Chapter 37 Flashcards
What is the third leading cause of death?
Colorectal cancer
Whats the #1 complaint in the ED?
Abdominal pain
What can help minimize or prevent chronic illness?
Keeping the GI tract healthy with proper nutrition
What are four common complaints of abdominal disorder?
-Anorexia
-Nausea
-Retching
-Vomiting
They can often signal the presence of disease
What is anorexia ?
Lack of appetite due to physiologic or psychologic responses or medication
What is nausea?
Unpleasant feeling
subjective sensation preceding vomiting
What is Retching?
Contractions of muscles like diaphragm, chest wall, and abdominal muscles
-making a effort to vomitt but nothing is coming out almost like gagging
-something may or may not come out
What is vomiting ?
Action of expelling stomach contents out of body
-Reflexive exclusion of stomach contents
What are alterations in swallowing?
Dysphagia
odynophagia
Achalasia
What is dysphagia?
Difficulty in swallowing
What is Odynophagia?
Painful swallowing
What is achalasia?
Failure of the esophageal sphincter to relax
-lower esophageal Sphincter does not relax properly
this can make it difficult for food and liquids to move into the stomach
What are the 4 local irritation and composition of contents that influence motility
-Diarrhea
-Constipation
-Impaction
-Obstruction
What is Diarrhea?
Excessive and frequent passage of loose or unformed stool typically watery.
3 times in one day or more and large in volume
What can diarrhea be cause by?
-Infection
-Food tolerance
-Drugs
-Or disease
What are two different types of diarrhea?
Acute and chronic
What is acute diarrhea?
-Less than two weeks
-Usually result of infection
-Could be non inflammatory or inflammatory
What is seen in non inflammatory acute diarrhea?
-Large volume
-water
-non bloody stools
-cramping, bloating, nausea and vomiting
What is seen in inflammatory acute diarrhea?
-Fever
-Blood diarrhea(Hematochezia) aka dysentery
What is chronic diarrhea?
Four weeks or longer in duration
What are different causes chronic diarrhea?
-Osmotic
-Secretory
-Inflammatory
What is osmotic in chronic diarrhea?
-Excess amounts of fluid
means theres a-lot more extracellular fluid then there should be
-results in body efforts trying to get rid of the excess fluid
“water pulled into bowel by hyper osmotic contents; bowel unable to manage excess fluid”
**Chronic diarrhea
What is secretory in chronic diarrhea?
excess bile acids in the colon coming from gall bladder
What is the inflammatory problem of chronic diarrhea
If it has a Underlying inflammatory chronic disease
What is constipation?
Infrequent, incomplete, difficult passage of stool
-Greater than 3 days
What are different types of constipation?
-Normal transit constipation
-Slow transit constipation
-chronic constipation
What is normal transit constipation
Poor fluid intake, poor fiber intake or both
-stool is not able to pass through bowel smoothly and efficiently
-All you need to do to fix this is increase of fluid or fiber or both
What is slow transit constipation?
-Directly related to alterations in motor functions of the bowel
-The muscles are not able to move along
like hirschsprung disease
What is chronic constipation?
usually related to neurologic disorders like paraplegia
What are common causes of constipation?
-Not going to the bathroom and holding onto the poop
-Not enough fluid
-Not enough fiber in diet
-Weak abdominal muscles, not enough pressure to help push poop out
-Too much inactivity or bed rest
-Pregnancy and hemorrhoids because of pressure onto the colon
-Drugs can be from prescription or from illicid drugs such as opioids and narcotics
What is fecal impaction?
Extreme result of constipation
-retention of hard, dry, puddy like rubbery stool the rectum or colon that leads to blockage of the stool
What causes fecal impaction?
-Anorectal disease
-tumors
-neurological disease
-antacids
-bulk laxatives(If someone is taking bulk laxative and not intaking alor of fluid then all that fiber will make the stool more dry.
-prolonged bed rest
-debility
What are signs and symptoms of fecal impaction?
-Severe constipation
-History of watery diarrhea
-Fecal soiling
-fecal incontinence
-Abdominal distention
-blood(hematochezia)
-Mucus in stool(steatorrhea)
-Urinary incontinence
What is Intestinal obstruction?
Impairment of movement of intestinal contents due to mechanical or paralytic causes
What is mechanical causes?
-Mechanical failure (muscles are not functioning properly)
Could be after hernia surgery or post operative adhesions, strictures, tumors, foreign bodies
What are paralytic causes?
Neurogenic or muscular impairment of peristalsis
What is paralytic ileus?
Motor activity impairment,
damages the nerves it is paralyzed and can not move
What are signs and symptoms of intestinal obstruction?
-Pain
-Absolute constipation
-Abdominal distension
-Signs of dehydration
-vomiting
What intestinal malabsorption?
Nutrients that are digested are not utilized by the body
-The nutrients and food is taken in but absorption is not happening in the small intestine
What can cause Intestinal malabsorption
-Infection
-medications
-Small intestine surgery
-Celiac disease
what are signs and symptoms of intestinal malabsorption
-Diarrhea
-Flatulence( Farting)
-Distention
-Abdominal pain or cramping
-Ascities (Extraacellular fluid in abdominal space)
-Weakness
-Muscle wasting
-Weight loss
-Abdominal distention
What can intestinal malabsrobtion also cause
- Body will not be able to absorb fat soluble vitamins(A,D,E and K) which will cause:
-Bruising easily
-Bone pain
-Fractures
-Tetany
-Microcytic anemia (Large RBC production)
-Glossitis (Inflamed tongue)
What is celiac disease?
Immune disorder that causes the intestinal vili to be inflamed
-Immune response is triggered by ingesting gluten, so gluten will be a server intolerance that will cause the villi to swell
-Macronutrients and fat soluble vitamins are not well absorbed
What are signs and symptoms in adults of celiac disease?
Diarrhea, constipation, bloating, flatus, belching
What are signs and symptoms of celiac disease that you will see in a child?
-Diarrhea,
-Muscle wasting
-Anemia
-Failure to thrive
