Essentials of Human Diseases and Conditions 4th edition

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Essentials of Human Diseases and Conditions 4th
edition

• Margaret Schell Frazier
• Jeanette Wist Drzymkowski

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Chapter 8 Diseases and Conditions of the
Digestive System
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Learning Objectives

• Trace the process of normal digestion and
  absorption.
• Discuss the importance of normal teeth and a
  normal bite.
• Describe the presenting symptoms of
  temporomandibular joint (TMJ) syndrome.
• Compare the etiology of herpes simplex to the
  etiology of thrush.
• Name a serious complication of esophageal varices.

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Learning Objectives (contd.)

• Explain the clinical significance of Barretts
  esophagus.
• Describe the pathology of peptic ulcers and
  identify the etiology.
• Explain the diagnosis of gastric cancer.
• Describe a hiatal hernia.
• Distinguish the types of abdominal hernias.

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Learning Objectives (contd.)

• Explain the differences between the pathology of
  Crohn disease and that of ulcerative colitis.
• Describe the etiology of gastroenteritis.
• Explain the difference between a functional and a
  mechanical obstruction of the bowel.
• Discuss the pathologic conditions that may result
  in intestinal obstruction.

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Learning Objectives (contd.)

• Distinguish between diverticulosis and
  diverticulitis.
• Discuss the screening program for and the
  treatment of colorectal cancer.
• Explain the relationship between broad-spectrum
  antibiotics and pseudomembranous enterocolitis.
• List the causes of inflammation of the peritoneum.

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Learning Objectives (contd.)

• Explain the pathologic symptoms and signs of
  cirrhosis of the liver.
• Name the most important etiologic factor for
  hepatocellular carcinoma and other additional
  risk factors.
• Contrast the causes and preventive measures of
  hepatitis A and hepatitis C. Explain how health
  care providers are at special risk for hepatitis
  B.

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Learning Objectives (contd.)

• Name the most common bloodborne infection in the
  United States.
• Describe the clinical picture of an individual
  with (a) biliary colic and (b) acute
  pancreatitis.
• State the prognosis of pancreatic cancer.
• Describe the clinical manifestations of
  malnutrition and malabsorption.

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Learning Objectives (contd.)

• Explain the diagnostic criteria for celiac
  disease.
• List some ways one can lower the risk of food
  poisoning.
• Distinguish between the clinical picture of the
  patient with anorexia and that of the patient
  with bulimia.
• State the components of a successful weight-loss
  program

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Chapter 8Lesson 8.1
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The Digestive System
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The Oral Cavity and Jaw

• Diseases and Conditions
• Missing teeth permanent teeth are missing
• Dental caries (tooth decay) infection resulting
  in erosion of tooth surface
• Gingivitis inflammation and swelling of the
  gums 
• Periodontitis destructive gum and bone disease
  around one or more of the teeth

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The Oral Cavity and Jaw (contd.)

• Diseases and Conditions
• Malocclusion specific angles of malposition and
  contact of the maxillary and mandibular teeth
• Temporomandibular joint (TMJ) syndrome a symptom
  complex related to inflammation, disease, or
  dysfunction of the temporomandibular joint

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The Oral Cavity and Jaw (contd.)

• Diseases and Conditions
• Herpes simplex (cold sores) a recurrent viral
  infection that affects the skin and mucous
  membranes.
• Thrush candidiasis of the oral mucosa, involving
  the mouth, tongue, palate, and gums.

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Oral Cancer

• Appears as white patchy lesion or oral ulcer that
  wont heal
• Pain occurs late in disease
• Lip is most common site
• Alcohol and smoking is multiplicative
• Treatment depends on stage
• Because of late diagnosis overall survival rate
  is about 51

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Digestive Distress Signals

• Hiccup
• Indigestion
• Heartburn
• Nausea
• Vomiting

• Colic
• Flatulence
• Diarrhea
• Constipation
• Fecal incontinence

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Diseases of theGastrointestinal Tract

• Esophageal varices are dilated submucosal veins
  that develop in patients with underlying portal
  hypertension and may result in serious upper
  gastrointestinal bleeding.
• Esophagitis inflammation and tissue injury of
  the esophagus
• Esophageal cancer cancer of the esophagus

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Diseases of theGastrointestinal Tract (contd.)

