

27. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Stomach Stomach cancer –Treatment: Surgical resection Chemotherapy Radiation –Prognosis good if discovered early

28. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Malabsorption syndrome –Small intestine unable to absorb nutrients Difficulty absorbing fats and minerals –Treatment: Diet therapy –Complication: Bleeding due to lack of vitamin K absorption

29. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Regional enteritis –Also known as Crohn’s disease and inflammatory bowel disease (IBD) –Chronic inflammatory disease most commonly affecting small intestine –Characterized by exacerbation and remission

30. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Regional enteritis –Symptoms: Anorexia Flatulence Abdominal pain Diarrhea and constipation –Supportive treatment: Low-residue diet Medications to control diarrhea, inflammation, infection, and depression

31. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Gastroenteritis –Inflammation of stomach and intestines –Causes: Bacteria Viruses Parasitic invasion

32. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Gastroenteritis –Symptoms: Nausea Vomiting Abdominal cramping Diarrhea Stomach rumbling Malaise

33. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Gastroenteritis –Treatment: Anti-nausea and anti-diarrheal medications Antibiotics Fluids Nutritional support

34. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Gastroenteritis –Prevention: Hand washing prior to food preparation Proper refrigeration Avoidance of contaminated food and/or water

35. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Inguinal hernia –Outpouching of small intestine and peritoneum into groin area –More common in males

36. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Small Intestine Inguinal hernia –Strangulated hernia if portions of herniated intestine become caught and twisted, cutting off blood supply to organ –Treatment: Surgical repair

37. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Appendicitis –Inflammation of appendix –Symptoms: Abdominal pain that shifts to right lower quadrant (RLQ) Nausea and vomiting Fever Leukocytosis

38. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Appendicitis –Treatment: Surgical excision –Hopefully before rupture

39. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Intestinal obstruction –Inability to move contents through intestine –Blockage in intestine, disease, or ileus May occur from tumors, hernias, volvulus, adhesions, intussusception, or paralytic obstruction

40. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Volvulus and Intussusception

41. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Intestinal obstruction –Symptoms: Mild to severe abdominal pain and distention Nausea and vomiting –Treatment: Nasogastric suctioning Surgery

42. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Ulcerative colitis –Chronic inflammation of colon –Symptoms: Lower abdominal pain Blood in stools Anemia Diarrhea

43. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Ulcerative colitis –Treatment: Dietary limitations Stress reduction Mild sedatives Anti-inflammatories –Surgery if other treatments unsuccessful

44. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Irritable bowel syndrome –Also known as spastic colon –Most common intestinal disorder –Inflammation of bowel with chronic lesions –Symptoms: Abdominal pain Altered motility Diarrhea or constipation

45. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Irritable bowel syndrome –Causes: Spicy foods and seasonings Caffeine Alcohol Stress –Treatment: Avoidance of causative factors

46. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Dysentery –Acute inflammation of colon –Main symptom: Massive diarrhea with blood, pus, and mucous accompanied by severe abdominal pain –Treatment dependent on cause But antibiotics may be used to treat bacterial infection

47. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Diverticulosis/diverticulitis –Diverticulosis Condition of diverticula or little outpouches –Diverticulitis Outpouches become packed with fecal material and become irritated and inflamed

48. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diverticulosis/Diverticulitis

49. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Diverticulosis/diverticulitis –Symptoms: Lower abdominal pain Cramping –Treatment: Antibiotics Dietary modification

50. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Colon polyps –Inward projection of mucosal lining of colon –Diagnosis by colonoscopy or sigmoidoscopy –Suspicious polyps excisionally biopsied

51. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Colon Polyp

52. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Colorectal cancer –Carcinoma of colon and rectum –Symptoms: Change in bowel habits Pencil-sized stools Blood in stools Anemia Abdominal discomfort and obstruction

53. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Colon Colorectal cancer –Adenocarcinomas Most common –Diagnosis by barium swallow and enema, stool exams for occult blood, and colonoscopy –Prevention: Diet and stool examinations

54. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Rectum Hemorrhoids –Varicose veins in rectum Internal or external –Causes: Pressure in anal area Constipation Prolonged standing Pregnancy and childbirth

55. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hemorrhoids

56. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Rectum Hemorrhoids –Prevention: Stool softening Good bowel habits Fluids and fiber Exercise Avoidance of laxative use

57. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diseases of the Rectum Hemorrhoids –Treatment: Medications Warm sitz baths Manual reduction Cryosurgery and hemorrhoidectomy

58. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Mouth –Causes: Motor vehicle accident Fall Abuse Burn Blunt or perforating injury

59. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Stomach or intestines –Causes: Perforation as result of stabbing or gunshot wound –Medical emergency –Treatment usually surgical

60. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rare Diseases Achalasia –Disorder of esophagus causing pain with swallowing Gluten-induced enteropathy –Also known as celiac sprue disease Intestinal polyps –Benign tumors found along intestine lining

61. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Effects of Aging Disorders common Decreased sense of taste Loss of teeth Increased incidence of ulcer disease Constipation problems Development of hemorrhoids