LOWER GI

IRRITABLE BOWL SYDROME

CHRONIC DISORDER: reoccurring abdominal pain w/ bowl movement

“Diagnosis of symptoms”

Triggered by stress, sleep deprivation, foods

fiber and relaxation techniques

MED MANAGEMENT/FOOD DIARY/FLUID INTAKE/ AVOID ALC/SMOKING

MALABSORPTION SYNDROME

INABILITY OF DIGESTIVE SYSTEM TO ABSORB ONE OR MORE MAJOR VITAMINS

DIRRHEA- MALABSORPTION

-HIGH FAT CONTENT IN STOOL

PTS WILL BE VIATMIN DEFECIT AND HAVE WEIGHT LOSS

DIARRHEA IMPLICATIONS

fat analysis, hydrogen breath test, d-xylose test

VITAMEN REPLACEMENT/ DIET CHANGE/ PROBIOTICS/ MONITOR OSETOPOROSIS

CELIAC DISEASE- MALABSORPTION

autoimmune response to consumption of gluten

BODY ATTACKS GI MUCOSA

INJURY/DEATH OF MUCOSA RESULTS IN INABILITY TO ABSORB NUTRIENTS

chronic, no cure, no meds, lifelong

COLORECTAL CANCER

multibacterial- family history- alc/obestity

BLOODY STOOL~INCOMPLETE EVACUATION~LONG MANIFESTATION

NEED SCREENING 45YRS AND SOONER WITH FAMILIAL RISK

PERITONITIS

Inflammation of peritoneum due to infection in GI system; 2nd infection; perforation

SYMPTOMS: DIFFUSE PAIN BECOMES LOCALIZED AND SEVERE, ELECTROLYTE IMBALANCE

X-RAY SHOWS ABCESS- FREE AIR FROM PERFORATION {DIAGNOSIS}

TREAT UNDERLYING CONDITION

SHOCK AND SEPSIS AND HTN(FLUID SHIFT DEPLETES VASC SPACE)

APPENDICITIS

appendix becomes inflamed and edenimis by becoming turned on itself or fecalif, enlarged lymph nodes

DIAGNOSED WITH ULTRASOUND/CT

Increase in intraluminal pressure= edema/obstruction(lead to ischemic tissue bacterial growth and perforation)

APPENDICITIS SIGNS AND MANAGEMENT

-PAIN AT MCBURNEY’S POINT=RLQ

-REBOUND PAIN

-ROBSING SIGN(PRESS ON LQ PAIN ON RQ)

pain relief/mon. infection/prevent atelectasis

npo- antibiotics

DIVERTICULAR DISEASE- LLQ SIGMOID COLON

diverticulum: herniations that form in colon and extend through defected muscle layer

diverticulosis: multiple diverticula w/o inflammation

diverticulitis: infection and inflammation of diverticula

NEED COLONOSCOPY~CAUSED BY STRAIN, CONSTIPATION

exercise, stool softener, laxatives, antibiotics, fiber

INTESTINAL OBSTRUCTION- NPO PTS

blockage prevents flow of contents through intestinal tract

MECHANICAL- IMPACTED-ADHESIONS-STOOLS-TUMOR

FUNCTIONAL- PARALYTIC- NO PERASTALIS

HERNIALVOLVUS- WRAPS IN ON ITSLEF, CAN STOP BLOODLFOW AND BECOME NECTROTIC

SHORT BOWL OBSTRUCTION

ACUTE AND SEVERE

visible peristalsis

hyperactive to absent bowl sounds

vomit/dehydration/low electrolytes

Metabolic Alkalosis

HTN-SHOCK

SHORT BOWL OBSTR. TR

GI CONTRAST MEDIA

-stimulate peristalsis-

LONG TERM BOWL OBSTRUCTION

gradual- constipation-HYPOACTIVE to absent

Weight loss

Vomit stool & digested food

INTESTINAL OBSTRUCTION SIGNS & MANAGEMENT

CRAMPS/ DISTENTION/ BLOOD PASSED BY RECTUM

bowl res/ I.V/ Decompression of Bowl

Monitor progress- ng output

LONG BOWL OBSTRUCT. TR

COLONOSCOPY, STENT, RESECTION

INFLAMMATORY BOWL DISEASE

COLONOSCOPY/BIOPSY NEEDED

>Chronic disorders result in inflammation/ulceration in bowl

Inflammation-Feverish-Dehydration-Malabsorption

IMMUNOMODULATOR-ANTIBITOIC-CORTICOSTEROID LAST RESORT-MESLAMINE TR REOCCURING INFLAMMATION

SEVERE DIARRHEA/ MALNOURISHED=B12 ANEMIA

ULCERATIVE COLITIS- IBD

LARGE INTESTINE

continuous area inflamm.

presents with bloody/mucus stool- CHRONIC BLOOD LOSS

small ulcers

L.INTESTINE REMOVAL = CURE

CROHN’S DISEASE- IBD

WHOLE GI TRACT- FAST ONSET

patchy inflammation

deep ulcers

less bloody stool