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Metabolism

Sum of all the body’s physical and chemical processes, including Anabolism and Catabolism

Anabolism

Building up more complex biochemical substances or synthesizing nutrients (e.g., Glycogenesis)

Catabolism

Breaking down biochemical substances into simpler substances (e.g., Glycogenolysis)

Aerobic Metabolism

Uses oxygen to extract energy from carbohydrates; end products: Carbon dioxide, water, and heat

Anaerobic Metabolism

Creates energy by burning carbohydrates in the absence of oxygen; end product: Lactic acid

Macronutrients

Nutrients that supply energy for metabolism: Carbohydrates, Fats, Proteins

Carbohydrates Breakdown Enzyme

Salivary Amylase and Amylase (produced by pancreas); breaks down carbohydrates

Fats Breakdown Enzyme

Lipase (released by pancreas) and bile; responsible for fat breakdown

Proteins Breakdown Enzyme

Trypsin (produced by pancreas); responsible for protein breakdown

Basal Metabolic Rate (BMR)

The amount of energy expended while at rest, influenced by factors like sex, age, body surface area, and hormones

Energy Requirements

Determined by BMR, activity level, and energy required for food digestion

BMR Influencing Factors

Sex, body surface area, age, growth, hormones (thyroxine), nutritional state, body temperature, diseases increasing cellular activity

Energy for Food Digestion

Energy expenditure increases after food intake due to digestion

Absorption

Most nutrient absorption occurs in the small intestine (first and second segments)

Liver Function

Involved in metabolism, nutrient absorption, and excretion of metabolic wastes

GI System Functions

Breakdown of food particles, absorption of small nutrient molecules, and elimination of waste products

GI System Abnormalities

Conditions affecting the GI tract include bleeding, perforation, obstruction, inflammation, and cancer

Small Intestine Function

Digestion continues in duodenum; absorption of nutrients in jejunum and ileum

Large Intestine Function

Absorbs water and electrolytes; bacteria assist in the breakdown of waste material

Hydrochloric Acid Function

Breakdown of food in the stomach; secreted by parietal cells in the stomach lining

Intrinsic Factor

Produced in the stomach, essential for Vitamin B12 absorption and red blood cell maturation

Subjective Data in GI Assessment

Includes pain, dyspepsia, nausea, vomiting, change in bowel habits, appetite, weight change

Objective Data in GI Assessment

Includes baseline data, vital signs, general nutritional state, body build, fat distribution

GI System Physical Examination

Includes inspection, auscultation, percussion, and palpation of mouth, abdomen, and rectum

Borborygmi

Loud, prolonged gurgles often referred to as stomach growling; indicates active peristalsis

Tympany

Hollow, drum-like sound heard over air-filled spaces during abdominal percussion

Murphy's Sign

Pain upon palpation of the right upper abdomen, indicative of acute cholecystitis

Rectal Examination Position

Knee-chest, left lateral, or standing with hips flexed for digital rectal exam

Fecal Occult Blood Test (FOBT)

Used for cancer screening, detects hidden blood in stool

Complete Blood Count (CBC)

Used to assess overall health and detect a range of disorders, including anemia and infection

Serum Amylase and Lipase

Enzymes measured to assess pancreatic function; elevated in pancreatic disorders

Cancer Antigen (CA) 19-9

Tumor marker for pancreatic cancer and other GI cancers

Barium Enema

Diagnostic imaging technique for the lower GI tract, used to detect abnormalities like tumors or polyps

Endoscopic Ultrasonography

Used to evaluate submucosal lesions, such as in Barret's esophagus or pancreatitis

Genetic Testing

Identifies genetic risks for GI disorders, including colon cancer, lactose deficiency, and inflammatory bowel disease

Colonoscopy

Gold standard for colorectal cancer screening; visualizes the colon and allows for biopsy

Laparoscopy

Minimally invasive technique for evaluating GI diseases; allows for biopsy or simultaneous surgery

Gastric Analysis

Measures secretory activity in the stomach to assess conditions like atrophic gastritis and ulcers

Cholecystitis

Inflammation of the gallbladder, often due to gallstones

Peptic Ulcer Disease (PUD)

Open sores that develop on the inner lining of the stomach or the upper part of the small intestine

Cirrhosis

Liver disease characterized by scarring of the liver tissue

Hepatitis

Infection or inflammation of the liver, often caused by a virus

Pancreatitis

Inflammation of the pancreas, can be acute or chronic

Diverticulitis

Infection or inflammation of small pouches in the colon

Gastroesophageal Reflux Disease (GERD)

Condition where stomach acid frequently leaks into the esophagus

Irritable Bowel Syndrome (IBS)

A disorder affecting the large intestine, causing symptoms like abdominal pain and bloating

Crohn’s Disease

Chronic inflammatory bowel disease that affects the digestive tract

Ulcerative Colitis

Chronic inflammation of the colon and rectum

Gallstones

Solid particles that form in the gallbladder and block bile flow

Celiac Disease

Autoimmune disorder where the ingestion of gluten damages the small intestine lining

