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Digestive System - Coggle Diagram
Digestive System
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Peptic Ulcer Disease: Multiple small erosions into the mucosa or submucosa layer related to an overproduction of acid and pepsin in the stomach
signs and symptoms
- epigastric, gnawing, burning pain in between meals.
- nausea
- weight loss
- nocturnal epigastric pain
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Diagnostic Findings:
- Presence of H. pylori antibodies in the blood.
- Low hemoglobin and hematocrit if it is a bleeding ulcer.
- H. pylori fecal antigen test.
- Endoscopic urease test indicating presence of H. pylori.
Common risk factors:
- stress
- h. pylori
- alcohol
- smoke
Treatment:
- Lifestyle changes related to smoking, food intake, caffeine, and stress.
- Antibiotics administered to eradicate H. pylori.
Chronic gastritis: Atrophy of the gastric mucosa and achlorhydria, most commonly caused by H. pylori infection that attacks the mucosal layer of the stomach. Lack of HCl decreases absorption of of iron and vitamin B12
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Signs and symptoms:
- epigastric pain, nausea, vomiting
- Hematemesis
causes: infectious, stress, meds
Treatment:
- life style changes with food, alcohol
GERD: Backflow of acid and stomach contents into the esophagus
- "asthma of the stomach"
- women are diagnosed more
Signs and Symptoms:
- burning sensation in the throat, painful swallowing, or substernal or epigastric pain
- increased pain is present after eating acidic or spicy foods.
- dry cough is present
- nocturnal asthma can be caused by GERD
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triggers:
- delayed stomach emptying
- hiatal hernia
- relaxed sphincter in the stomach
- foods/drinks: alcohol, acidic foods
Treatment:
- antacids
- sleeping upright
- avoiding carbonated drinks
- milk
- tums
Esophageal Varices: Distended, fragile veins located at the lower esophagus that expand because of portal hypertension, usually caused by liver disease.
Signs and Symptoms:
- No symptoms if unruptered; however, other signs of portal hypertension are frequently present such as ascites and enlarged liver. If the varices rupture hematemesis results.
- Other concerns are hypotension, tachycardia, pallor, and dizziness caused by blood loss
assessment findings:
- Hematemesis; blood in vomitus, sometimes referred to as “coffee-ground” emesis.
- Melena; tarry, dark stool caused by blood in stool.
- Hypotension, pallor, tachycardia, syncope if large blood loss.
diagnostics:
- Decreased hemoglobin and hematocrit caused by bleeding.
- Decreased plasma volume caused by fluid loss with bleeding.
Treatment:
- Temporary tamponade of the lower esophageal veins.
- Endoscopic sclerotherapy, endoscopic band ligation, and other types of endoscopic ablation, insertion of a TIPS.
- Vasopressin, somatostatin, and octreotide are strong vasoconstrictors that can be administered intravenously to control the bleeding. Beta blockers or nitrate may be needed to reduce blood pressure.
Short Bowel Syndrome: A result of any disease, traumatic injury, vascular accident, or other pathology that leaves less than 200 cm of the intestine
- vitamin and nutrient deficiency
- results in malabsorption of water, electrolytes, macronutrients, micronutrients
signs and symptoms
- diarrhea
- dehydration
- weight loss
- muscle wasting
- fatigue
- skin irritations
- weakness
assessment findings:
- Poor skin turgor,
- hypotension
- pallor
- muscle wasting
- weakness.
diagnostics:
- Upper GI series/barium study or CT scan to show shortened bowel.
- Low hemoglobin and hematocrit levels caused by malabsorption of iron, vitamin B12, and vitamin K.
treatment:
- Vitamin replacement. Parenteral or enteral nutrition.
- Slowly increase oral feedings until bowel regenerates enough absorptive surface for total oral nutrition.
Pyloric Stenosis: Narrowing and hypertrophy of the pyloric sphincter, which causes backup of contents of the stomach.
- birth defect
- stricture or closure altogether
- food comes back up and projectile vomiting
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Diagnostics: Ultrasound, upper GI series (barium) are used to demonstrate the narrowing at the pylorus.
assessment findings:
- a palpable mass may be felt in the pyloric area of the stomach
signs and symptoms:
-abdominal pain and distention
Gastroenteritis: inflammation of the GI lining caused by a pathogen
Signs and Symptoms:
- frequent episodes of watery diarrhea
- weight loss
- fatigue
- fever possible
- colicky cramping
assessment findings:
- auscultation of borborygmi
- dehydration
- fever
diagnostics:
- Presence of bacteria or virus in serum or stools.
- Dehydration and electrolyte imbalance caused by fluid loss and fluid shifts.
- Decreased albumin caused by malabsorption.
Treatment:
- Fluid and electrolyte replacement to treat dehydration.
- Antibiotics to eradicate bacteria.
- Antidiarrheal medications. Antiemetic medications to stop vomiting.
- self limiting
- flagyl
Small Bowel Obstruction: Tumor, adhesions, hernia, or inflammation can cause obstruction. A partial obstruction decreases the flow of intestinal contents through the bowel. A complete obstruction prevents passage of all contents and fluid through the bowel.
Assessment findings:
- Abdominal distention, vomiting, and hyperactive bowel sounds.
- Diarrhea, if partial obstruction.
Diagnostics:
- Abdominal x-ray shows excessive intestinal gas proximal to the obstruction.
- CT scan or ultrasound can show area of obstruction.
Signs and symptoms:
- Abdominal pain, abdominal distention, nausea, vomiting.
- Diarrhea, if partial obstruction.
Treatment:
- Nasogastric tube to decompress intestine.
