Heartburn - A burning sensation in the chest or throat; acid reflux

Hyperglycemia - High sugar in the blood

Hypoglycemia - Low sugar in the blood

Jaundice - Yellowish color of the skin or whites of the eyes

Vomitus - Food and fluids expelled from the stomach through the mouth; emesis

Digestive system includes the accessory organs - liver, gallbladder, and pancreas. Pancreas is also apart of the endocrine system

The Digestive System

GI system

• Mouth to the Anus

• Using chewing motions, the teeth cut, chop, and grind food into small particles for digestion and swallowing.

• The tongue aids in chewing and swallowing.

• Salivary glands in the mouth secrete saliva.

• Saliva moistens food particles to ease swallowing and begins digestion.

• tongue pushes food into the pharynx (throat)

• Contraction of the pharynx pushes food into the esophagus

• The esophagus extends from the pharynx to the stomach

• Involuntary muscle contraction move food down the esophagus through the GI tract

• The stomach is a muscular, pouch-like sac.

• The mucous membrane lining the stomach contains glands that secrete gastric juices.

• Peristalsis pushes chyme from the stomach into the small intestine

• The first part of the small intestine is the duodenum.

• More digestive juices are added to the chyme.

• One is called bile- a greenish liquid made in the liver.

• Bile is stored in the gallbladder.

• Juices from the pancreas and small intestine are added to the chyme.

• Digestive juices chemically break down food into nutrients for absorption

• Peristalsis moves the chyme through the 2 other parts of the small intestine: the jejunum and the ileum.

• Most nutrient absorption takes place in the small intestine

• Undigested chyme passes from the small intestine into the large intestine

• Colon absorbs most of the water from the chyme

• Remaining semi-solid material is called feces

• Feces pass through the colon into the rectum by peristalsis

Digestive Disorders

Breaks down food into nutrients for the body to absorb. Solid wastes are eliminated.

Gastroesophageal Reflux Disease

When a muscle at the end of the esophagus doesn’t close properly.

Stomach contents flow back up into the esophagus

Stomach contains acid that can irritate and inflame esophagus lining

Esophagitis - inflammation of the esophagus

Signs and Symptoms:

• Heartburn is most common symptom

• Pain in the chest or upper abd

• Hoarseness or sore throat

• Dysphagia

• Dry cough

• Bad breath

• Nausea and vomiting

Risk factors:

• Over-weight

• alcohol or coffee

• pregnancy

• smoking

• Hiatal hernia

Large meals, eating late at night, and lying down after eating cause gastric reflux

• Chocolate

• caffeine

• friend and fatty foods

• garlic

• onions

• spicy foods

• tomatoes

Life-style changes include:

• No smoking or drinking alcohol

• losing weight

• eating small meals and slowly

• wearing loose belts and loose-fitting clothes

• not lying down for at least 3 hrs after eating

• Raising hob 6 to 9 inches so that head and shoulders are higher than stomach

Vomiting

Signals illness or injury. Aspirated vomitus can obstruct the airway. Vomiting large amounts of blood can lead to shock

Measures need:

• Standard Precautions and bloodborne pathogen standard

• Turn person’s head well to 1 side if person is supine

• Place kidney basin under the chin

• Move vomit away from the person

• Provide oral hygiene

• Eliminate odors

• Provide for comfort

Diverticular Disease

• Small pouches can develop in the colon.

• the pouches bulge outward through weak spots in the colon wall.

• A pouch is called a diverticulum.

Risk factors:

• Obesity

• smoking

• lack of exercise

• low-fiber diet

• some drugs

When feces enter the pouches, they can become inflamed and infected

Signs and Symptoms:

• Abd pain

• Tenderness in the lower left abd

• Fever

• Nausea and vomiting

• chills

• cramping

• constipation

Raptured pouch is rare

Feces spill the abd

Causes severe life-threatening infection

Pouch can cause blockage in the intestine

Feces and gas cannot move past the blocked part

Treatment:

• Antibiotics

• pain-relief drugs

• liquid diet

• Surgery - diseased part of the bowel is removed

Inflammatory Bowel Disease

Inflammation of the GI tract

Two types

Crohn’s disease - GI tract from the mouth to the anus can be affected. Small intestine is usually involved before the large intestine

