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GASTROINTESTINAL TRACT (COMMON FINDINGS AND SYMPTOMS (anorexia- loss of…
GASTROINTESTINAL TRACT
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HEALTH EDUCATION
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personal hygiene, perineal care to limit ascending infection.
striclly bedrest, excecises must be planned to ensure adequate mobility
REGULATIONS
regulated by the central nervous system, which controls gastric secretions and the endocrine system which controls hormones involved in digestion.
- Cephalic phase: parasympathetic axcite pepsin and acid production.
- Gastric phase: local mysenteric secretory stimuli, vagal reflexes, gastrin stimulation.
- Intestinal phase: nernouse mechanism, hormonal mechanism
RISK FACTORS
mechanical and chemical irritation to the mucosal lining: chemical irritants include alcohol, tobacco,spicy food and mouth infections from poor oral hygiene. mechanical irritants are sharp edges of broken teeth.
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fatigue and emotional stress: results in contractions of the colon, decrease secretion of saliva due to the dryness of the mouth, decrease mucous secretions cause irritation and erosion of gastric mucosa and increase acid secretion in the stomach that results in ulceration of the mucosa.
drugs: such as aspirin and ibuprofen cause erosion and ulcer in the stomach especially on eldery people and when taken on empty stomach, some antibiotics that cause diarrhoea that destroy the normal flora of the gut.
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anxiety: due to the lack of knowledge about the disease process, psychological problems such as depression and withdrawal.
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FEEDING MODALITIES
1..Enteral nutrition- delivery of nutrients directly into the gastrointestinal tract via a feeding tube. for example: solicone tubes, nasogastric tubes, nasointestinal tubes, gastrostomy tubes.
- Parental nutrition: it is indicated to those patients whose gastrointestinal tract is not functioning well.
NUTRITIONAL DISORDERS
Malabsorption is the condition that prevents of nutrients through the small intestines. disorder that form common feature to assimilate one or more ingested nutrients
PATHOPHYSIOLOGY
In general , the digestion and absorption of food materials can be divided into 3 major phases: luminal,mucosal and postabsorptive. the luminal phase is the phase in which dietary fats,proteins and carbohydrates are hydrolysed and solubilized by secreted digestive enzymes and bile.
The mucosal phase relies on the intergrity of the brush-border membrane of intestinal epithelial cells to transport digested products from the lumen into the cells.
In postabsorptive phase reassembled lipids and other key nutrients are transported via lymphatics and portal circulation from the epithealial cells to other parts of the body.
Perturbation by disease processes in any of these phases frequently results in malabsorption.
MANAGEMENT
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Teach the patient: to maintain adequate nutrition. about the warning signs and complications such as vitamin deficiency. gentle care to promote comfort. safe administration of TPN. about the protein-calorie malnutrition