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3/9/2017 Digestive system and its Health problems 1 3/9/2017 Digestive Diseases The digestive system made up of the gastrointestinal tract (GI), liver, pancreas, and gallbladder helps the body digest food. Digestion is important for breaking down food into nutrients, which your body uses for energy, growth, and cell repair. Some digestive diseases and conditions are acute, lasting only a short time, while others are chronic, or long‐lasting. 2 3/9/2017 Digestive system 3 3/9/2017 Common Problems of Digestive system Irritable Bowel Syndrome (IBS), Crohn's Disease. Celiac Disease, Bowel Control Problems, Gas, Lactose Intolerance, Diarrhea, Constipation, Diverticulosis, Acid Reflux (GER). 4 3/9/2017 Constipation 5 3/9/2017 What is constipation Constipation is the slow movement of stool through the large intestine. The longer it takes for the stool to move through the large intestine, the more it loses fluid and the drier and harder it becomes. The patient may be unable to have a bowel movement, have to push harder to have a bowel movement, or have fewer than their usual number of bowel movements. 6 3/9/2017 What Causes Constipation? Reasons for constipation could include: Less fiber: If you don’t eat enough high‐fiber foods like vegetables, fruits, and whole grains. High‐fat meats, dairy products eggs, and sugary sweet may cause constipation. Using too many laxatives and enemas. Lack of exercise 7 3/9/2017 What Causes Constipation?.......Cont ‐ Holding back bowel movements. Ignoring an urge to have a bowel movement. ‐ Medical conditions, like stroke, diabetes, or a blockage in the intestines. ‐ Some medicines, Antacids, some supplements. Spinal cord injury, Paralysis, Stroke or other disorders, ‐ Peripheral neuropathy , Weakness of the diaphragm, abdominal muscles weakness. 8 3/9/2017 find the cause of the constipation: The following tests and procedures used: Physical exam: Check signs of health, bowel sounds and swollen, painful abdomen, Digital rectal exam (DRE): gloved finger into the lower part of the rectum to feel for lumps or anything else Fecal occult blood test: Check stool for blood that can only be seen with a microscope. Proctoscopy: An exam of the rectum using a proctoscope, inserted into the rectum. Colonoscopy: Look inside the rectum and colon for polyps, abnormal areas, or cancer 9 3/9/2017 Treatment of Constipation 10 3/9/2017 Treatment choices for constipation include: •Medications. •Exercise and activity •Home remedies •Diet and fluids 11 3/9/2017 Medications Medications for constipation can include: Suppositories, mineral oil, stool softeners, laxatives, such as Senokot. •Taking a medication too often can reduce its effectiveness or aggravate negative side effects. 12 3/9/2017 Exercise and Activity Physical activity can help prevent and relieve constipation. Exercise helps constipation by decreasing the time it takes food to move through the large intestine, thus limiting the amount of water absorbed from the stool into the body. Hard, dry stools are harder to pass. 13 3/9/2017 Home Remedies Home remedies may include: Karo corn syrup •prune juice mixed with a good‐quality apple juice or applesauce to make it more palatable. •Allowing enough time on the toilet. Some doctors suggest 10 to 15 minutes at least twice a day. •Enemas, but only when recommended by a doctor. 14 3/9/2017 Diet for Constipation 15 3/9/2017 Diet and Fluids Include: Drinking enough water and juice can help you have regular bowel movements. •Add fiber to the diet, including whole grain breads, whole grain cereals, bran cereals or muffins, and popcorn. •Ground beans also can be added to other foods. •Increase the amount of fruits and vegetables. 16 3/9/2017 Diet and Fluids…..Cont Take probiotic, Proposed probiotic for constipation involves: Bifidobacteria (B. bifidum, B. infantis, and B. longum) and Lactobacillus (L. reuteri, L. casei, L. plantarum, and L. rhamnosus). Specific foods for constipation: Berries, beans, and Broccoli. Dried fruits, such as dates, figs, prunes, apricots, and raisins. whole grain bread. Plums, Pears, and Apples. Nut https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291444/ 17 3/9/2017 Use this table as a tool to help replace less healthy foods with foods that have fiber 18 3/9/2017 What should you avoid eating if you’re constipated? Try not to eat too many foods with little or no fiber, such as - Cheese, chips, fast food, ice cream, meat, high in fat and low in fiber - ‐ Avoid processed foods, such as hot dogs or some low fiber microwavable dinners Limit soft drinks and drinks containing caffeine, such as cola, coffee, and tea. 19 3/9/2017 Acid Reflux (GER) 20 3/9/2017 WhatisAcid Reflux (GER)? Acid Reflux (GER) happens when your stomach contents come back up into your esophagus. Stomach acid that touches the lining of your esophagus can cause heartburn. Acid Reflux (GER) happen when your lower esophageal sphincter becomes weak or relaxes when it shouldn’t, causing stomach contents to rise up into the esophagus, causes increased pressure on your abdomen. 