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Chapter 11
Digestive System Diseases and
Disorders
Copyright
Copyright
© 2010
© 2010
Delmar,
Delmar,
Cengage
Cengage
Learning.
Learning.
ALLALL
RIGHTS
RIGHTS
RESERVED.
RESERVED.
Anatomy and Physiology
• Two main purposes:
– Change foods into simpler substances
– Eliminate waste products
• Alimentary canal
– Continuous tube running from mouth to anus
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Anatomy and Physiology
• Accessory organs:
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Tongue
Teeth
Salivary glands
Gallbladder
Pancreas
Liver
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Animation
Click Here to Play Digestion Animation
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Related to hemorrhage, perforation, and
altered motility
• Terms identifying bleeding:
– Hematemesis
– Hematochezia
– Melena
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Common Signs and Symptoms
• Perforation in stomach or intestines causes
peritonitis and septicemia
• Alteration in motility include diarrhea,
vomiting, nausea, or constipation
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Tests
• X-ray
• Endoscopic exam
– Esophagogastroduodenoscopy (EGD)
• GI series
– Barium swallow and enema
• Occult blood
• Ova and parasites
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EGD
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Diseases of the Mouth
• Dental caries
– Disease of teeth due to bacteria on tooth surface
• Plaque
• Periodontal disease
– Affects supporting structures of teeth/gums
– Main cause of tooth loss in adults
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Diseases of the Mouth
• Periodontal disease
– Causes:
• Poor oral hygiene
• Inadequate diet leading to gingivitis
– Inflammation of gums
– Prevention:
• Brushing and flossing
• Regular dental care
• Adequate diet
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Mouth
• Mouth cancer
– Squamous cell carcinoma of lip
• Common oral cancer
– Usually on lower lip from exposure to sunlight, chewing
tobacco, or pipe/cigar smoking
– Treatment:
• Radiation
• Surgical excision
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Cancer of the Lip
Photo courtesy Mark L. Kuss
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Throat and Esophagus
• Pharyngitis
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Also known as sore throat
Viral or bacterial
Diagnosis by throat culture
If caused by strep, treated with antibiotics
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Throat and Esophagus
• Reflux esophagitis
– Inflammation of tissue at end of esophagus
– Caused by backflow of stomach acids through cardiac
sphincter upward into esophagus
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Diseases of the Throat and Esophagus
• Reflux esophagitis
– Symptoms:
• Heartburn
• Burning sensation in mid-chest or epigastric area
– Long-term reflux can lead to bleeding, ulceration, and
scarring of esophagus
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Throat and Esophagus
• Reflux esophagitis
– Treatment:
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Reduce reflux
Avoid large meals
Avoid spicy foods, caffeine, and tight clothing
Take stool softeners
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Throat and Esophagus
• Reflux esophagitis
– Treatment:
• Take laxatives
• Take antacids or other drugs that tighten gastroesophageal sphincter
• Sleep with head of bed elevated
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Throat and Esophagus
• Hiatal hernia
– Part of stomach sliding into chest cavity
– Increases with age and weakness of cardiac sphincter
– May be asymptomatic
• But can be related to reflux
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Hiatal Hernia
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Diseases of the Throat and Esophagus
• Esophageal varices
– Enlarged, tortuous veins of esophagus
– Usually related to liver cirrhosis
– Causes:
• Excessive alcohol consumption
– Hemorrhage
• Life-threatening
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Stomach
• Gastritis
– Inflammation of stomach
– Symptoms:
• Epigastric pain
• Bloating
• Nausea
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Diseases of the Stomach
• Gastritis
– Causes:
• Irritating agents
– E.g., aspirin, alcohol, coffee, tobacco, bacterial-laden foods
• Helicobacter gastritis caused by small bacteria in stomach lining
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Stomach
• Gastritis
– Diagnosis of helicobacter gastritis by biopsy
– Treatment:
• Pepto-Bismol
• Flagyl
• Amoxicillin
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Stomach
• Peptic ulcer
– Found in stomach and duodenum
– Caused in part by action of pepsin
– Also known as gastric ulcers
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Stomach
• Peptic ulcer
– Treatment:
• Reduction of contributory factors
• Antacids
• Surgery in severe cases
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Stomach
• Stomach cancer
– Affects more males than females
– Often goes undiagnosed until metastasizes
– Symptoms:
• Loss of appetite
• General stomach distress
• Heartburn
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Stomach
• Stomach cancer
– Treatment:
• Surgical resection
• Chemotherapy
• Radiation
– Prognosis good if discovered early
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Malabsorption syndrome
– Small intestine unable to absorb nutrients
• Difficulty absorbing fats and minerals
– Treatment:
• Diet therapy
– Complication:
• Bleeding due to lack of vitamin K absorption
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Regional enteritis
– Also known as Crohn’s disease and inflammatory bowel
disease (IBD)
– Chronic inflammatory disease most commonly affecting
small intestine
– Characterized by exacerbation and remission
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Regional enteritis
– Symptoms:
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Anorexia
Flatulence
Abdominal pain
Diarrhea and constipation
– Supportive treatment:
• Low-residue diet
• Medications to control diarrhea, inflammation, infection, and
depression
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Gastroenteritis
– Inflammation of stomach and intestines
– Causes:
