An elderly male patient with stomach cancer recently had a feeding tube inserted into his alimentary
canal to bypass the esophagus, stomach and duodenum. He had his gall bladder
removed several years ago.
The Digestive Tract:
Stomach: holding sac where chemical and mechanical digestion continues on the bolus; initiates the chemical digestion of protein and fat.
Greater curvature
Lesser Curvature
Cardia
Cardiac Orifice
Fundus
Body
Pylorus
Pyloric Orifice
Pyloric Sphincter
Accessory Digestive Tract: assist in the digestion of food and produce secretions that empty into the GI Tract.
Gastrointestinal Tract: mechanical and chemical digestion, similar to the ACT, accomplishes swallowing which moves the bolus down to stomach which then turns to chyme, and finally feces.
Small Intestine: finishes chemical digestion & is responsible for absorbing most of the nutrients from food.
Duodenum
Duodenojejunal Flexure
Jejunum
Ileum
Ileocecal Valve
Vili
Lacteals
Microvili
Brush Border Enzymes
Intestinal Glands
Goblet Cells
Submucosal Glands
Segmentation
Colon: second region of the large intestine
Ascending Colon
Transverse Colon
Descending Colon
Sigmoid Colon
Basic Nutrients Needed:
Carbohydrates
Protein
Lipids
Nucleic Acid
Oral Cavity: chemical and mechanical
Pharynx: passageway of food
Esophagus: prevents reflux of materials from the stomach
Large Intestine: chemical digestion; absorbs water and electrolytes from the remaining digested material and compacts it into feces.
Rectum: stores fecal material.
Anal Canal: where poop exits.
Enzymes:
Pancreatic Amylase: initiates chemical digestion of starch.
Pancreatic Lipase: chemical digestion of triglycerides.
Pancreatic Proteases: when activated, they chemically digest proteins.
Pancreatic Trypsin & Chymotrypsin: polypeptide and peptide fragments.
Bile from the Liver & Gallbladder: mechanical digestion, neutralization of acidic chyme within the small intestine.
Salivary Amylase from Salivary Gland: chemically breaks chemical bonds between glucose molecules.
Stomach- Lingual & Gastric Lipase: chemically break down monoglycerides and fatty acids.
Brush Border Enzymes from the Small Intestine: chemically break down amino acids.
A feeding tube bypassed the mouth, throat (esophagus, pharynx, etc.)
Intrinsic Factor from Parietal Cells: absorb B12
Saliva doesn't break down parts of starch.
Teeth don't mechanically break down food.
Bolus is not formed.
Side Effects of Stomach Cancer:
Vomiting/Indegestion
Lining of the stomach is reduced.
The elderly can be more susceptible to food borne illnesses and the cancer only adds to it.
Because he is elderly, he is more sensitive to procedures like a feeding tube shoved down his throat....
Ingestion, motility, secretion, and mechanical digestion from the upper gastrointestinal and accessory digestive tract do not occur.
The food will need to be a smoothy-like substance in order for the stomach to break it down further.
Artificial enzymes will need to be added in order to break down the initial components.
A lubricant should be used to limit the amount of friction against the tube and esophagus.
Peristalsis
Gastroileal Reflex
Bloating
Possible diarrhea
The cancer can spread to other parts of the body.