copyright © 2010 delmar, cengage learning. all rights reserved. chapter 11 digestive system...
TRANSCRIPT
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Chapter 11
Digestive System Diseases and Disorders
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Anatomy and Physiology
• Two main purposes:– Change foods into simpler substances
– Eliminate waste products
• Alimentary canal– Continuous tube running from mouth to anus
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Anatomy and Physiology
• Accessory organs:– Tongue
– Teeth
– Salivary glands
– Gallbladder
– Pancreas
– Liver
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Animation
Click Here to Play Digestion Animation
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Common Signs and Symptoms
• Related to hemorrhage, perforation, and altered motility
• Terms identifying bleeding:– Hematemesis
– Hematochezia
– Melena
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Common Signs and Symptoms
• Perforation in stomach or intestines causes peritonitis and septicemia
• Alteration in motility include diarrhea, vomiting, nausea, or constipation
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Diagnostic Tests
• X-ray
• Endoscopic exam– Esophagogastroduodenoscopy (EGD)
• GI series– Barium swallow and enema
• Occult blood
• Ova and parasites
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EGD
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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
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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
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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
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Cancer of the Lip
Photo courtesy Mark L. Kuss
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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
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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
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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
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Diseases of the Throat and Esophagus
• Reflux esophagitis– Treatment:
• Reduce reflux
• Avoid large meals
• Avoid spicy foods, caffeine, and tight clothing
• Take stool softeners
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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
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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
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Hiatal Hernia
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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
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Diseases of the Stomach
• Gastritis– Inflammation of stomach
– Symptoms:• Epigastric pain
• Bloating
• Nausea
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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
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Diseases of the Stomach
• Gastritis– Diagnosis of helicobacter gastritis by biopsy
– Treatment:• Pepto-Bismol
• Flagyl
• Amoxicillin
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Diseases of the Stomach
• Peptic ulcer– Found in stomach and duodenum
– Caused in part by action of pepsin
– Also known as gastric ulcers
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Diseases of the Stomach
• Peptic ulcer– Treatment:
• Reduction of contributory factors
• Antacids
• Surgery in severe cases
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Diseases of the Stomach
• Stomach cancer– Affects more males than females
– Often goes undiagnosed until metastasizes
– Symptoms:• Loss of appetite
• General stomach distress
• Heartburn
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Diseases of the Stomach
• Stomach cancer– Treatment:
• Surgical resection
• Chemotherapy
• Radiation
– Prognosis good if discovered early
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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
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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
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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
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Diseases of the Small Intestine
• Gastroenteritis– Inflammation of stomach and intestines
– Causes:• Bacteria
• Viruses
• Parasitic invasion
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Diseases of the Small Intestine
• Gastroenteritis– Symptoms:
• Nausea
• Vomiting
• Abdominal cramping
• Diarrhea
• Stomach rumbling
• Malaise
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Diseases of the Small Intestine
• Gastroenteritis– Treatment:
• Anti-nausea and anti-diarrheal medications
• Antibiotics
• Fluids
• Nutritional support
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Diseases of the Small Intestine
• Gastroenteritis– Prevention:
• Hand washing prior to food preparation
• Proper refrigeration
• Avoidance of contaminated food and/or water
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Diseases of the Small Intestine
• Inguinal hernia– Outpouching of small intestine and peritoneum into groin
area
– More common in males
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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
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Diseases of the Colon
• Appendicitis– Inflammation of appendix
– Symptoms:• Abdominal pain that shifts to right lower quadrant (RLQ)
• Nausea and vomiting
• Fever
• Leukocytosis
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Diseases of the Colon
• Appendicitis– Treatment:
• Surgical excision– Hopefully before rupture
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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
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Volvulus and Intussusception
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Diseases of the Colon
• Intestinal obstruction– Symptoms:
• Mild to severe abdominal pain and distention
• Nausea and vomiting
– Treatment:• Nasogastric suctioning
• Surgery
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Diseases of the Colon
• Ulcerative colitis– Chronic inflammation of colon
– Symptoms:• Lower abdominal pain
• Blood in stools
• Anemia
• Diarrhea
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Diseases of the Colon
• Ulcerative colitis– Treatment:
• Dietary limitations
• Stress reduction
• Mild sedatives
• Anti-inflammatories
– Surgery if other treatments unsuccessful
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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
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Diseases of the Colon
• Irritable bowel syndrome– Causes:
• Spicy foods and seasonings
• Caffeine
• Alcohol
• Stress
– Treatment:• Avoidance of causative factors
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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
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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
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Diverticulosis/Diverticulitis
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Diseases of the Colon
• Diverticulosis/diverticulitis– Symptoms:
• Lower abdominal pain
• Cramping
– Treatment:• Antibiotics
• Dietary modification
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Diseases of the Colon
• Colon polyps– Inward projection of mucosal lining of colon
– Diagnosis by colonoscopy or sigmoidoscopy
– Suspicious polyps excisionally biopsied
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Colon Polyp
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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
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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
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Diseases of the Rectum
• Hemorrhoids– Varicose veins in rectum
• Internal or external
– Causes:• Pressure in anal area
• Constipation
• Prolonged standing
• Pregnancy and childbirth
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Hemorrhoids
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Diseases of the Rectum
• Hemorrhoids– Prevention:
• Stool softening
• Good bowel habits
• Fluids and fiber
• Exercise
• Avoidance of laxative use
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Diseases of the Rectum
• Hemorrhoids– Treatment:
• Medications
• Warm sitz baths
• Manual reduction
• Cryosurgery and hemorrhoidectomy
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Trauma
• Mouth– Causes:
• Motor vehicle accident
• Fall
• Abuse
• Burn
• Blunt or perforating injury
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Trauma
• Stomach or intestines– Causes:
• Perforation as result of stabbing or gunshot wound
– Medical emergency
– Treatment usually surgical
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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
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Effects of Aging
• Disorders common
• Decreased sense of taste
• Loss of teeth
• Increased incidence of ulcer disease
• Constipation problems
• Development of hemorrhoids