• Bacteria
• Viruses
• Parasitic invasion
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Gastroenteritis
– Symptoms:
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Nausea
Vomiting
Abdominal cramping
Diarrhea
Stomach rumbling
Malaise
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Gastroenteritis
– Treatment:
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Anti-nausea and anti-diarrheal medications
Antibiotics
Fluids
Nutritional support
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Gastroenteritis
– Prevention:
• Hand washing prior to food preparation
• Proper refrigeration
• Avoidance of contaminated food and/or water
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Inguinal hernia
– Outpouching of small intestine and peritoneum into groin
area
– More common in males
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Small Intestine
• Inguinal hernia
– Strangulated hernia if portions of herniated intestine
become caught and twisted, cutting off blood supply to
organ
– Treatment:
• Surgical repair
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Appendicitis
– Inflammation of appendix
– Symptoms:
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Abdominal pain that shifts to right lower quadrant (RLQ)
Nausea and vomiting
Fever
Leukocytosis
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Appendicitis
– Treatment:
• Surgical excision
– Hopefully before rupture
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Intestinal obstruction
– Inability to move contents through intestine
– Blockage in intestine, disease, or ileus
• May occur from tumors, hernias, volvulus, adhesions,
intussusception, or paralytic obstruction
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Volvulus and Intussusception
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Intestinal obstruction
– Symptoms:
• Mild to severe abdominal pain and distention
• Nausea and vomiting
– Treatment:
• Nasogastric suctioning
• Surgery
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Ulcerative colitis
– Chronic inflammation of colon
– Symptoms:
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Lower abdominal pain
Blood in stools
Anemia
Diarrhea
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Ulcerative colitis
– Treatment:
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Dietary limitations
Stress reduction
Mild sedatives
Anti-inflammatories
– Surgery if other treatments unsuccessful
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Irritable bowel syndrome
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Also known as spastic colon
Most common intestinal disorder
Inflammation of bowel with chronic lesions
Symptoms:
• Abdominal pain
• Altered motility
• Diarrhea or constipation
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Irritable bowel syndrome
– Causes:
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Spicy foods and seasonings
Caffeine
Alcohol
Stress
– Treatment:
• Avoidance of causative factors
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Dysentery
– Acute inflammation of colon
– Main symptom:
• Massive diarrhea with blood, pus, and mucous accompanied by
severe abdominal pain
– Treatment dependent on cause
• But antibiotics may be used to treat bacterial infection
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Diverticulosis/diverticulitis
– Diverticulosis
• Condition of diverticula or little outpouches
– Diverticulitis
• Outpouches become packed with fecal material and become
irritated and inflamed
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diverticulosis/Diverticulitis
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Diverticulosis/diverticulitis
– Symptoms:
• Lower abdominal pain
• Cramping
– Treatment:
• Antibiotics
• Dietary modification
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Colon polyps
– Inward projection of mucosal lining of colon
– Diagnosis by colonoscopy or sigmoidoscopy
– Suspicious polyps excisionally biopsied
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Colon Polyp
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Colorectal cancer
– Carcinoma of colon and rectum
– Symptoms:
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Change in bowel habits
Pencil-sized stools
Blood in stools
Anemia
Abdominal discomfort and obstruction
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Colon
• Colorectal cancer
– Adenocarcinomas
• Most common
– Diagnosis by barium swallow and enema, stool exams for
occult blood, and colonoscopy
– Prevention:
• Diet and stool examinations
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Rectum
• Hemorrhoids
– Varicose veins in rectum
• Internal or external
– Causes:
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Pressure in anal area
Constipation
Prolonged standing
Pregnancy and childbirth
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Hemorrhoids
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Rectum
• Hemorrhoids
– Prevention:
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Stool softening
Good bowel habits
Fluids and fiber
Exercise
Avoidance of laxative use
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diseases of the Rectum
• Hemorrhoids
– Treatment:
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Medications
Warm sitz baths
Manual reduction
Cryosurgery and hemorrhoidectomy
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Trauma
• Mouth
– Causes:
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Motor vehicle accident
Fall
Abuse
Burn
Blunt or perforating injury
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Trauma
• Stomach or intestines
– Causes:
• Perforation as result of stabbing or gunshot wound
– Medical emergency
– Treatment usually surgical
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Rare Diseases
• Achalasia
– Disorder of esophagus causing pain with swallowing
• Gluten-induced enteropathy
– Also known as celiac sprue disease
• Intestinal polyps
– Benign tumors found along intestine lining
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Effects of Aging
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Disorders common
Decreased sense of taste
Loss of teeth
Increased incidence of ulcer disease
Constipation problems
Development of hemorrhoids
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.