GI disorders

 Dysphagia Difficulty swallowing

o Causes Nero disease: Parkinson’s, dementias, muscular dystrophy, Huntington’s, ALS, MN,

Guillain Barre Syndrome. Other: Congenital issues/cerebral palsy, Esophageal stenosis,

esophageal diverticula, tumors, stroke, achalasia

 Vomiting – why and consequences Why: protect against substance, reverse peristalsis, increase

intracranial pressure, severe pain. Consequences: lead to fluid, electrolyte, pH imbalance, aspiration

o Emesis types and why the emesis would be a problem Hematemesis: blood in vomit (protein),

Yellow/green: presence of bile. Deep brown: fecal matter. Undigested food

o Treatment of vomiting disorders Antiemetic med., fluid replacement, correct electrolyte

imbalance, restore acid-base

 Esophageal disorders

o Hiatal hernia Stomach section protrudes through diaphragm

 Causes: Weakening of diaphragm muscle, trauma, congenital defects.

 Manifestation: Indigestion; heartburn; frequent belching; nausea; chest pain; strictures;

dysphagia; and soft abdominal mass

 diagnosis: H & P; barium swallow; upper GI Xrays; EGD ,

 treatment: eat small meals, sleep elevated, antacid

o GERD

 Causes: Certain foods: chocolate, caffeine, carbonated beverages, citrus fruit, tomatoes,

spicy or fatty foods, peppermint

 Alcohol consumption; nicotine

 Hiatal hernia

 Obesity; pregnancy

 Certain medications – such as corticosteroids; beta blockers; calcium-channel blockers;

anticholinergics

 NG intubation

 Delayed gastric emptying

 Manifestations: Heartburn, Epigastric pain, Dysphagia, Dry cough, Laryngitis

Pharyngitis, Food regurgitation, Sensation of lump in throat

 Diagnosis: H & P; barium swallow; EGD; esophageal pH monitoring

 Treatments: Avoid triggers; avoid restrictive clothing

 Eat small frequent meals; high Fowler’s positioning, Weight loss; stress reduction;

Antacids; acid reducing agent; mucosal barrier agents, Herbal therapies (licorice,

chamomile), Surgery

 Complications: Esophagitis; strictures; ulcerations; esophageal cancer; chronic

pulmonary disease

o Gastritis/gastroenteritis

 Acute: Can be mild, transient irritation or can be severe ulceration with hemorrhage

 Usually develops suddenly

 Likely to also have nausea & epigastric pain

 Chronic: Develops gradually

 May be asymptomatic but usually accompanied by dull epigastric pain and a sensation of

fullness after minimal intake

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 Complications: peptic ulcer; gastric cancer; hemorrhage

 H. pylori: Most common cause of chronic gastritis

 Bacteria embeds in mucous layer; activates toxins & enzymes that cause inflammation

 Genetic vulnerability & lifestyle behaviors (smoking, stress) may increase susceptible

 Other causes : Organisms through food/water contamination, LT NSAID use, Excess

alcohol use, Severe stress, Autoimmune conditions

 Manifestations of GI bleeding: Indigestion; heart burn, Epigastric pain; abdominal

cramping, N/V; anorexia, Fever; malaise, Hematemesis, Dark, tarry stools = ulceration &

bleeding

 GI tract disorders

o Peptic ulcer disease

 Duodenal: Most commonly associated with excess acid or H.pylori infections, Typically

present with epigastric pain relieved by food

 Gastric: Less frequent; more deadly, Typically associated with malignancy and NSAIDs,

Pain worsens with food

 Symptoms

 Curling’s ulcer from what: associated with burns

 Cushing’s ulcer from what: associated with head injuries

 Complications of ulcers: GI hemorrhage; obstruction; perforation; peritonitis

 Manifestations: Epigastric or abdominal pain, Abdominal cramping, Heartburn;

indigestion, N/V

 Diagnosis: same as gastritis

 Treatment: Same as for gastritis, Surgical repair may be necessary for perforated or

bleeding ulcers, Prevention is crucial – may need prophylactic medications (ex: acidreducers) for at-risk clients

o Gallbladder disorders

 Cholelithiasis: Gallbladder stones

 Cholecystitis: Inflammation or infection in the biliary system caused by calculi

 Manifestations: Biliary colic; abdominal distension; N/V; jaundice; fever; leukocytosis

 Diagnosis: H & P; abdominal Xray; gallbladder US; laparoscopy

 Treatments: Low-fat diet, medications to dissolve calculi, Antibiotic therapy, NG tube

with intermittent sxn, Lithotripsy, Choledochostomy, Laparoscopic surgery

o Liver disorders

 Hepatitis – infectious: A, B, C, D, E vs. noninfectious: Giant cell hepatitis, Ischemic

hepatitis, Non-alcoholic fatty liver hepatitis, Autoimmune hepatitis, Toxic & drug-induced

hepatitis, Alcoholic hepatitis

 Transmission of viral hepatitis: If it’s a Vowel, it comes from the Bowel. All others are

blood

 Define: acute: Proceeds through 4 stages—asymptomatic stage then 3 symptomatic

stages chronic: Characterized by continued liver disease > 6 months

 Symptom severity and disease progression vary by degree of liver damage

 Can quickly deteriorate with declining liver integrity fulminant: Uncommon, rapidly

progressing form that can quickly lead to

 Liver failure, hepatic encephalopathy, or death within 3 wks

 Diagnosis: H & P, Serum hepatitis profile, Liver enzymes, Clotting studies, Liver

biopsy, Abdominal US

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