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Pearson's Comprehensive Medical Assisting:Administrative and Clinical Competencies, 3/eBeaman | Routh | Papazian-Boyce | Sesser | Mills | Maly

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The Digestive SystemLesson 2:Pathology of the Digestive System

30



Lesson Objectives

Upon completion of this lesson, students should be able to:

1. Define and spell the terms to learn for this chapter.

2. Briefly explain common disorders associated with the digestive system.



Critical Thinking Question

1. What are some causes of digestive system disorders?



Common Disorders Associated with the Digestive System

• Digestive Disorders

Range from nonserious to serious and life-threatening

Most complex with subtle symptoms and often unknown causes

Some may be genetic

Some may develop from stress, fatigue, diet, smoking, alcohol abuse




• Medical history and physical examination for accurate diagnosis

Laboratory tests

Endoscopic procedures

Imaging techniques




• Appendicitis

Inflammation of appendix

Occurs most often between ages 10 and 30

Appears to have no known function

Removal does not cause change in digestive function




• Appendicitis

Acute pain at McBurney point

Pain not relieved by over-the-counter pain relievers, rest, or change of position



FIGURE 30-9 McBurney point.




• Appendicitis

Surgical removal (appendectomy) only course of treatment

Considered medical emergency

Most common acute surgical emergency of abdomen

If treatment delayed, appendix can burst, causing infection and even death




• Cirrhosis

Potentially life-threatening condition

Scarring (fibrosis) replaces healthy tissue

Prevents liver from functioning normally




• Cirrhosis

Develops after years of liver inflammation

Causes

• Years of excessive alcohol consumption and forms of viral hepatitis




• Cirrhosis

Nonalcoholic fatty liver disease (NAFLD) caused by excessive amounts of fat in liver

Common in obese patients

Other causes

• Problems with immune system or inherited diseases




• Cirrhosis

Fluid buildup in legs (edema); abdomen (ascites)

Fatigue

Yellowing of skin (jaundice)

Itching

Nosebleeds




• Cirrhosis

Redness of palms and easy bruising

Weight loss and muscle loss

Abdominal pain

Frequent infections

Confusion




• Cirrhosis

Avoid substances that further damage liver (alcohol; nonsteroidal antiinflammatory drugs)

Dietary changes

Weight loss

Medications

Surgery

Liver transplant




• Colitis

Inflammation of large intestine




• Colitis

Many disease processes may cause colitis

• Abdominal pain

• Diarrhea

• Dehydration




• Colitis

Many disease processes may cause colitis

• Fever and chills

• Abdominal bloating

• Increased intestinal gas

• Bloody stools




• Colitis

Identified by flexible sigmoidoscopy or colonoscopy

Treating underlying cause:

• Infection

• Inflammation

• Lack of blood flow

• Another cause




1. What does the term "colitis" tell about the disorder?




• Colorectal Cancer

Colon cancer

• Cancer of large intestine (colon)

Rectal cancer

• Cancer of rectum

Second-leading cause of cancer-related deaths of men and women in United States





Most cases of colon cancer begin as adenomatous polyps that become cancerous

Regular screening tests important





Predisposing factors

• Increases with age

• Inflammatory bowel disease

• Type II diabetes

• Family history of colorectal cancer

• Race and ethnicity




1. What are some ways to prevent colon cancer?





Change in bowel habits

Bloody stools

Long and thin stool

Persistent abdominal cramping

Gas abdominal pain

Appetite loss and weight loss

Excessive fatigue





Surgery main treatment

If part of colon removed, sometimes remaining colon brought to surface of abdomen so stool comes out of a stoma (colostomy) into attached receptacle instead of through rectum

Chemotherapy

Radiation




• Crohn's Disease and Ulcerative Colitis

Chronic inflammatory disease of intestines

Closely related to ulcerative colitis

Two diseases referred to as inflammatory bowel disease (IBD)

