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

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

Chapter 11

Digestive System Diseases and Disorders

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


Anatomy and Physiology

• Accessory organs:– Tongue

– Teeth

– Salivary glands

– Gallbladder

– Pancreas

– Liver


Animation

Click Here to Play Digestion Animation


Common Signs and Symptoms

• Related to hemorrhage, perforation, and altered motility

• Terms identifying bleeding:– Hematemesis

– Hematochezia

– Melena


Common Signs and Symptoms

• Perforation in stomach or intestines causes peritonitis and septicemia

• Alteration in motility include diarrhea, vomiting, nausea, or constipation


Diagnostic Tests

• X-ray

• Endoscopic exam– Esophagogastroduodenoscopy (EGD)

• GI series– Barium swallow and enema

• Occult blood

• Ova and parasites


EGD


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



• Periodontal disease– Causes:

• Poor oral hygiene

• Inadequate diet leading to gingivitis– Inflammation of gums

– Prevention:• Brushing and flossing

• Regular dental care

• Adequate diet



• 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


Cancer of the Lip

Photo courtesy Mark L. Kuss


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



• Reflux esophagitis– Inflammation of tissue at end of esophagus

– Caused by backflow of stomach acids through cardiac sphincter upward into 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



• Reflux esophagitis– Treatment:

• Reduce reflux

• Avoid large meals

• Avoid spicy foods, caffeine, and tight clothing

• Take stool softeners



• Reflux esophagitis– Treatment:

• Take laxatives

• Take antacids or other drugs that tighten gastroesophageal sphincter

• Sleep with head of bed elevated



• 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


Hiatal Hernia



• Esophageal varices– Enlarged, tortuous veins of esophagus

– Usually related to liver cirrhosis

– Causes:• Excessive alcohol consumption

– Hemorrhage• Life-threatening


Diseases of the Stomach

• Gastritis– Inflammation of stomach

– Symptoms:• Epigastric pain

• Bloating

• Nausea



• Gastritis– Causes:

• Irritating agents– E.g., aspirin, alcohol, coffee, tobacco, bacterial-laden foods

• Helicobacter gastritis caused by small bacteria in stomach lining



• Gastritis– Diagnosis of helicobacter gastritis by biopsy

– Treatment:• Pepto-Bismol

• Flagyl

• Amoxicillin



• Peptic ulcer– Found in stomach and duodenum

– Caused in part by action of pepsin

– Also known as gastric ulcers



• Peptic ulcer– Treatment:

• Reduction of contributory factors

• Antacids

• Surgery in severe cases



• Stomach cancer– Affects more males than females

– Often goes undiagnosed until metastasizes

– Symptoms:• Loss of appetite

• General stomach distress

• Heartburn



• Stomach cancer– Treatment:

• Surgical resection

• Chemotherapy

• Radiation

– Prognosis good if discovered early


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



• 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



• Regional enteritis– Symptoms:

• Anorexia

• Flatulence

• Abdominal pain

• Diarrhea and constipation

– Supportive treatment:• Low-residue diet

• Medications to control diarrhea, inflammation, infection, and depression



• Gastroenteritis– Inflammation of stomach and intestines

– Causes:• Bacteria

• Viruses

• Parasitic invasion



• Gastroenteritis– Symptoms:

• Nausea

• Vomiting

• Abdominal cramping

• Diarrhea

• Stomach rumbling

• Malaise



• Gastroenteritis– Treatment:

• Anti-nausea and anti-diarrheal medications

• Antibiotics

• Fluids

• Nutritional support



• Gastroenteritis– Prevention:

• Hand washing prior to food preparation

• Proper refrigeration

• Avoidance of contaminated food and/or water



• Inguinal hernia– Outpouching of small intestine and peritoneum into groin

area

– More common in males



• Inguinal hernia– Strangulated hernia if portions of herniated intestine

become caught and twisted, cutting off blood supply to organ

– Treatment:• Surgical repair


Diseases of the Colon

• Appendicitis– Inflammation of appendix

– Symptoms:• Abdominal pain that shifts to right lower quadrant (RLQ)

• Nausea and vomiting

• Fever

• Leukocytosis



• Appendicitis– Treatment:

• Surgical excision– Hopefully before rupture



• 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


Volvulus and Intussusception



• Intestinal obstruction– Symptoms:

• Mild to severe abdominal pain and distention

• Nausea and vomiting

– Treatment:• Nasogastric suctioning

• Surgery



• Ulcerative colitis– Chronic inflammation of colon

– Symptoms:• Lower abdominal pain

• Blood in stools

• Anemia

• Diarrhea



• Ulcerative colitis– Treatment:

• Dietary limitations

• Stress reduction

• Mild sedatives

• Anti-inflammatories

– Surgery if other treatments unsuccessful



• 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



• Irritable bowel syndrome– Causes:

• Spicy foods and seasonings

• Caffeine

• Alcohol

• Stress

– Treatment:• Avoidance of causative factors



• 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



• Diverticulosis/diverticulitis– Diverticulosis

• Condition of diverticula or little outpouches

– Diverticulitis• Outpouches become packed with fecal material and become

irritated and inflamed


Diverticulosis/Diverticulitis



• Diverticulosis/diverticulitis– Symptoms:

• Lower abdominal pain

• Cramping

– Treatment:• Antibiotics

• Dietary modification



• Colon polyps– Inward projection of mucosal lining of colon

– Diagnosis by colonoscopy or sigmoidoscopy

– Suspicious polyps excisionally biopsied


Colon Polyp



• Colorectal cancer– Carcinoma of colon and rectum

– Symptoms:• Change in bowel habits

• Pencil-sized stools

• Blood in stools

• Anemia

• Abdominal discomfort and obstruction



• Colorectal cancer– Adenocarcinomas

• Most common

– Diagnosis by barium swallow and enema, stool exams for occult blood, and colonoscopy

– Prevention:• Diet and stool examinations


Diseases of the Rectum

• Hemorrhoids– Varicose veins in rectum

• Internal or external

– Causes:• Pressure in anal area

• Constipation

• Prolonged standing

• Pregnancy and childbirth


Hemorrhoids



• Hemorrhoids– Prevention:

• Stool softening

• Good bowel habits

• Fluids and fiber

• Exercise

• Avoidance of laxative use



• Hemorrhoids– Treatment:

• Medications

• Warm sitz baths

• Manual reduction

• Cryosurgery and hemorrhoidectomy


Trauma

• Mouth– Causes:

• Motor vehicle accident

• Fall

• Abuse

• Burn

• Blunt or perforating injury


Trauma

• Stomach or intestines– Causes:

• Perforation as result of stabbing or gunshot wound

– Medical emergency

– Treatment usually surgical


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


Effects of Aging

• Disorders common

• Decreased sense of taste

• Loss of teeth

• Increased incidence of ulcer disease

• Constipation problems

• Development of hemorrhoids

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