• Gastroesophageal reflux disease (GERD) the
  clinical manifestations of regurgitation of
  stomach and duodenal contents into the esophagus
• Barretts esophagus severe consequence of GERD
  that replaces normal striated squamous epithelium
  of the distal esophagus with abnormal columnar
  epithelium

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Diseases of theGastrointestinal Tract (contd.)

• Peptic ulcers sores or lesions in the mucous
  membrane of the stomach or upper intestinal tract
• Duodenal ulcers ulcers of the first part of the
  small intestine
• Gastric ulcers ulceration of the gastric mucosa
  of the stomach that follows chronic gastritis

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Acute Appendicitis

• Inflammation of the appendix
• Symptoms begins with vague abdominal discomfort
  that localizes as pain in right lower quadrant of
  abdomen nausea vomiting fever diarrhea or
  constipation
• Treatment surgical removal

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Diseases of theGastrointestinal Tract (contd.)

• Hiatal hernia a defect in the diaphragm that
  permits segment of stomach to slide into thoracic
  cavity
• Symptoms heartburn, chest pain, swallowing
  difficulty some cases asymptomatic
• Abdominal hernia a condition in which an organ
  protrudes through an abnormal opening in the
  abdominal wall
• Symptoms lump or bulge groin pain

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Chapter 8Lesson 8.2
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Diseases of theGastrointestinal Tract (contd.)

• Crohn disease (ileitis) chronic inflammatory
  disorder of the gastrointestinal tract
• Ulcerative colitis chronic inflammatory bowel
  disease affecting the mucosa and submucosa of the
  rectum and colon
• Gastroenteritis acute inflammation of the
  stomach and intestines

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Intestinal Obstruction

• Mechanical or functional blockage of intestines
  contents cannot move forward
• Severe pain, nausea, vomiting, bloated abdomen
  without passage of stool or gas
• Sudden or severe onset requires urgent care
• Treatment surgery for mechanical blockage NPO,
  stomach tube for functional blockage

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Diverticular Conditions

• Diverticulosis outpouches (diverticula) of
  mucosa penetrate weak points in muscular layer of
  large intestine
• Symptoms mild discomfort, irregular bowels may
  be asymptomatic
• Diverticulitis trapped fecal matter causes
  inflammation of diverticula
• Symptoms fever, nausea, pain, changes in bowel
  function

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Diseases of theGastrointestinal Tract (contd.)

• Colorectal cancer a cancer that arises in any
  part of the colon or rectum
• Symptoms abdominal pain, change in bowel habits,
  bloody stools, weight loss, weakness, rectal
  bleeding, iron deficiency anemia
• Serum level of tumor marker CEA is used to plan
  treatment and assess prognosis
• Treatment options surgical resection colostomy
  chemotherapy radiation

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Diseases of theGastrointestinal Tract (contd.)

• Pseudomembranous enterocolitis acute
  inflammation with a plaque-like adhesion of
  necrotic debris and mucus adhered to the damaged
  superficial mucosa of the small and large
  intestine
• Symptoms fever, weakness, abdominal cramping and
  tenderness, nausea, vomiting, diarrhea

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Diseases of theGastrointestinal Tract (contd.)

• Peritonitis inflammation of the peritoneum that
  can be acute or chronic, local or generalized
• Symptoms abdominal pain, nausea, vomiting,
  weakness, sweating, fever, distended abdomen,
  paralytic ileus

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Diseases of the Liver, Biliary Tract, and Pancreas

• Cirrhosis of the liver an irreversible chronic
  degenerative disease that results in the
  replacement of normal liver cells with hard,
  fibrous scar tissue
• Symptoms loss of appetite and weight, nausea,
  vomiting, indigestion, abdominal distention,
  edema, easier bleeding and bruising, jaundice,
  pruritis, spider nevi

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Diseases of the Liver, Biliary Tract, and
Pancreas (contd.)