Not contagious

Exact cause unknown

May have genetic component





Abdominal pain

Pain with defecation

Watery diarrhea

Weight loss





Poor appetite

Fever

Night sweats

Rectal pain

Rectal bleeding





No cure

Goals of treatment

• Induce remission

• Maintain remission

• Minimize side effects of treatment

• Improve quality of life




• Diverticulosis and Diverticulitis

Diverticulosis

• Condition of having diverticula, small pouches or sacs in wall of colon

• Few or no symptoms

• Abdominal cramping and bloating





Diverticulitis

• Inflammation or infection of diverticula

• Pain

• Fever

• Chills

• Cramping





Diverticulitis

• Inflammation or infection of diverticula

• Bloating

• Decreased appetite

• Constipation

• Diarrhea





Preventing formation of diverticula in colon

High-fiber diet

Treatment of diverticulitis depends on severity of condition and symptoms



FIGURE 30-10 Colon with diverticulosis. An inflamed or infected diverticulum is called diverticulitis.




1. Why is there a higher incidence of diverticulosis in the elderly?




• Gastroesophageal Reflux Disease (GERD)

Cardiac sphincter does not close tightly or relaxes inappropriately

Gastric fluids and stomach contents back up into esophagus (reflux)





Risk factors

• Obesity

• Hiatal hernia

• Pregnancy

• Smoking

• Certain types of medications





Complications

• Reflux esophagitis

• Barrett's esophagitis

• Perforation of esophagus

• Esophageal cancer

• Esophageal stricture

• Esophageal ulcers





Heartburn (worse when lying down)

Sore throat

Hoarse voice

Bad taste in mouth





Sensation of food being stuck behind breast bone

Belching

Regurgitation of food





Treatment

• Medications that block production of hydrochloric acid and protect mucosa of esophagus

• Surgery that tightens cardiac sphincter

• Dilation, or expansion, of narrowed area




• Hemorrhoids

Dilated, or enlarged, vein in walls of anus and sometimes rectum

Caused by increased pressure in the anus

Major sign is bleeding after defecation, particularly bright red blood

Itching and pain in anal region




1. How can increasing fiber intake help to control hemorrhoids?




• Hemorrhoids

Topical hemorrhoid creams relieve discomfort from itching and irritation

Corticosteroid creams reduce swelling and inflammation

Hemorrhoid removal (hemorrhoidectomy)




• Hernia

Abnormal protrusion of an organ or part of an organ through a weakness in the wall of the body cavity that contains it

Common types of abdominal hernias include:

• Hiatal hernias

• Inguinal hernias




• Hiatal Hernia

Upper portion of stomach protrudes into chest cavity through opening in diaphragm

• Obesity

• Poor seated posture

• Frequent coughing




• Hiatal Hernia

Upper portion of stomach protrudes into chest cavity through opening in diaphragm

• Straining with constipation

• Frequent bending over or heavy lifting

• Heredity

• Smoking

• Congenital defects



FIGURE 30-11 Hiatal hernia.




• Hiatal Hernia

Chest pain or pressure

Difficulty swallowing

Coughing, belching, hiccups

Can be associated with GERD

Heartburn

Treatment: medications used to treat acid reflux

Only cure is surgical repair




1. What other serious condition has symptoms of chest pain and/or pressure?




• Inguinal Hernia

Part of intestine pushes through abdominal wall in groin area causing a bulge




• Inguinal Hernia

Causes

• Appear gradually or suddenly

• Lifting heavy weights

• Coughing

• Bending

• Straining

• Even laughing




• Inguinal Hernia

Incarcerated hernia can worsen to point of strangulation

Strangulated hernia so constricted that blood supply to intestine is cut off

Can be potentially life-threatening condition



FIGURE 30-12 Inguinal hernia.




