Gastrointestinal System

Upper GI

mouth, esophagus, stomach

upper GI function

ingestion and inital digestion of food

lower GI

small intestine (duodenum, jejunum, ilium) and large intestine (cecum, colon, rectum)

small intestine

major digestive and absorption (nutrients) process occurs here

large intestine

primarily absorbs water and electrolytes and stores and eliminates waste products

accessory organ

salivary glands, liver, pancreas

accessory organs function

aid in digestion by producing digestive secretions

peristaltic movement

propels food and fluids by rhythmic intermittent contractions of smooth muscle

exept for pharynx and upper half of esophagus

neural control of GI system

enteric nervous system

division of ANS

vagus nerve reflex

vasovagal

controls secretions and the motility of the GI tract

nausea

occurs as a result of irritation of nerve endings in the stomach and other parts of the body

vomiting

typically occurs following nausea, caused by anything that triggers nausea

complications from vomiting

fluid and electrolyte imbalance

pulmonary aspiration of the vomitus

malnutrition

mucosal or GI damage

diarrhea

frequent, watery, unformed stools

amount of fluid loss determines severity

prolonged leads to dehydration, electrolyte imbalance, dizziness, thirst, weight loss

diarrhea causes

diverticulitus, inflammatory bowel disease, irritable bowel syndrome, hyperthyroidism, infectious disease, laxative overuse, cancer chemotherapy, food allergy, lactose intolerance

colostridium difficile

life threatening diarrhea

equioment must be cleaned with chlorine bleach or spore killing disinfectant

constipation

disease in elimination with excessively hard, lumpy stools

difficult to expel, infrequent stools, feeling of incompleteness after evacuation, along with general discomfort

constipation causes

diet lacking bulk or fiber, hypothyroidism, inadequate fluid consumption, sedentary lifestyle, older age

drugs

acute or chronic disease of the digestive system, extra abdominal disease, depression, emotional stress

LBP in patients who are muscle

obstipation

intractable constipation with resulting fecal impaction or inability to pass gas

can cause partial or complete bowel obstruction

back pain may be one of symptoms, especially in older adults

anorexia

aversion to food or loss of appetite

often associated with nausea and vomiting and sometimes associated with diarrhea

anorexia nervosa

eating disorder

associated with anxiety, fear, depression

anorexia cachexia

systemic response to cancer due to increased metabolism

dysphagia

difficulty swallowing

sensation of catching sticking of food in the esophagus

initially occurs with dry coarse food, later with anything that is swallowed

achalsia

condition in which the lower esophageal sphincter falls to relax and food is trapped in the esophagus

heartburn

painful burning sensation felt in the esophagus in midepigastric region behind the sternum or in the throat

often symptoms of GERD

heartburn aggravating factors

certain foods - fatty foods, citrus fruits and juices, chocolate, peppermint, alcohol, coffee, caffeine

certain movements - bending, stooping, lifting after a large meal, increased abdominal pressure due to tight clothing, pregnancy, back support

abdominal pain

visceral pain

aggravated by coughing, sneezing, straining

pain can be mechanical, inflammatory, ischemic or referred

mechanical abdominal pain

stretch induced pain

inflammatory abdominal pain

occurs as a result of reduced blood flow to the organs or abdominal muscles

GI Bleeding coffee ground color (vomit)

perforated peptic or duodenal ulcer

GI bleeding red (vomit)

esophageal bleeding

bloody diarrhea

ulcerative colitis

bright red blood (stool)

pathology in rectum or anus

melena (tarry or black stools)

upper digestive tract bleeding

stomach or duodenal ulcer

reddish or mahogany colored stool

caused by eating certain foods

such as beets or a significant amount of red food color

bleeding lower GI tract

white gray or clay colored stool

liver

pancreas

colon disorder

occult bleeding

can appear as midthoracic back pain with radiation to RUQ can be revealed only by fecal occult blood test and lab test

hepatitis

acute or chronic inflammation of liver

heptatitis cause

viral infection, chemical agents, drug reaction, alcohol abuse, autoimmune hepatitis, biliary cirrhosis, metabolic disorder

hepatitis A

acute infection - mild to severe

transmission through fecal oral route

hepatitis A prevention

good personal hygiene

hand washing

sanitaton

vaccination

hepatitis B

mild (acute, usually last for several weeks) to severe (chronic, lifelong)

transmission through blood, body fluids, or body tissues

hepatitis B prevention

education on disposable needles

screening of blood donors

immunization

hepatitis C

acute or chronic

transmission through blood, body fluids, organs transplants

hepatitis D

acute or chronic

transmission through blood, body fluids

dependent on having HBV coinfection

poor prognosis, liver failure

hepatitis E

acute, infectious

transmission through fecal oral route

signs and symptoms of acute hepatitis

malaise, fatigue, mild fever, nausea, vomiting, anoreixia, RUQ pain, occasional diarrhea, jaundice, dark urine, clay colored stools

signs and symptoms of chronic hepatitis

fatigue, malaise, jaundice, RUQ pain, anorexia, arthralgia, fever, splenomegaly, hepatomegaly, weakness, ascites, hepatic encephalopathy