H. Pylori Infection

Bacterial infection linked to the development of peptic ulcers

GI Bleeding

Internal bleeding within the gastrointestinal tract, can lead to anemia

Appendicitis

Infection or inflammation of the appendix, often requiring surgical removal

Hemorrhoids

Swollen blood vessels in the rectum or anus, causing discomfort or bleeding

Gastroesophageal Reflux Disease

Backflow of gastric or duodenal contents into the esophagus causing symptoms or mucosal injury

Incompetent Lower Esophageal Sphincter

Failure of the LES to close properly, leading to acid reflux

Pyloric Stenosis

Condition that may contribute to gastroesophageal reflux by delaying gastric emptying

Hiatal Hernia

Condition in which part of the stomach protrudes through the diaphragm into the chest

Esophagitis

Inflammation of the esophagus caused by repeated exposure to stomach acid

Pyrosis

Heartburn; a common symptom of GERD

Dyspepsia

Indigestion, often accompanied by bloating and discomfort

Regurgitation

The backflow of stomach contents into the mouth or throat

Dysphagia

Swallowing difficulty, common in GERD and esophageal disorders

Odynophagia

Painful swallowing often seen with esophageal irritation

Hypersalivation

Excessive salivation, often seen in GERD or esophageal disorders

Substernal Pain

Chest pain beneath the sternum, commonly associated with GERD

Esophageal pH Monitoring

A test to evaluate acid reflux over 24-36 hours, gold standard for diagnosing GERD

Bernstein Test

Acid perfusion test used to diagnose GERD

Esophageal Manometry

A test that assesses the function of the esophagus and LES

Antacids

Medications that neutralize stomach acid to relieve heartburn and indigestion

H2 Receptor Antagonists

Drugs that block histamine receptors to decrease stomach acid production (e.g., Ranitidine)

Proton Pump Inhibitors

Medications that reduce stomach acid production, helping heal the esophagus (e.g., Omeprazole)

Prokinetics

Drugs that enhance motility and improve LES function (e.g., Metoclopramide)

Stretta Procedure

An endoscopic procedure that reduces GERD symptoms by modifying the vagus nerve

Enteryx Procedure

An endoscopic procedure that tightens the LES to prevent reflux

Nissen Fundoplication

Surgical procedure to reinforce the LES and prevent acid reflux

Hiatal Hernia Risk Factors

Obesity, pregnancy, aging, trauma, and increased abdominal pressure

Sliding Hiatal Hernia

The most common type, where the stomach slides upward into the chest through the diaphragm

Paraesophageal Hiatal Hernia

A type of hernia where part of the stomach pushes through the diaphragm but stays beside the esophagus

Complications of Hiatal Hernia

Esophageal reflux, strangulation, and obstruction

Pyrosis in Sliding Hiatal Hernia

Heartburn occurring 30-60 minutes after meals, commonly associated with reflux

Regurgitation in Sliding Hiatal Hernia

The backflow of stomach contents, causing discomfort in the chest or throat

Gastric Ulcer

Pain occurring in the upper epigastrium, relieved by vomiting, associated with food intake

Duodenal Ulcer

Pain occurring on an empty stomach, relieved by food intake or antacids

Achalasia

A disorder causing difficulty swallowing, with a feeling of food being stuck in the throat

Incomplete LES Relaxation

Failure of the LES to relax during swallowing, causing dysphagia in achalasia

Esophageal Motility Disorder

A condition affecting the muscle contractions of the esophagus, leading to swallowing problems

Diffuse Esophageal Spasm

A non-peristaltic, motor disorder characterized by painful, irregular contractions of the esophagus

Tertiary Contractions

Uncoordinated, non-peristaltic contractions of the esophagus seen in diffuse esophageal spasm

Diffuse Esophageal Spasm Symptoms

Chest pain, heartburn, painful swallowing (odynophagia), and regurgitation

Aggravating Factors of Diffuse Esophageal Spasm

Hot and cold liquids, large meals

Diagnosis of Diffuse Esophageal Spasm

Barium esophagography (corkscrew pattern) and esophageal manometry

Esophageal Manometry in Diffuse Esophageal Spasm

Reveals intermittent contractions and normal peristalsis

Calcium Channel Blockers

Primary drug therapy for diffuse esophageal spasm to reduce muscle contractions

Nitrates

Medications used in diffuse esophageal spasm to relax the esophageal muscles and relieve pain

Sedatives

Used to relax the muscles of the esophagus in diffuse esophageal spasm

Diet for Diffuse Esophageal Spasm

Soft, frequent meals, eating in an upright position, and avoiding aggravating foods

Surgical Treatment for Diffuse Esophageal Spasm

Esophageal dilation and myotomy are rarely used

Nursing Management of Diffuse Esophageal Spasm

Monitor for pain relief, educate on diet and drug therapy, and encourage relaxation techniques

Calcium Channel Blocker Use in Diffuse Esophageal Spasm

Relaxes the smooth muscles of the esophagus to alleviate symptoms