• Inguinal Hernia

Pain and discomfort

Swelling, heaviness, tugging or burning sensation in area of hernia, scrotum, or inner thigh

Nausea and vomiting

Surgery is the only treatment and cure




• Irritable Bowel Syndrome (IBS)

Common disorder that interferes with normal colon function





Causes

• Unclear and may be stress-related

• Abdominal pain and cramps

• Changes in bowel movements

• Gassiness and bloating

• Nausea





Causes

• Unclear and may be stress-related

• Urgency to defecate

• Passage of mucus during bowel movements

• Feeling bowels are not emptied





No cure

Treatment

• Controlling symptoms and improving day-to-day quality of life

Dietary and lifestyle changes

Psychological treatment




• Oral Cancer

Starts in flat squamous cells that line mouth

• Aging, particularly after 50

• Gender: more men

• Smoking and heavy alcohol consumption, particularly if combined




• Oral Cancer

Starts in flat squamous cells that line mouth

• Using chewing tobacco, snuff, chewing betel nut

• Excessive sun exposure to lips

• Human papillomavirus (HPV)

• Poor dental hygiene

• Immunosuppressant medications




• Oral Cancer

Sores, ulcers, irritation, or swelling in mouth that lasts longer than two weeks

Velvety red or white patches in mouth

Persistent sore throat

Sores under dentures

Lump in lip, tongue, or neck




• Oral Cancer

Weight loss

Swollen lymph nodes in neck

Trouble chewing, swallowing, or speaking




• Oral Cancer

Treatment depends on extent and stage of condition when diagnosed

Surgery

Radiation

Chemotherapy




• Pancreatic Cancer

Adenocarcinoma

• Develops in exocrine glands of pancreas

Very rare form

• Pancreatic neuroendocrine carcinoma (islet cell tumor)

One of the deadliest of all cancers





Signs and symptoms generally vague

• Clay-colored stool and/or diarrhea

• Dark urine

• Jaundice or yellowing of skin

• Upper abdominal pain or discomfort





Signs and symptoms generally vague

• Weight loss and loss of appetite

• Nausea and/or indigestion

• Fatigue

• Back pain

• Blood clots





Complete surgical removal of the cancer only known cure

Most common procedure performed is Whipple procedure

Radiation

Chemotherapy

High mortality rate




• Peptic Ulcer Disease (PUD)

Disruption in lining of stomach, esophagus, or duodenum

Duodenal ulcers most common

Ulcers in stomach also common

Common cause is infection with bacterium Helicobacter pylori (H. pylori)

Causes erosion of the stomach mucosa



FIGURE 30-13 Peptic ulcer disease (PUD).





Prevented by avoiding alcohol and tobacco and limiting use of NSAIDs and aspirin

• Abdominal pain

• Nausea and vomiting

• Weight loss

• Heartburn





Prevented by avoiding alcohol and tobacco and limiting use of NSAIDs and aspirin

• Chest pain

• Tarry black or maroon stools

• Bright red blood in stools

• Burning or gnawing pain in stomach or back




• Stomach or Gastric Ulcers

Pain or burning sensation (similar to indigestion)

Pain made worse by eating

Difficulty swallowing or regurgitation

Bloating, retching, and feeling sick

Vomiting and nausea

Loss of appetite and weight loss

Bleeding may indicate a serious problem





Avoidance of tobacco and alcohol

Antibiotics

Medication change

Proton pump inhibitors

Histamine (H2) blockers

Occasionally, surgery may be required




• Pyloric Stenosis

Develops in some infants when pylorus gradually swells and thickens, interfering with flow of food into intestine

Can occur between birth and 6 months of age




• Pyloric Stenosis

Main symptom is infant's repeated vomiting after feeding

Always treated with surgery (pyloromyotomy)



Questions?

Documents

Pearson's Comprehensive Medical Assistingftc-drthorson.weebly.com/uploads/5/5/4/4/55444029/beaman... · 2019-09-10 · with the Digestive System •Digestive Disorders Range from