Elderly male patient with stomach cancer utilizes a feeding tube in order…
Elderly male patient with stomach cancer utilizes a feeding tube in order to eat. The feeding tube bypasses the esophagus, stomach, and duodenum. The gall bladder has been removed.
Stomach cancer often leads to an increase in weight loss and malnutrition. Patients will lose appetite and will have trouble eating and meeting the nutritional needs.
A feeding tube is used in order to facilitate eating. This tube allows the patient to receive all nutrition in order to support weight and strength. In this case the organs that are bypassed by the feeding tube are the esophagus and stomach.
Placing a feeding tube down the esophagus and leading it directly to the duodenum will help with digestion and remove the need for the stomach use for food storage and churning.
Removal of the gal bladder can result in problems digesting certain foods that are high in fat. Bile will still be produced but only in minimal amounts and therefore fatty foods should be avoided.
Placement of feeding tube will replace various roles in digestion in the stomach, esophagus, gal bladder
Placing feeding tube down esophagus will eliminate the function of moving food along naturally by smooth muscles and will need to place only foods that able to move along feeding tube
Bypasss via feeding tube will stop the need for churning of food in the stomach and will lead directly to to small intestine causing only certain foods that are already broken down to be digested. Removal of gal bladder will lack the ability to hold bile for excess fat foods.
feeding tubes can also cause involuntary movements within the esophagus, rips and tears of areas around feeding tube, infection, nausea and vomiting, abdominal pain
issues regarding stomach cancer
Poor diet and insufficient nutrients
indigestion or heart burn
nausea and vomiting
diarrhea or constipation
loss of appetite
issues with removal of gal bladder
bile between meals can no longer be stored
Insufficient bile for fatty foods
Digestive tract associated organs
Including the toungue, teeth, salivary glands, cheeks, lips. lined with stratified squamous epithelium
occupies the floor of the mouth, composed of interlacing bundles , contains both intrinsic and extrinsic muscles
glands that secrete saliva, contains enzyme amylase, includes parotid, sublingual and submandibular glands
muscular tube that connects the oral and nasal cavity to the larynx and esophagus
Lined with mucosa, connects to stomach, contains valve called cardiac sphincter, muscular tube about 8 inches long
Receives food from esophagus, composed by cardia, fundys, and body, contains valves, sac like organ
dark reddish brown organ, located in the upper right portion of abdominal cavity
Pear shaped, hollow structure, holds bile, attaches to liver and stomach
Beginning tube after stomach, divided into three parts Duodenum, jejunum, ileum
Large tube following the small intestine, divided into three parts ascending, transverse, and descending.
Ends in sigmoid colon, then rectum, and lastly the anal canal
Processes involved in digestive system
Ingestion - taking food into the digestive tract
Propulsion - food moving through the alimentary canal, involving Peristalsis meaning alternating waves of contraction and relaxation of muscles in the organ walls
Mechanical breakdown - increases surface area of ingested food, physically preparing it for digestion by enzymes, involves chewing, saliva, churning food in the stomached segmentation meaning mixing food with digestive juices
Digestion- a catabolic process, involves a series of steps in which enzymes secreted in to lumen
Abosrption - the passage of digested end products from the lumen of the GI tract through the mucosal cells by active or passive transport into blood or lymph
Defecation - eliminates indigestible substances from the body via the anus in the form of feces
Walls of alimentary canal contains four basic layers
The mucosa - innermost layer, secrets mucus, digestive enzymes, and hormones, absorbs the end products of digestion into the blood , protects against disease, composed of simple columnar epithelium, lamina propria, muscular mucosal
The Submucosa - external to mucosa, composed areolar connective tissue , contains rich supply of blood and lymphatic vessels, lymphoid follicles and nerve fibers
The Muscular Externa - responsible for segmentation and peristalsis, composed of smooth muscle , forms valves that control passage of food
The serosa - outermost layer, composed of visceral peritoneum , and a single layer of squamous epithelial cells
Hormones and Paracrines that act in digestion
Cholecystokinin CCK - Produced by Duodenal mucosa, stimulied by fatty chyme, Inhibits secretory activity , increases output of enzyme rich pancreatic juice, stimulates contractions and expel stored bile, relaxes sphincter , stimulates insulin release.
Gastric inhibitory peptide - produced by duodenal mucosa, stimulated by fatty chyme , inhibits HCI production , stimulates insulin release
Gastrin - produced by stomach mucosa, stimulated by food and acetylcholine released by nerve fibers, stimulates gastric emptying, contraction of intestinal muscle relaxes ileocecal valve, mass movements
Histamine - Produced by stomach mucosa, stimulied by food in stomach, activates parietal cells to release HCI
Intestinal gastrin - Produced by duodenal mucosa, stimulated by acidic and partially digested food in duodenum, stimulates gastric glands and motility
Motilin - produced by duodenal mucosa, stimulated by fasting, stimulates migrating motor complex
Sceretin - produced by duodenal mucosa, stimulated by acidic chyme, inhibits gastric gland secretion and gastric motility, increases output of pancreatic juices, increases bile out put
Serotonin - produced by stomach mucosa, stimulated by food in stomach, cause contraction of stomach muscle
Somastostatin - produced by stomach mucosa and duodenal mucosa, stimulated by food in stomach and sympathetic nerve fibers, inhibits gastric secretion of all products, inhibits secretion, inhibits GI flow and intestinal absorption, inhibits contraction an bile release
Vasoactive intestinal peptide - produced by enteric neurons, stimulated by chyme containing partially digested foods, stimulates buffer secretion, increases blood flow through intestinal capillaries, relaxes intestinal smooth muscle, increases secretion, inhibits acid secretion.
How each nutrient is processed
Carbohydrate digestion - Enzymes responsible for digestion are amylase. source of enzyme includes mouth (salivary amylase), Pancreas (pancreatic amylase), small intestine.
Protein digestion - Enzymes responsible for digestion are Protases, source of enzyme include stomach (pepsin) ,small intestine (trypsin, amino peptidase)
Fat digestion - Enzyme responsible fro digestion include lipase, source of enzyme include Mouth ( lingual lipase), stomach (gastric lipase), small intestine ( pancreatic lipase
Nucleic acid digestion - Enzyme responsible for digestion include nuclease, source of enzyme include Small intestine
Essential nutrients required for the human body
Carbohydrates - includes bread, cereal, crackers, flour, pasta. Starch. Polysaccharides, disaccharide, monosaccharides.
Lipids - includes saturated and unsaturated fats , meat and dairy food, nuts, seeds, fish oil, egg yolks fish
Proteins - complete and incomplete proteins, milk, meat, pork, beef, lamb, nuts and seeds, cereals
Physiology of digestive system organs
mouth - including tougue, salivary glands, and teeth help with physical breakdown of food, salivates and moistens food creating a bolus, chewing and grinding
esophagus - connects with stomach, creates a gastrointestinal tube, also moves along food
Pharynx - functions in swallowing, serves as a passage way for food to esophagus, thick muscles helps move food along
stomach - secretes acids and enzymes, churns food, stores food, major role in digestion and absorption, pyloric valve allows for opening to small intestine.
Liver -produces enzymes & bile, process nutrients, connects with gal bladder, filters liquids
gal bladder - produces enzymes and bile, aids in digestion, helps digest excess fats
small intestine - responsible for digestion and absorption ,mixes food with digestive juices, absorbs water, absorbs nutrient into blood
large intestine - recovers water and electrolytes, formation and storage of feces, major role in deification