Digestive Diseases

1
Digestive Diseases
2
GASTROENTEROLOGIST

• A physician that specializes in disorders and
  diseases of the digestive system

3
REVIEW

• Small intestine where digestion is completed
  and absorption occurs
• Here you have the addition of enzymes from
  pancreas and bile from liver/gallbladder

4
Absorption

• Absorption occurs when
• 1. Carbohydrates are converted to glucose
• 2. Proteins broken down to amino acids
• 3. Fats changed to fatty acids and glycerol

5
GASTROENTERITIS

• Inflammation of mucus membrane lining of stomach
  and intestine
• Common causes virus
• Symptoms diarrhea and vomiting for 24 36
  hours
• Complication - dehydration

6
REVIEW

• Regulation of H2O balance by absorbing large
  quantities back into bloodstream
• Also absorbs Vitamin B complex and K
• Bacterial action on undigested food decomposed
  products excreted through colon bacteria form
  moderate amounts of B complex and Vitamin K

7
FECES

• Is undigested semi-solid consisting of bacteria,
  waste products, mucous and cellulose
• Defecation when lg intestine fills, defecation
  reflex triggered colon and rectal muscles
  contract while internal sphincter relaxes
• E-Coli live in lg intestine and feed on
  undigested fiber in fecal material to help reduce
  amount of feces produced.
• 1/3 of feces excreted is made up of E-Coli
  bacteria

8
(No Transcript)
9
DIARRHEA

• Loose, watery, frequent bowel movements when
  feces pass along colon too rapidly and not enough
  water is absorbed
• Caused by infection, poor diet, nervousness,
  toxic substances or irritants in food
• When the lg. Intestine is irritated and inflamed,
  the intestinal mucosa secretes large amounts of
  water and electrolytes in addition to mucus.

10
CONSTIPATION

• Slow movement of feces through the large
  intestine
• Feces become dry and hard because of the
  increased fluid absorption during its extended
  time in the large intestine

11
CONSTIPATION

• If passage of feces through lg intestine is
  prolonged beyond 5 days, the feces lose volume
  and become more solid
• Causes include irregular defecation patterns,
  intestinal blockages, tumors, and diverticulitis

12
CONSTIPATION

• Treatment includes diet with cereals, fruits,
  vegetables, (roughage), drinking plenty of
  fluids, exercise, and avoiding tension

13
Colon removed from a man that did not have a
bowel movement for 30 days.

14
HEMORRHOIDS or PILES

• Enlarged or inflamed veins (varicose veins) that
  protrude from the anal lining
• Cause excessive straining during defecation or
  childbirth
• Rx remove pressure that causes the condition or
  in severe cases they can be removed surgically

15
FLATULENCE

• Gas formation (flatus) is from 1-3 pints per day
• It passes through the rectum at least 14 times a
  day
• Bacteria in the large intestine produce the gases
  (methane CH4

16
COLITIS (Irritable Bowel Syndrome)

• Any inflammatory condition of the lg intestine
• Cause unknown may be result of emotional
  stress or an autoimmune disease such as
  ulcerative colitis
• Symptoms alternating episodes of constipation
  or diarrhea and abdominal cramps
• Rx high fiber diet, relaxation, and
  antispasmodic drugs. If these dont work
  affected part can be surgically removed.

17
DIVERTICULOSIS

• Little sacs (diverticuli) develop in wall of
  colon
• Most people over the age of 50 who eat low fiber
  foods have this
• When the sacs become inflamed DIVERTICULITIS
• Symptoms abdominal pain and swelling, diarrhea,
  constipation,gas, and rectal bleeding

18
APPENDICITIS

• Inflammation of the appendix that usually occurs
  because of obstruction of the appendix
• If it ruptures, bacteria from appendix can spread
  to the peritoneal cavity causing PERITONITIS
• Symptoms acute pain in RLQ, loss of appetite,
  nausea, vomiting, and mild fever
• Rx surgical removal