21 3/9/2017 Does GER have another name? Doctors also refer to Acid Reflux (GER) acid indigestion acid regurgitation heartburn reflux 22 3/9/2017 Who is more likely to have Acid Reflux (GER) ? . You are more likely to have Acid Reflux (GER ) if you are Overweight or obese a pregnant woman taking certain medicines a smoker or regularly exposed to secondhand smoke 23 3/9/2017 ComplicationsofAcid Reflux (GER) Adults who have chronic esophagitis over many years are more likely to develop: - precancerous changes in the esophagus including narrowing and cancer. - Asthma and chest congestion. - Cough or a sore throat 24 3/9/2017 ComplicationsofAcid Reflux (GER) hoarseness—the partial loss of your voice laryngitis—the swelling of your voice box that can lead to a short-term loss of your voice pneumonia—an infection in one or both of your lungs—that keeps coming back wheezing—a high-pitched whistling sound when you breathe 25 3/9/2017 ComplicationsofAcid Reflux (GER) …Cont Other common Acid Reflux (GER) complications include: Bad breath Nausea Pain in your chest or the upper part of your abdomen problems swallowing or painful swallowing Respiratory problems Vomiting The wearing away of your teeth 26 3/9/2017 Causes Acid Reflux (GER) o Certain medicines, including: medicines that treat asthma or high blood pressure, antihistamines (antiallergy), Painkillers, Sedatives and o Antidepressant medicines o Smoking o Hiatal hernia can also cause acid o reflux (GER) 27 3/9/2017 Diagnoses Several tests can help a doctor diagnose Acid Reflux (GER) including: . Upper gastrointestinal (GI) endoscopy and biopsy. An x-ray technician performs this procedure at a hospital or an outpatient center. barium shows up on the x-ray and can find problems related to Acid Reflux (GER) , such as: hiatal hernias, esophageal strictures, ulcers, 28 3/9/2017 Diagnoses……Cont Most accurate procedure to detect acid reflux is esophageal pH and impedance monitoring. Esophageal pH and impedance monitoring measures the amount of acid in your esophagus while you do normal things. 29 3/9/2017 Treatment of Acid Reflux (GER) 30 3/9/2017 Lifestylechanges Not eating 2 to 3 hours before bedtime Lose weight, if needed. Wear loose-fitting clothing around your abdomen.. Stay upright for 3 hours after meals. Avoid reclining and slouching when sitting. Raise the head of your bed 6 to 8 inches Quit smoking 31 3/9/2017 Medicines Over-the-counter medicines such as Antacids, Maalox, or Rolaid. Prescribed Medicine Such as: Nexium, Prevacid, Protonix, rabeprazole , AcipHex . Antibiotics. Antibiotics, including erythromycin, can help your stomach empty faster. 32 3/9/2017 Surgery Your doctor may recommend surgery if your Acid Reflux (GER) disease symptoms don’t improve with lifestyle changes or medicines. You’re more likely to develop complications from surgery than from medicines 33 3/9/2017 Other Treatments - Hypnosis, massage, and other relaxation techniques may help reduce symptoms of Acid Reflux (GER) . Stress often makes GER symptoms worse. ‐ 34 3/9/2017 Diet and Acid Reflux (GER) ? 35 3/9/2017 Conditions and Foods that may relieve Acid Reflux (GER) ? - Exclusion of overeating, last meal at 2‐3 hours before sleep. Eating small, frequent meals instead of three large meals Chew your food well and relax while you eat Chewing gum after a meal might help. 36 3/9/2017 Foods, Juices and supplements that help - Sauerkraut or cabbage juice, having a few teaspoons of cabbage juice before eating. - Apple cider vinegar, Mix 1 tbsp of apple cider vinegar with one ounce of water about 10-20 minutes before a meal. - Use High-quality sea salt (unprocessed salt), such as Himalayan salt. 37 3/9/2017 Foods, Juices and supplements that help ……Cont - Digestive enzymes: Enzymes amylase, lipase, and protease support the breakdown of foods. - Probiotics (25+ billion live bacteria), Choose a probiotic with soil based microorganisms and lactobacillus strains, which is usually present in fermented yoghurt. - Essential Oils, Supplementing with essential oils of, ginger and fennel. Put two drops in water as a supplemental dose - 38 3/9/2017 Foods, Juices and supplements that help ……Cont - Baking soda, One-half to one full teaspoon of baking soda (sodium bicarbonate) in an eight-ounce glass of water. - Aloe juice, Drink about 1/2 cup of aloe Vera juice before meals. - Ginger root or chamomile tea. Drink about 20 minutes or so before your meal. 39 3/9/2017 Foods, Juices and supplements that help - Folate or folic acid (vitamin B9) found to reduce acid reflux by approximately 40%. - Vitamin D, Vitamin D is important for addressing any infectious component. - Melatonin, have shown a positive effect on acid reflux disease symptoms. 40 3/9/2017 Foodstobeavoided Avoid eating or drinking the following items that may make acid reflux worse: Chocolate, caffeinated and carbonated beverages Spicy foods Tomatoes and tomato products Alcoholic drinks 41 3/9/2017 Foodstobeavoided…………Cont Citrus fruits Fried and fatty foods Garlic and onions Refined sugar and carbohydrates Chili dogs 42 3/9/2017 END 43