460 ~ 4 April 2006

1
460 4 April 2006

• Still no handout / notes from Saw Palmetto
  McDonagh to Persico ?
• Module VII Integrative Approaches re Common
  Health Issues GI system today
  chronic fatigue oncology next
  day

2
Tomorrow

• Wednesday of this week, at two minutes and
  three seconds after 100 in the  morning, the
  time and date will be 010203 04/05/06That
  won't  ever happen again

3
T h e G I S y s t e m
You are what you eat, Or, You are what you
ingest, And . . . what you cant ingest ?
4
Bodily Systems
5
GI Groups

• 1. Abu-Romeh to Blanchette
• 2. Blommers to Connor
• 3. Crowther to Eastwood
• 4. Fabian to Geddis
• 5. Girvan to Hudders

• 6. Jagielnik to Korczynski
• 7. Kusmider to Mazur
• 8. McDonagh to Persico
• 9. Pone to Sklazeski
• 10. Snider to Zettler

Groups 1 3 What is the GI system, how does it
work ? Groups 4 6 How do we care for it what
goes wrong ? Groups 7 10 What are possible CAM
preventions/therapies ?
6
GI Components

• Esophagus
• Stomach
• Duodenum
• Small bowel
• Colon
• Liver and biliary system
• Spleen
• Pancreas
• GI - Other

7
Functions of GI System

• Broadly ingest, digest, absorb food
• Immune surveillance response
• Detoxification
• Neuro-endocrine regulation

8
(No Transcript)
9
(No Transcript)
10
Digestive function support by

• Mastication
• Peristalsis
• Enzymes secretions that facilitate enzymes
  functions

11
Absorptive function facilitated by

• Immense surface area of small intestine (villi
  and microvilli)
• Active transport and diffusion (transmucosal,
  energy-driven processes) along entire lengths of
  small and large intestines

12

• diseases 
• radiological findings, 
• differential-diagnosis lists  
• pertinent anatomy, pathology, and physiology

13
Esophageal Issues
14
(No Transcript)
15
every centimeter of GI tract is colonized
by bacteriaevery meal bathes this surface with
antigens, organisms, active substances
derived from food drink text
16
The GIs Strategy of Digestion
17
Sudburys Science North

• GI Slide
• Kids can slide and crawl through a giant 3D model
  of the digestive system from mouth to large
  intestine.  This exhibit is 8 high and over 30
  long

18
A brief travel thru main components of GI tract
. . .
19
The Oesophagus
20
The Stomach
21
The Stomach Histology
22
The Small Intestine

• Duodenum
• Jejunum
• Ileum

23
The Small Intestine The Jejunum
24
The Pancreas

• structurally, the pancreas has four sections
  head, neck, body and tail the tail stretches
  back to just in front of the spleen.
• The pancreas consists mainly of exocrine glands
  that secrete enzymes to aid in the digestion of
  food in the small intestine. the main enzymes
  produced are lipases, peptidases and amylases for
  fats, proteins and carbohydrates respectively.
  These are released into the duodenum via the
  duodenal ampulla, the same place that bile from
  the liver drains into
• Pancreatic exocrine secretion is hormonally
  regulated, and the same hormone that encourages
  secretion (cholesystokinin) also encourages
  discharge of the gall bladder's store of bile
• As bile is essentially an emulsifying agent, it
  makes fats water soluble and gives the pancreatic
  enzymes lots of surface area to work on

25
The Large Intestine
26
What goes wrong ?

• Cancers of GI tract some 21 of all cancers are
  GI ones
• Eating too much
• Drinking too much
• Diarrhea
• Anorexia, nausea, vomiting, pain
• Acid reflux
• Gas, bloating, flatulence, heartburn
• Irritable bowel syndrome
• Dyspepsia
• Ulcers
• GI toxicity from NSAIDs
• Hemorrhoids

27
Medline Plus is a terrific allopathic source of
GI issues treatments
28
Allopathy and your gastroenterologist ?

• Gastroenterology
• The branch of medicine dealing with the study of
  disorders affecting the stomach, intestines, and
  associated organs

29
Gastroenterology complex field of medicine

• CPT Codes
• ICD-9 Codes
• HCPCS Supply Codes
• Modifiers
• RBRVS Values
• CCI Edits

• Medicare Guidelines
• Documentation Requirements
• National Coverage Decisions
• Local Medicare Review Policies
• Anatomy Terminology Reference
• Evaluation Management Guidelines