• Viral hepatitis
• Hepatitis A highly contagious condition caused
  by the hepatitis A virus (HAV) causing mild,
  acute liver infection.
• Hepatitis B inflammation of the liver caused by
  the hepatitis B virus (HBV).
• Hepatitis C chronic condition caused by the
  hepatitis C virus (HCV) resulting in gradual,
  insidious liver disease.

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Chapter 8Lesson 8.3
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Cancer of the Liver

• Hepatocellular carcinoma primary tumor of the
  liver usually arises in chronic liver disease
  setting
• Symptoms same as liver diseaseupper abdominal
  pain, weight loss, early satiety, palpable
  abdominal mass, ascites, hepatomegaly
  splenomegaly, jaundice

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Diseases of the Liver, Biliary Tract, and
Pancreas (contd.)

• Cholelithiasis (gallstones) condition in which
  there is abnormal presence of calculi that form
  in the bile.
• Pancreatitis acute or chronic inflammation of
  the pancreas with variable involvement of
  adjacent or remote organs.

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Cholecystitis

• Symptoms acute, colicky pain, nausea, and
  vomiting
• Causes obstruction of biliary duct by gallstones
• Treatment dietary modification with elimination
  of fatty foods in acute cases, intravenous
  feeding

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Pancreatitis

• Symptoms sudden onset of severe abdominal pain
  radiating to the back, nausea, and vomiting
• Causes alcoholism, biliary disease, gallstones
• Treatment Acute pancreatitis may require
  emergency treatment of intravenous fluid and
  electrolyte replacement

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Diseases of the Liver, Biliary Tract, and
Pancreas (contd.)

• Pancreatic cancer A neoplasm, usually an
  adenocarcinoma, that occurs more often in the
  head of the pancreas.

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Pancreatic Cancer

• Symptoms abdominal pain, weight loss, or
  jaundice
• Causes cigarette smoking, obesity, family
  history of pancreatitis or diabetes
• Treatment surgical resection

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Diseases of NutrientIntake and Absorption

• Malnutrition a disorder of nutrition caused by
  primary deprivation of protein energy or
  secondary to deficiency diseases
• Malabsorption syndrome a group of disorders in
  which intestinal absorption of dietary nutrients
  is impaired

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Malnutrition

• Symptoms decreased or increased appetite
  emaciation or obesity loss of energy diarrhea
• Causes deprivation of protein energy from eating
  disorders, chronic illnesses, etc.
• Treatment nutritional supplements, oral and
  intravenous feeding

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Malabsorption Syndrome

• Symptoms impaired digestion, inability to absorb
  fat or other components of diet
• Causes defective mucosal cells in the small
  intestine
• Treatment high-protein, high-calorie diet

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Obesity

• Obesity is defined by Body Mass Index
• The study of obesity is called Bariatrics
• 35 of adult Americans are obese, defined as
  being 27 overweight obesity can lead to severe
  health problems.
• Contributing factors for obesity include low rate
  of energy expenditure, inactivity, and endocrine
  disorders.
• Treatment options include exercise and control of
  food intake through behavior modification.

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Diseases of NutrientIntake and Absorption
(contd.)

• Celiac disease (gluten enteropathy) a disease of
  the small intestine characterized by
  malabsorption, gluten intolerance, and damage to
  the lining of the intestine
• The disease has multisystem effects

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Celiac Disease

• Symptoms weight loss, anorexia, diarrhea,
  flatulence, abdominal distention
• Causes toxic or immunologic reaction to
  component of gluten (found in wheat, barley, and
  oats)
• Treatment gluten-free diet if no improvement,
  corticosteroid drugs

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Diseases of NutrientIntake and Absorption
(contd.)

• Food poisoning an illness resulting from the
  ingestion of foods that contain bacterial or
  toxic substances

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Food Poisoning

• Symptoms sudden nausea, vomiting, and diarrhea
• Causes poisoning from mushrooms, shellfish,
  contaminated foods
• Treatment nutritional support and fluid
  replacements

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Eating Disorders

• Anorexia nervosa psychological disturbance in
  which self-imposed starvation and compulsion to
  be thin leads to denial of hunger
• Bulimia behavioral disorder characterized by
  recurring episodes of binge eating followed by
  self-induced vomiting or purging