19
COLORECTAL CANCER

• 2nd leading cause of death from cancer in the
  United States
• Occurs most frequently after age 50 and even more
  frequently after the age of 70
• Risk factors family history, inflammatory bowel
  disease, intestinal polyps, high saturated-fat
  intake diet, and increasing age
• Symptoms fecal blood, a change in bowel habits,
  decrease in stool diameter, weight loss, fatigue,
  and onset of abdominal pain

20
COLONOSCOPY

• Early detection for colon cancer is critical
  need a colonoscopy after age 50
• Colonscope (flexible viewing tube) is passed
  through the anus into the colon
• Can take pictures and obtain tissue samples

21
HEMOCCULT SLIDE

• Stool slide specimen to look for hidden (occult)
  blood
• Hemoccult annual screening tests can reduce the
  risk of death from CRC by up to 33
• In the privacy of their home, they collect a
  small amount of stool specimen on 3 different
  days and return the test card to your doctor or
  laboratory

22
COLON CANCER

• Rx surgical resection
• May also require a COLOSTOMY opening in
  abdomen, healthy bowel brought to skin after
  cancer removed
• Pouch worn to collect waist

23
CIRRHOSIS

• Chronic progressive disease of the liver
• Normal tissue is replaced by fibrous connective
  tissue
• Symptoms nausea, anorexia, gray-white stools,
  weakness, and pain

24
CIRRHOSIS

• Causes hepatitis, chronic alcohol abuse,
  malnutrition, or infection
• 75 caused by excessive alcohol consumption
• Rx Remove cause and put on high protein diet.
  Liver transplant may be needed for extensive
  damage

25
CIRRHOSIS OF THE LIVER

• Ascites is an abnormal accumulation of fluid
  containing large amounts of protein and
  electrolytes detectable when more than 500 ml
  of fluid has accumulated
• Is a complication of cirrhosis
• Rx diet therapy and diuretic therapy

26
CIRRHOSIS

• Jaundice yellow color of skin and sclera when
  bile pigment gets in bloodstream
• Best place to assess for jaundice is the hard
  palate
• Is a symptom of liver disease and biliary
  obstruction

27
HEPATITIS A

• Known as infectious hepatitis
• Cause virus
• Spread through contaminated food and water
• Occurs commonly in young people

28
HEPATITIS A

• Symptoms Makes you feel like you have the flu
  tired, sick to your stomach, fever, anorexia,
  diarrhea, dark yellow urine (tea colored), gray
  stools, and jaundice
• Rx Bedrest and no alcohol
• Can protect yourself by getting a Hepatitis A
  Vaccine. Also always wash your hands after using
  the bathroom and drink bottled water when you are
  in another country

29
HEPATITIS B (Serum Hepatitis

• Caused by virus found in the blood
• Transmitted by blood transfusion or being stuck
  with contaminated needles (drug addicts)
• Can block the flow of blood through the liver,
  thus causing it to back up into the hepatic
  portal circulation.
• This causes portal hypertension and to relieve
  the pressure new veins that connect to the
  systemic veins are formed.

30
HEPATITIS B

• Health care workers at risk and should be
  vaccinated
• Use standard precautions for prevention

31
CHOLELITHIASIS

• Condition of gallstones
• Gallstones are solid clumps of material (mostly
  cholesterol)
• Can block the bile duct causing pain and
  digestive disorders
• Small ones may pass on their own, large ones
  surgically removed
• Surgical removal of gallbladder - CHOLECYSTECTOMY

32
CHOLECYSTITIS (Gallbladder Inflammation

• Often seen with gallstones
• Risk factors for gallstone formation severely
  obese people because the liver produces higher
  level of cholesterol and also people who have a
  significant weight loss in a
• short amount of time

33
LAPAROSCOPIC CHOLECYSTECTOMY

• Most common method of cholecystectomy
• Small abdominal incisions allow insertion of
  surgical instruments and small video camera
• Surgeon performs procedure by watching monitor
  and manipulating instruments
• Stomach muscles are not cut, healing is quicker

34
LAPAROSCOPIC CHOLECYSTECTOMY

35
ULCERS

• Craterlike sore or lesion that forms in the
  mucosal lining of the stomach
• 1 in 10 people in the US will suffer from an
  ulcer
• Gastric ulcers in the stomach and duodenal ulcers
  in the duocenum
• Cause H. pylori (bacteria) is primary cause
  burrows through the mucosa and impairs the
  linings ability to produce protective mucus

