Disease and Conditions of the Digestive System

1
Disease and Conditions of the Digestive System

• Chapter 8

2
GERDGastroesophageal Reflux Disease

• Regurgitation of stomach and esophageal contents
  into the esophagus.
• Symptom Heartburn, Belching, Burning in mouth
  and chest, coughing.
• Chronic GERD has its own problems.

3
Chronic GERD

• Dysphagia, erosive esophagitis, stricture,
  erosion of tooth enamel, ulcerations, pulmonary
  aspiration.

4
Treatment

• Elevate HOB
• Light evening meals
• Limit ETOH intake

• Antacids
• Rx medications
• Stop smoking
• Surgery

5
Esophageal Varices

• Varicose veins of the esophagus
• Danger Rupture/hemorrhage/hypovolemic shock/death

6
Causes

• Pressure in the veins of esophagus when portal
  vein of the liver is obstructed.
• Cirrhosis of the liver

7
Treatment

• If bleeding.stop the GI bleed.
• Ice water lavage
• Epigastric tamponade with a balloon
• Return blood volume and F/E balance

8
Esophagitis

• Inflammation of the esophagus
• Heartburn
• May believe having a heart attack
• Pain usually comes after eating or drinking

9
Cause

• Defect of the cardiac sphincter
• Regurgitation of acidic stomach contents will
  cause inflammatory response.
• Erosion can occur

10
Diagnosis

• Patient hx.
• Upper GI
• Esophagoscopy

11
Treatment

• Bland diet to ease inflammation
• Antacids
• Medications to relieve discomfort and promote
  healing
• Small frequent mealsavoid alcohol.

12
Gastric and Duodenal Peptic Ulcers

• GI tract has a protective mucous membrane.
  Breakdown of this membrane can cause
  ulcerations/perforations.
• Most common peptic ulcer is a duodenal ulcer.
• Midepigastric pain/heartburn.
• Most intense pain is 2hours pp.

13
Danger

• Bleeding (occult or frank)
• If perforation occurs can cause a leakage of
  stomach content into the peritoneal cavity.

14
Causes

• Helicobacter pylori infection (H-Pylori).
• NSAIDs
• Stress

15
Diagnosis

• S/S
• Confirmation Barium xrays, endoscopy, biopsy to
  determine presence of bacteria, stool for blood,
  blood tests, etc.

16
Gastritis

• Inflammation of the lining of the stomach
• Epigastric pain, indigestion, feeling of
  fullness.
• Nausea, belching (eggs), loss of appetite.

17
Causes

• H.pylori may be the culprit
• Medications
• ETOH
• Infectious diseases, stress

18
Diagnosis

• Gastroscopy
• Xrays

19
Gastric Cancer

• Most gastric neoplasms are malignant
• Patient may be asymptomatic
• Indigestion, gastric discomfort, anorexia, bloody
  stool, emesis.

20
Causes

• Usually starts as an ulcer!

21
Diagnosis/Treatment

• Barium swallow
• Biopsy
• CT scan
• Ultrasound
• Partial or total gastrectomy
• Radiation/Chemotherapy

22
Appendicitis

• Inflammation of the useless appendix
• Abdominal pain/McBurneys point, rebound
  tenderness
• Elevated WBC

23
Causes

• Dont know
• May become obstructed with fecal material,
  neoplasm, worms or foreign body
• Bacteria invade and wall off the appendix
  impairing the circulation.

24
Hernias

• Weakness in the musculature that allows certain
  parts of the bowel to protrude.
• Hiatal upper part of the stomach slips thru the
  opening in the diaphragm.
• Abdominal hernia Can occur anywhere
• Inguinal hernia Loop of the bowel slips into the
  inguinal canal.