Ulcerative colitis - Large intestine and rectum are affected

Signs and symptoms:

• Persistent diarrhea

• Abdominal pain and cramping

• Fever

• Rectal bleeding and bloody stools

• Loss of Appetite

• Weight loss

Risk factors:

• People under 30

• Family history of IBD

• cigarette smoking

• drugs

• diet high in fat and refined foods

Complications:

• Bowel obstruction

• Ulcer in the GI tract

• colon cancer

• Osteoporosis

• liver disease

Treatment:

• Diet changes

• drug therapy

• surgery - remove damaged parts of the small intestine or colon

Gallstones

• Bile is a liquid made in the liver. It is stored in the gallbladder until needed to digest fat.

• Gallstones form when the bile hardens into stone-like pieces.

• Ducts carry bile from the liver through the gallbladder and to the small intestine. Bile flow is blocked. The gallbladder and ducts become inflamed. The liver and pancreas may be involved. Ducts carry bile from the liver through the gallbladder and to the small intestine

Could be as small as a grain of sand or as big as a golf ball. One large stone or several that vary in size

Risks factors:

• Women - Pregnant or use hormone replacement therapy - take birth control

• Older persons

• Known to have a family history of gallstones

• American Indians or Mexican Americans

• Over-weight or obese or have had fast weight loss

• Diabetics

Gallbladder attack or gallstone atack usually occurs suddenly after eating

Signs and Symptoms

• Nausea

• Vomiting

• pain in upper right abd, back or right underarm

Hepatitis

Inflammation and infection of the liver caused by a virus

Signs and Symptoms

• Jaundice

• Fatigue

• Abd and joint pain

• Loss of appetite

• NVD

• BM- light, clay colored

• Urine- dark

• Fever

• Itching

• Weight loss

Hepatitis A

Spread through contact with infected feces

Person’s at risk:

• Travelers to developing countries

• Persons who have sex with infected people

• Men who have sex with men

• Users of illegal drugs

• Homeless people

• Persons who live with or for some with Hepatitis A

• People who live with or care for child recently adopted from a country where Hepatitis A is common

Treatment:

• Rest

• Drinking plenty of fluids

• Healthy diet

• No alcohol

• Drugs are ordered

• Careful handling of bedpans, toilets, commodes, diapers, and rectal thermometers

• Checking persons with fecal incontinence, confusion, or dementia for contaminated items and areas

• Hepatitis A vaccine to protect against the disease

Hepatitis B

Spread through contact with the infected person’s fluids

Persons at risk:

• Are infected with HIV

• Have lived with a person with Hepatitis B

• Had sex with a person with Hepatitis B

• Had more than 1 sex partner in the last 6 months

• Had sex with a partner with a history of a STD

• Are men who have sex with men

• Are injection drug users

• Have contact with blood, needles, or body fluids at work

• Have lived or traveled to areas where hepatitis B is common

• Have been on kidney dialysis

• Are taking drugs that weaken the immune system

• Have lived or worked in a prison

• Had a blood transfusion or an organ transplant before the mid 1980s

• Are infants born to infected mothers

Treatment:

• Drugs are ordered

• Hepatitis B vaccine to protect against the disease

• Safe sex

• Stop use of illicit drugs

• Caution when choosing to have a tattoo or body piercing

Hepatitis C

Spread through contact with an infected person’s blood

Persons at Risk:

• Have injected or inhaled illicit drugs

• Had a blood transfusion or an organ transplant before July 1992

• Received a blood clotting factor before 1987

• Have been on kidney dialysis

• Have contact with blood, needles, or bodily fluids at work

• Have tattoos or body piercings

• Have lived or worked in a prison

• Were born to a mother with hepatitis c

• Are infected with HIV

• Had more than 1 sex partner in the last 6 months

• Had sex with a partner with a history of a STD

• Are men who have sex with men

• Are infants born to infected mothers

Treatment:

• Drugs are orders

• Stop illicit drug use

• safe sex

• caution when choosing to have tattoo or body piercing

Cirrhosis

A liver condition caused by chronic liver damage. Scarred liver tissue blocks blood flow through the liver. Normal liver functions are affected

• Fighting infection

• processing, storing and delivering nutrients to the body

• cleaning the blood of toxins, fats, cholesterol, and drugs

• Making proteins for blood clotting

• Producing bile for fat digestion

Common causes:

• Chronic hepatitis B and C

• Extra fat in the liver

• Obesity

Signs and Symptoms:

• Weakness and fatigue

• Loss of appetite and weight loss

• Nausea and vomiting

• Ascites - abdominal bloating from fluid buildup in the abd

• Edema

• Itching

• Spider-like blood vessels on the skin

• Jaundice

• Pain or discomfort in the right upper abd

Infection, bruising, and bleeding occur. Blood vessels in the esophagus and stomach enlarge and burst. Gallstones may develop. Toxins build up in the brain, causing confusion, personality changes, and memory loss. Liver cancer is at risk.

Treatment:

Aimed to keep cirrhosis from getting worse

Low sodium diet, limited protein

Diuretic drugs

Antibiotics

Avoid alcohol

may need liver transplant

Endocrine Disorders

Made up of glands. Secrete hormones that affect there organs and glands. Diabetes, the most common endocrine disorder involves the pancreas

Endocrine system (Pancreas)

Endocrine glands secrete chemical substances called hormones into the bloodstream. Hormones regulate the activities of other organs and glands in the body. The pancrease secretes insulin. Insulin regulates the amount of sugar in the blood available for use by the cells. Insulin is needed for sugar to enter the cells. Without insulin, sugar cannot enter the cells. If sugar cannot enter the cells, excess amounts build up in the blood. This is called diabetes

Diabetes

Body cannot produce or use insulin properly. Without any or enough insulin, sugar builds up in the blood. Blood glucose is high. Cells do not have enough sugar for energy and cannot function

Types of Diabetes

Type 1 - Most often in children and young adults but can develop in adults. Pancreas makes no insulin. Too much glucose stays in the blood. Onset is rapid

Type 2 - Body doesn’t make enough insulin or use insulin well. Most common type. Risky for people 45 or older, having history or diabetes in family, being obese

Gestational- Develops during pregnancy. Usually goes away after baby is born. At risk for type 2

Signs and Symptoms:

• Being very thirsty

• Frequent urination

• Feeling very hungry or tired

• Weight loss without trying

• Sores that heal slowly

• Dry, itchy skin

• Tingling or loss of feeling in te feet

• Blurred vision

Complications

High blood glucose can cause serious health problems. Heart disease, stroke, kidney disease, eye problems, and nerve damage are examples Dental disease and foot problems.

Treatment:

Type 1 - daily insulin therapy, healthy eating and exercise

Type 2 - healthy eating, exercise, weight loss

Good foot care

Hypoglycemia (Low Blood Sugar)

Causes:

• Too much insulin or diabetic drugs

• Increased exercise

• Skipping or delaying a meal

• Eating too little food

• Vomiting

• Drinking alcohol

Sign and Symptoms:

Mild to Moderate:

• Shaky or jittery

• sweaty

• Hunger

• Headache

• Blurred vision

• Sleepy or tired

• Dizzy or being light-headed

• Confused or disorentied

• Pale skin

• Uncoordinated movements

• Irritable or nervous

• Arguing or being combative

• Behavior or personaily changes

• Trouble concentrating

• weakness

• Pulse rapid or irregular

Severe:

• Cannot eat or drink

• Seizures or convulsions

• unconsciousness

Hyperglycemia (High Blood Sugar)

Causes:

• Not enough insulin or diabetic drugs

• Too little exercise

• Eating too much food

• Emotional stress

• Infection or sickness

• Undiagnosed diabetes

Signs and Symptoms:

Early:

• Frequent urination

• Increased thirst

• Blurred vision

• Being tired

• Headache

• Hunger

Late:

• Weakness

• dry mouth

• shortness of breath

• Nausea and vomiting

• Confusion

• abdominal pain

• coma