Learn proven tips for correctly coding and
billing dozens of Gastroenterology procedures and
services including Diagnostic Sigmoidoscopy
Therapeutic Colonoscopy Diagnostic
Therapeutic Esophagogastroduodenoscopy (EGD)
Endoscopic Examination--Upper Gastrointestinal
Tract Modified Barium Swallow Studies
Telemetric Gastrointestinal Capsule Imaging
Gastric Bypass Surgery for Morbid Obesity
30
Complex area is this system consider allopathic
text re drugs

• Pharmacology in Nursing Practice Introduction
  Drugs Affecting the Immune System Antivirals
  and Antifungals Biologic Response Modifiers and
  Immunosuppressants Antineoplastics Drugs
  Affecting the Nervous System Sympathetic
  Nervous System Agents Parasympathetic Nervous
  System and Antiparkinsonism Agents Central
  Nervous System Stimulants and Skeletal Muscle
  Relaxants Anticonvulsants Anesthetics
  Anxiolytics, Antidepressants, Mood Stabilizers,
  and Antipsychotics Drugs Affecting the
  Hematologic System Agents Affecting
  Coagulation, Bleeding and Blood Formation Drugs
  Affecting Blood Pressure and Blood Flow
  Antihypertensives Antilipidemics Drugs
  Affecting the Cardiac System Agents Affecting
  Cardiac Output Antiarrhythmics Drugs
  Affecting the Respiratory System Agents
  Affecting Upper Respiratory Disorders
  Antihistamines Antiasthmatics and
  Bronchodilators Drugs Affecting the Endocrine
  System Thyroid, Parathyroid Agents Anterior
  Pituatory Hormones, Glucocorticoids,
  Mineralcorticoids, and Adrenal Hormone Inhibitors
  Antidiabetics Drugs Affecting the
  Gastrointestinal System Agents Affecting
  Hyperacidity, Gastric Mucosa, Motility and
  Flatulance Antiemetics, Emetics and Agents Used
  for Digestive Problems Laxatives and
  Antidiarrheals Drugs Affecting the
  Genitourinary Tract and Renal Disorders Agents
  Used in Urinary Tract Alterations and to Improve
  Renal Output Agents used in Renal Failure
  Drugs Affecting the Reproductive System Male
  and Female Hormones Agents Affecting Uterine
  Motility, Fertility, and Infertility Drugs
  Affecting the Musculoskeletal System
  Anti-Inflammatory Agents Drugs Affecting
  Nutrition Agents Used for Nutritional
  Imbalances Drugs Affecting the Sensory System
  Ophthalmics and Otics Dermatologics
  Analgesics for Pain Relief

31
Aspirin

• BMJ 20003211170-1171 ( 11 November 2001 )
• Aspirin, like all other drugs, is a poison We
  do not know who should be given what dose and for
  how long
• Long term use has resulted in severe GI
  hemorrhaging
• Enteric or coated aspirin

32
Solutions from Sci North

• Burp Man
• A larger than life cartoon character drinks from
  a three-foot pop can pumped by visitor
• The stomach pressure increases until the
  character releases a giant burp, while a second
  interactive exhibit shows how the sphincter works

33
Solutions from Sci North

• Gas Attack!
• Everyone loves to play pinball 
• Two custom pinball games are positioned in front
  of an animated pig sitting atop a pile of poop  
• The games are customized to teach children which
  foods create more gas in their bodies  
• The animated pig says funny quips at the start
  and end of each game

34
Text Integrative Approaches to GI System

• Complex terminology?
• Know concepts, not host of medical terms
• Concept of dysbiosis or dys-symbiosis
• Dysbiosis is re indigenous flora of the gut
  start to promote illness NOT infection
• Discusses regulation of GI flora by diet,
  motility, secretions like HCl, immunity,
  antibiotics, and probiotics

35
Text Intestinal Permeability Gut Barrier
Function

• Nutrient absorption
• How nutritional deficiencies affect absorption
• Treatment of increased permeability
  (hyper-permeability) by removing the cause ex
  NSAIDs then nourishing the gut
• Problems of fiber supplements

36
Text and specific GI Disorders

• discusses multi-component, integrative,
  evidence-based approaches to
  Inflammatory bowel disease Crohns
  disease Ulcerative colitis
  functional bowel disorders
• examines integrative therapies for Irritable
  Bowel Syndrome by asking series of questions
• Finishes by looking at Acid-Peptic diseases like
  ulcers and the use of acupuncture, herbs, dietary
  regulation

37
(No Transcript)
38
(No Transcript)
39
(No Transcript)
40
(No Transcript)
41
(No Transcript)
42
(No Transcript)
43
Next Day . . .

• Chronic Fatigue
• Oncology