LOWER GI Flashcards
How do you treat C Diff
Treated w/ IV or oral metronidazole (flagyl) and/or
oral vancomycin
Probiotics and fecal transplantation
C. Diff Clinical Manifestations
- Loose or liquid stool, blood or mucus
- Fever, headache, malaise
- N/V, abdominal cramping
C Diff Diagnostic Tests
– Stool studies
* Blood, mucus, WBCs,
parasites
* Culture to identify
organism
* C. difficile identified
by measurement of
its toxins (toxin A &
B)
What is the Etiology and Pathophysiology of Fecal Incontinence
– Motor function
* Obstetric trauma
* Childbirth, aging, menopause
* Fecal impaction
* Damage from anorectal surgery
– Sensory function
* Neurologic conditions
* Diabetic neuropathy
* Decreased LOC
What are Assessment and Diagnostic
Studies done for Fecal Incontinence
- Requires sensitivity
- H & P
- Rectal exam
- Abdominal x-ray
How might your treat Fecal Incontinence
- Remove impaction
- Regular defecation, high-
fiber diet, increased
fluids - Kegel exercises
- Surgical repair
Etiology and Pathophysiology of Constipation
- Insufficient dietary fiber
- Inadequate fluid intake
- Decreased physical activity
- Ignoring urge to defecate
- Medications (opioids)
- Diseases (DM, neurologic diseases)
Clinical Manifestations of Constipation
Decreased frequency of stools, difficult to pass
stools, a decrease in stool volume, and/or
retention of feces in the rectum
Best way to fix constipation
- Nutritional therapy
- Medications
Which medications for constipation can be taken daily
- Bulk-forming laxatives
- Methylcellulose (Citrucel),
Psyllium (Metamucil) - Stool softeners
- Docusate (Colace)
- Saline and osmotic solutions
- Polyethylene glycol (Miralax)
- Stimulants
- Senna (Senokot)
Which medications for constipation should only be taken as needed d/t dependance
- Stool lubricants
- Mineral Oil Enema (Fleet’s)
- Saline and osmotic solutions
- Magnesium citrate, milk of
magnesia - Lactulose (Chronulac)
- Stimulants
- Bisacodyl (Dulcolax)
Define Diverticulosis
Diverticulosis is the condition of having multiple pouches (diverticula) in the colon that are not inflamed. These are outpockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall.
- Common to have no
symptoms - Discovered during routine
colonoscopy - Other symptoms
- Abdominal pain
- Bloating
- Flatulence
- Change in bowel habits
- Blood in stool
Define Diverticulitis
The presence of diverticula is known as diverticulosis (die-vur-tik-yoo-LOE-sis). When one or more of the pouches become inflamed, and in some cases infected, that condition is known as diverticulitis (die-vur-tik-yoo-LIE-tis).
- Left lower quadrant
abdominal pain (sigmoid
colon) - Elevated temperature
- Leukocytosis
- Palpable abdominal
mass
Describe complications of diverticular disease
Diverticulum may bleed into the intestine.
Diverticulum may rupture, causing bacteria and blood to spill into abdominal cavity, causing infection. An abnormal channel (fistula) may form between the large intestine and another organ
What diagnostic tests are used for diverticulosis and diverticulitis
- Preferred test is abdominal CT w/ oral contrast
- Abdominal and chest x-rays to rule out other
causes
Home Care:
* Oral antibiotics
* Clear liquid diet
* Rest
Hospitalized
* NPO
* Bed rest
* IV antibiotics
* IV fluids
* Monitor for
complications
* May require
surgical
intervention
- Surgical Implementation
- Usually involves resection of involved colon with
primary anastomosis or temporary colostomy - If colostomy, it is reanastomosed after the colon
heals