36
ULCERS

• Lifestyle factors that contribute
• Cigarette smoking
• Alcohol
• Stress
• Certain Drugs
• Symptoms burning pain in abdomen, between meals
  and early morning, may be relieved by eating or
  taking antacid

37
ULCERS

• Diagnosis -X-ray and presence of H.pylori
  (bacteria)
• The bacteria is diagnosed by biopsy, breath, or
  blood antibody tests
• If not treated, these lesions may result in
  hemorrhage, perforation, widespread infection,
  scarring, and other serious medical complications
• Rx H2 blockers (drugs) that block release of
  histamine

38
PANCREAS REVIEW

• Lies behind stomach
• Both endocrine and exocrine gland
• Pancreatic juice is the most important digestive
  juice
• It contains enzymes that digest all three major
  kinds of foods

• Pancreatic juice contains sodium bicarbonate, an
  alkaline substance that neutralizes the
  hydrochloric acid
• Pancreatic juice enters the duodenum in the same
  place bile enters

39
PANCREATITIS

• Inflammation of pancreas
• Acute pancreatitis usually results from blockage
  of the common bile duct pancratic enzymes back
  up and digests it.
• In some cases of stomach inflammation from excess
  alcohol consumption or in gallbladder disease,
  irritation may extend to the pancreas and cause
  abnormal activation of the pancreatic enzymes
• ½ of cases are fatal

40
PYLORIC STENOSIS

• Normally stomach contents are moved through the
  pyloric sphincter within about 2 to 6 hours after
  eating
• Narrowing of pyloric sphincter, often found in
  infants- more common in boys
• Symptoms projectile vomiting
• Treatment surgery to modify the muscle to food
  can pass from the stomach into the duodenum

41
GASTROESOPHAGEAL REFLUX DISEASE (GERD)

• Cardiac sphincter is weak and relaxes
  inappropriately
• Esophagus is irritated by acid that comes up from
  the stomach
• Also called Acid Reflux
• Some people feel nothing
• Symptoms heartburn pain, a bitter taste in your
  mouth, coughing at night, hoarseness in the
  morning, or worsening asthma
• Stomach acid in the esophagus can cause ulcers,
  stenosis, and cancer

42
GERD

• Dietary habits that improve GERD
• 1. Eat small portions
• 2. Avoid onions, chocolate, peppermint, high-fat
  or spicy foods, citrus fruits, garlic, and
  tomatoes
• Avoid drinking citrus juices, alcohol, coffee,
  tea, soft drinks, and other caffeinated and
  carbonated drinks
• Avoid eating or drinking for 3 hours before going
  to bed

43
GERD

• Lifestyle habits that improve GERD
• 1. Lose weight if overweight
• 2. Stop smoking
• 3. Avoid wearing tight fitting clothing or belts
• 4. Avoid lying down or prolonged bending over,
  especially after eating
• 5. Avoid straining and constipation
• 6. Elevate the HOB 6 to 8 inches
• 7. Avoid stress

44
GERD

• Additional treatments
• 1. Over-the-counter antacids or
  non-prescription-strength acid-blocking
  medications called H2 receptor antagonists such
  as Tagamet, Zantac, or Pepcid
• 2. Severe cases require surgery

45
HIATAL HERNIA

• When stomach protrudes above diaphragm through
  esophageal opening
• More common in people over 50
• GERD is a symptom for hiatal hernia

46
TO BE CONTINUED
47
Bell Ringer
48
Bell Ringer

• Bookbag in cubicles and be in your seat quiet.
• 2. Take out a piece of paper and answer
  the following
• question. It will be taken up in
  exactly 8 minutes and graded. If you are talking
  or looking at your neighbors, you will get a
  zero. There will not be any extra
• time. You may use your book and notes.
• Using 4 anatomical directions terms, describe the
  location
• o.f the heart. Please use 4 sentences
• Explain how you get the following
• Greasy hair
• Goose Bumps