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DIGESTIVE ISSUES:
Diseases, Disorders, and Dysfunctions
5This powerpoint contains images that some students may find disgusting. (www.teclasap.com.br)
Swallowing and NOT Choking
Make note of the steps in swallowing!1. Mastication (chewing)= mechanical digestion2. Addition of salivary amylase= chemical digestion3. Tongue pushes food to back of mouth4. Swallow- read the diagrams!5. Peristalsis is the wave of muscle contraction behind the bolus (ball of food) that moves the food through the entire digestive tract- mouth to anus.
Choking
the mechanical obstruction (food!) of the flow of air from the environment into the lungs
can be partial (allowing inadequate flow of air into the lungs) or complete
prolonged or complete choking results in asphyxia (look it up!) and it is potentially fatal
oxygen stores in the blood and lungs keep the victim alive for several minutes after breathing is stopped completely
Gastroesophageal Reflux Disease
Normal: Closed LES (lower esophageal sphincter) Open LES
LESAcid reflux
5Gross image next. (www.teclasap.com.br)
GERD
gastroesophageal reflux disease (GERD) is also called gastric reflux disease or acid reflux disease
chronic symptoms of mucosal damage caused by stomach acid coming up from the stomach into the esophagus
a typical symptom is heartburn
GERD Treatments
1. eating smaller meals earlier in the evening 2. avoiding things that affect the LES (caffeine,
smoking, chocolate, fatty foods, spicy foods, peppermint, alcohol consumption)
3. taking antacids and LOTS water! 4. prescription pharmaceuticals to reduce acid
production or increase motility 5. surgery to rebuild the lower esophageal sphincter6. endoscopic treatments to tighten the LES (by
suturing or applying radio-frequency waves to create scar tissue)
Ulcers
Gastric Ulcer
Esophageal Ulcer
Duodenal Ulcer
An ulcer is a small erosion (hole) in the gastrointestinal tract. The most common type, duodenal, occurs in the first 12 inches of small intestine beyond the stomach.
Ulcers that form in the stomach are called gastric ulcers.
5
Gross. Ulcers. (www.teclasap.com.br)
Gastric Ulcer
mainly associated with Helicobacter pylori
also caused by prolonged use of anti-inflammatory drugs, such as Ibuprofen and aspirin, which damage the stomach lining
severe complications include bleeding or perforations = complete hole into abdomen (can cause death due to contamination)!
Ulcer: Treatment
Symptoms: burning pain- feels worse when stomach is empty, but pain returns a couple of hours after eating, black blood in stools
Diagnosis: series of x-rays, endoscopy, tissue sample to identify bacteria
Treatment: antibiotic to kill H. pylori Meds to reduce HCl secretion (rest
stomach)no smoking, no alcohol, decrease NSAID use
e.g. ibubuprofen
Recall the location of the gall bladder?
No? It’s the storage sac tucked under the liver
Purpose? Stores bile until needed for digestion
Gallstones
Small calculi (stones) Big calculi Big calculi withcholecystitis (inflammation)
Gallstones
an accumulation of hardened cholesterol and/or calcium deposits in the gallbladder
can be as small as a grain of sand or as large as a golf ball
can either be “passed” (OUCH!!) or surgically removed
Gallstone Treatment
New treatment: extracorporeal lithotripsy
Shockwave is used to break up gallstones
Used with ERCP- endoscopy with fluoresence to make sure all the big stones are broken up
Pain immediately follows the treatment
Look up the meaning of endoscopy!
Diarrhea
a gastrointestinal disturbance characterized by decreased water absorption and increased peristaltic activity of the large intestine
this results in increased, multiple, watery feces
this condition may result in severe dehydration, especially in infants & elderly
Constipation
a condition in which the large intestine is emptied infrequently and/or with difficulty
too much water is reabsorbed in the colon
the solid waste hardens and is difficult to pass
greater fluid intake, more fibre, and increased exercise are recommended
Hemorrhoids
Internal hemorrhoids
External hemorrhoids
Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum.
The most common symptom of internal hemorrhoids is bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement.
About 75 percent of people will have hemorrhoids at some point in their lives. Hemorrhoids are most common among adults ages 45 to 65 and in pregnant women.
rectum
anus
Hemorrhoids treatment
Increase dietary fibre Moderate exercise Drink more fluids Cleanliness! May be related to stress = mindfulness,
yoga
Inflammatory Bowel Disease (IBD)
Healthy colon Crohn’s disease
inflammation
Inflammatory Bowel Disease Crohn’s disease is one of a group
of disorders categorized as inflammatory bowel disease (IBD), which also includes ulcerative colitis
intestines become inflamed (red and swollen) and develop sores
causes pain, cramps, intestinal bleeding, weight loss, diarrhea
diagnosed based on symptoms and results of a sigmoidoscopy or a colonoscopy, as well as x-rays
Endoscopy
5This powerpoint contains images that some students may find disgusting. (www.teclasap.com.br)
Crohn’s and IBD
Severity of the disease varies, but occasionally leads to complete obstruction, which sometimes requires surgery
IBD Treatment
goal of treatment is to reduce inflammation and suppress the immune system response
When all medications have been tried and the patient is still suffering, a fecal transplant is
the penultimate option
if ulcerative colitis becomes so severe that all treatment is unsuccessful, it may be necessary to surgically remove part or all of the colon (resulting in a colostomy or ileostomy)
Ostomy
5
Gross. Polyps. (www.teclasap.com.br)
Intestinal Polyps
Peduncular polyp
Sessile polyp
Polyps are abnormal growths arising from the inside lining of the colon or rectum.
They protrude into the intestinal canal. Some are flat (sessile) while others are on a stalk (peduncular).
Diagnosis of polyps?
Sigmoidoscopy or colonoscopy
Tissue samples may be removed using a snare (wire loop) and checked to see if they are benign or malignant
More gross pictures follow.
More pictures of polyps
Intestinal Polyps
Polyps are very common, occurring in 15-20% of the adult population
Although most polyps are benign (not cancerous) some can change into cancer
Colonoscopy is used to identify and remove polyps
Regular screening begins at age 50
Colon cancer
Colon Cancer
Stage I Stage II Stage III
Appendicitis
an inflammation of the appendix due to infection common treatments involve antibiotics and removal of the
appendix (appendectomy) if untreated, appendix can burst causing infection
(peritonitis) and death
Appendectomy
the surgical (open) or laparoscopic (minimally invasive) removal of the appendix
laparoscopy involves tiny incisions where a camera and surgical instruments are inserted
Clostridium difficile Infection anaerobic, endospore-forming
bacteria found in hospitals and other long-term care facilities (look it up!)
causes severe diarrhea and other intestinal diseases when competing bacteria in the gut flora have been wiped out by antibiotics
can be life-threatening, especially among the elderly
Bleach wipes, hand-washing with soap and water, and gloves are effective and reducing infection
Alcohol-based hand sanitizers are not effective at killing the spores
Polyp Removal Stomach Ulcer Gallbladder stones
THE END!HW: Eat well, exercise, eat more fibre and rest… Unit Test Thursday! Learn the vocab!!!
The second long answer question on your unit test will be to describe the path of a bite of food (containing fat, protein and carbohydrates e.g. steak and potatoes) from mouth to toiletInclude in your answer:1. All the structures the food/bolus/chyme
passes2. Location of mechanical digestion2. Location of chemical digestion3. 4. Any diseases associated with each structure5. All the enzymes- for fat, carbs and proteins- their origin of production, where they are active, what the digestive product is etc.
60 points = 30 marks