Assessment Techniques Physical exam:

VisualizationAuscultationPercussionPalpatation

Gastric analysis:hemoccult, pH

Fecal analysis:hemoccult, cultures, O&P

Radiography

Abdominal CT ScanRadiographic procedureDetailed cross sectional view within the

abdomen (detects tumors and obstruction)Abdominal ultrasound

Noninvasive procedure using sound wavesUpper GI Series/Barium SwallowLower GI Series/Barium Enema

Endoscopy

• Colonoscopy visualizes the colon,

from rectum to cecum

Endoscopy (continued)• Gastrointestinal endoscopy

visualizes esophagus, stomach and duodenum

• Protoscopy Visualizes rectum and anus

• Sigmoidoscopy Visualizes the entire rectum, sigmoid colon, and

possibly a portion of the descending colon

Pathology of the Digestive SystemExamples of symptoms:Anorexia - lack of appetiteEructation - gas expelled from the stomach

through the mouthSteatorrhea - fat in the feces; frothy, foul-

smelling fecal matterAscites - abnormal accumulation of fluid in

the abdomenFlatus – gas expelled through the rectum

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Disorders of the Digestive System Alactasia

Also called “lactose intolerance.” Not enough of the enzyme lactase is produced. The unabsorbed lactose ferments in the intestines leading to gas, cramps, and diarrhea

AnorexiaLack of appetite

Anorexia nervosaCompulsive dieting and excessive exerciseCan become emaciated and have

electrolyte/cardiac disorders

Pathological Conditions (cont’d.)

Upper Gastrointestinal Tractachalasia - failure of the lower esophagus

sphincter (LES) muscle to relax

Copyright © 2005 by Elsevier Inc. All rights reserved.

Disorders of the Digestive System (continued)Anal fistula

almost always the result of a previous abscess

a small tunnel connecting the anal gland from which the abscess arose to the skin of the buttocks outside the anus.

Disorders of the Digestive System (continued)Appendicitis

Inflammation of the appendix; Can rupture and cause peritonitisTx: Appendectomy

Bulemia nervosa

Disorders of the Digestive System (continued)Cleft Lip and

Cleft Palate Incomplete closure

or fusion of the embryotic structure, specifically the maxillary processes and the nasal elevation during the second month of gestation.

Disorders of the Digestive System (continued)

CholelithiasisChole = bile or

Gall; lithiasis – means presence of stones

Disorders of the Digestive System (continued)

Cholecystitis Inflammation of the gallbladder

CirrhosisA chronic degenerative condition of the liver

accompanied by the formation of scar tissueColitis

Inflammation of the colonColon cancer

An abnormal growth in the large intestineConstipation

The inability to defecate

Disorders of the Digestive System (continued)Celiac disease;

usually symptoms develop 2 to 4 months after solid foods are introduced.

Children are unable to digest gliadin, which is a component of gluten – a protein found in wheat, rye, barely, and oats.

Thought to be related to IgA deficiency and early introduction of protein solids.

Crohn’s disease Inflammation and ulceration, usually affecting the ileum

and colon, or bothSymptoms include chronic diarrhea, abdominal pain,

fever, anorexia, wt. loss, FTT, enlarged regional lymph nodes, RLQ mass or fullness.

Disorders of the Digestive System (continued)Diverticulitis

The weakening of the colon wall, leading to formation of a pouch causing infection or abscesses if fecal material trapped

Disorders of the Digestive System (continued)Gastroenteritis – vomiting (emesis)

and diarrheaAcute caused by:

Infections (bacterial, viruses) - RotavirusToxinsAntibiotic therapyDiet conditions

Chronic caused by:Malabsorption disorders (such as Chrons,

celiac)Structural defectsAllergic disorders

Disorders of the Digestive System (continued)Food Poisoning

Botulism Characterized by paralysis and is often fatal

E. Coli Watery bloody diarrhea that is often accompanied

by a high feverSalmonella

Severe diarrhea, nausea and vomiting accompanied by a high fever

Disorders of the Digestive System (continued)

Gastritis Inflammation of the stomach lining

Gastroesophageal reflux disease Frequent heartburn or chest pain, bitter

taste in the mouth, difficulty swallowing, frequent hoarseness or coughing due to regurgitation

Halitosis Or bad breath, is caused by anaerobic

bacteria

Disorders of the Digestive System (continued)Heartburn

A painful burning sensation in the esophagus caused by the backflow of acidic chyme from the stomach

HemorrhoidA painful dilated vein in the lower rectum or

anusHepatitis

A viral infection of the liver Jaundice (icterus) – yellow discoloration of skin

caused by excessive bilirubin in the blood

HepatitisHepatitis A

passed by fecal-oral route, most commonly by poor sanitation or poor hand washing in day-care centers

symptoms generally mild Hepatitis B

transmitted via blood and body fluids as well as vertically from mother to fetus

Can result in long-term sequelae of cirrhosis, liver cancer, fulminating hepatitis, and hepatocellular carcinoma.

Hepatitis continuedHepatitis C

transmitted through the blood -predominantly parenterally spread; often thru blood transfusion

Most cases are subclinical but can lead to cirrhosis and hepatocellular carcinoma

Hepatitis D only occurs in children infected with HBV

Hepatitis E waterborne and is responsible for outbreaks in developing

countries. Infection may be severe but it does not become chronic.

Hepatitis G – relatively new virus transmitted through blood. individuals with HGB may be asymptomatic, and most

infections are chronic

Disorders of the Digestive System (continued)Ileus

Temporary stoppage of intestinal peristalsisIntestinal obstruction (bowel obstruction)

Complete stoppage to the passage of intestinal contents

IntussusceptionTelescoping of the bowel onto itself

Inguinal herniaProtrusion of a small loop of bowel thru a weak

place in lower abdominal wall or groin

Disorders of the Digestive System (continued)

Pancreatitis A mild acute or

chronic condition resulting from gallbladder stone blockage, disease, injury, or alcoholism

Peptic ulcer Ulcer of the stomach

PeritonitisAn inflammation of

the abdominal cavity caused by bacteria

Disorders of the Digestive System (continued)Phenylketonuria

Inherited disease that can lead to mental retardation if untreated

Pyloric stenosisA birth defect in which a constricted pyloric

sphincter does not allow food to pass easily into the small intestine

Disorders of the Digestive System (continued)Tay-Sachs

A recessive genetic disorder in which fat cells accumulate in the body and cause damage to normal cells

Ulcer An open sore on the lining of the digestive tract