- IV fluids.
- Pain management, antiemetic medications, and antibiotics are frequently necessary.
- May require surgical intervention.
Peritonitis: Inflammation of the peritoneal membrane. Infection of peritoneum commonly caused by rupture of organs into the peritoneal cavity.
Assessment Findings:
- abdominal tenderness on palpitation and guarding of abdomen
- rebound tenderness
- hypoactive or absent bowel sounds
- tachycardia
- fever
- tachypnea
Diagnostics:
- Elevated WBC count caused by inflammation.
- Electrolyte imbalance caused by fluid shifts into the peritoneum.
- CT scan to find source of peritoneal inflammation, such as ruptured organ.
Signs and symptoms:
- abdominal pain and rigidity
- anxiety
- increased heart rate and respirations
- fever
Treatment:
- Fluid and electrolyte replacement caused by fluid shifts into peritoneal cavity.
- Antibiotics to eradicate bacteria entering peritoneum.
- Peritoneal lavage to cleanse the peritoneal cavity.
- Nasogastric tube to decompress GI system.
Hernia: Protrusion of loop of bowel through the muscle layers of the abdominal well. It can become incarcerated or strangulated, causing ischemia of the bowel.
- most common digestive problem
- part of digestive tract pushed through
- if intestine gets completely strangulated --> completely stops digestive process
- intestines get pushed through wherever there is weakness.
Signs and Symptoms:
- increased abdominal pressure, a protrusion of intestine under the skin is demonstrated.
Diagnostics:
- Presence of bacteria or virus in serum or stools.
- Dehydration and electrolyte imbalance
caused by fluid loss and fluid shifts.
- Decreased albumin caused by malabsorption.
Assessment findings: fever, dehydration, auscultation of borborygmi
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Duodenal Ulcer: single erosion near the duodenal bulb, with a punched out appearance.
Assessment findings:
- fatigue
- abdominal pain and tenderness
- hematemesis
- melena
Diagnostics:
- Presence of H. pylori antibodies in the blood.
- H. pylori fecal antigen test.
- Endoscopic urease test indicating presence of H. pylori.
- Low hemoglobin and hematocrit if it is a bleeding ulcer.
signs and symptoms:
- pain relief when eating
- pain increases in stomach 2 to 3 hours after eating
- epigastric or upper abdominal pain
- nocturnal epigastric pain
Treatment:
- Antibiotics to eradicate H. pylori.
- PPIs to decrease acid to allow ulcer to heal.
- Histamine-2 receptor blockers to diminish acid.
Esophagitis: Inflammation of the esophagus caused by reflux of gastric acid that injures the esophageal squamous epithelium
Signs and Symptoms:
- patient complains of burning sensation in the throat, pain swallowing, or substernal or epigastric pain.
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Causes:
- reflux
- infection
- medication induced
Treatment:
- Instruct the patient to avoid eating or drinking items that have an extreme temperature or spiciness.
- Decrease inflammation and relieve symptoms through antacids such as PPIs.
Upper GastroIntestinal Bleed (UGIB): An area in the esophagus, stomach, or duodenum that is bleeding small, moderate, or large amounts.
- Most common causes are PUD and esophageal varcies
Assessment findings:
- hematemesis; blood in vomitus, sometimes referred to as "coffee ground emesis"
- Melena; tarry dark stool caused by blood in the stool.
- Hypotension
Diagnostics:
- Decreased hemoglobin and hematocrit caused by bleeding.
- Decreased plasma volume because of fluid loss with bleeding.
- Positive FOBT
- Increased BUN caused by dehydration.
Signs and Symptoms:
- fatigue
- anemia
- abdominal pain
- rapid pulse
- syncope
- shortness of breath
- decreased urine output
Treatment:
- Treatment is specific to the cause of bleeding.
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Dumping Syndrome: Rapid gastric emptying because of removal of part of the stomach
- happens with really sugary foods
- can also happen with stress
- stuff from stomach going rapidly into the stomach
- gut goes into hyperdrive to flush stuff out.
assessment findings:
- diaphoresis, tachycardia, hyperactive bowel sounds
Diagnostics: endoscopy, GI series
Signs and Symptoms:
- Phase 1: abdominal pain, diarrhea, diaphoresis
- Phase 2: gastric fullness, symptoms of hypoglycemia
weakness, dizziness, vertigo, diaphoresis. abdominal cramping, epigastric fullness
Treatment:
- Frequent, small feedings; fluids only between meals.
- Medications that slow peristalsis.
- Diet supplementation with multivitamins, iron, and calcium.
- self limiting
- no fluids with meals
- no high carbs
Celiac Disease: Autoimmune disorder triggered by gluten, which causes malabsorption
assessment finding:
- steatorrhea
- abdominal distention
- muscle wasting
Diagnostics:
- Low hemoglobin and hematocrit levels caused by malabsorption of iron, vitamin B12, and vitamin K.
- Abnormal electrolytes caused by malabsorption.
- Positive celiac disease antibodies in blood.
Signs and Symptoms
- abdominal pain and bloating
- weight loss
- fatigue
- diarrhea
- weakness
- streatorrhea
treatment:
- Removal of gluten from diet.
- Vitamin A, D, E, K replacement.
- Corticosteroids.
Hiatal Hernia: A protrusion of the stomach upward into the chest.
- it can occur when the diaphragm opening for the esophagus and vagus nerve is stretched out.
- can cause strictures or pushing out
- rubber band scenario
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Treatment:
- lifestyle changes related to diet, smoking, drinking, and exercise
Signs and symptoms:
- heartburn when laying flat
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