dig system 6

8/7/2019 Dig System 6

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Overview March 7

Clinical Applications

Sjogrens Syndrome

Acid Reflux Disease

GERD: Gastroesophageal Reflux Disease

Gall Bladder Disease

Crohns Disease

Appendicitis


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Digestive System: Overview

Figure 23.1


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Sjogrens Disease

Dry eyes and dry mouth

Autoimmune disease

Inflammation of glands of body

Glands that produce tears

Glands that produce saliva

Cause is unknown

Genetic associations

90% of patients are females


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Salivary Glands

Figure 23.9a


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Symptoms

Mouth dryness

Difficulty in swallowing

Mouth sores and tooth and gum disease

Saliva crystals and infection of parotid glands

Heartburn from acid reflux


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Treatment

No cure is available

Drink plenty of fluids

Humidify air

Sucking on sugarless lemon drops

Drugs: saliva stimulants

Artificial saliva

Diligent dental care


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Acid Reflux Disease

Stomach is filled with acids to help digest foods

Very strong acids in stomach

Acid backup into esophagus

Heartburn

Heartburn 2 or more days per week for at least 3 mos

Acid reflux disease

Valve separating the esophagus from the stomach does not

close properly (esophageal sphincter) Chronic heartburn

Can lead to more serious medical complications

Erode lining of esophagus


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Microscopic View of the Lining of the Digestive Tract


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Esophageal Sphincter

Normal GERD


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Lifestyle Treatments

Diet avoid:

Fatty and fried foods

Chocolate

Peppermint

Citrus fruits

Tomato juice

Alcohol

Coffee

Cold or spicy foods


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Lifestyle Treatments (cont)

Avoid tight clothes and tight belts

Raise head about 6-9 inches when supine

Avoid excessive bending, lifting and stooping


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Treatment

Medications

Antacid

Neutralizes acid that backs up into esophagus

Salts of magnesium, calcium, and aluminumbicarbonate

Turn off acid pumps in stomach (Nexium thepurple pill, Pepcid)

Can also heal esophageal erosion


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Swallow pill and view digestive tract

cameratransmitter

Alternative to endoscopy

Pill moves through digestive tract by peristalisis

Eliminated from body 12-24 hrs later

Pillcam


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Gall BladderDisease

Includes inflammation, infection, gall stones, gallbladder obstruction

Trapped bile

Becomes more concentrated Causes irritation, infection, perforation

Conditions which slow or obstruct flow of bile out

of gall bladder

Cholescyctitis (inflammation of gall bladder)

Gall stones


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Gall Bladder Position


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Gallbladder and Associated Ducts

Figure 23.20


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Symptoms

Abdominal fullness or gas

Abdominal pain right side or upper middle abdomen

Occurs after meals; particularly after fatty food intake

Worse during intake of deep breath

Pain under sternum

Fever and chills

Nausea and vomiting

Heartburn


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Treatment

Gall bladder removal

Open surgery large abdominal cut throughabdominal muscles

Laparoscopic surgery

4 tiny incisions in abdomen


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Gall Bladder Laparoscopic Surgery


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Crohns Disease

Chronic inflammation of digestive tract (type of

inflammatory bowel disease)

Most commonly affects lower small intestine (ileum)

ileitis

Swelling deep into lining of wall of affected area

Severe pain

Severe diarrhea

Higher rates among Jewish people

African Americans at lower risk for disease


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Figure 23.1


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Causes ofCrohns Disease

Several theories

Autoimmune disease

Own bodys immune system attacks digestive

system

Accumulation of white blood cells in intestinal

lining

Causes chronic inflammation


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Treatment

65-75% of patients with Crohns disease need surgery

Relief of symptoms

Correct complications

Blockages

Perforation (tear in intestinal lining)

Bleeding

Remove part of small intestine

Large intestine

Need colectomy remove large intestine

Ileum (base of small intestine) is brought to surface andpouch is attached to collect waste


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Crohns Disease

Normal ileum Ileum with Crohns disease


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Diet, Drug Therapy and Crohns Disease

Decreased appetite

Diarrhea and poor absorption of nutrients

Nutritional supplements

High calorie liquid supplements

Intravenous feeding

Reduce fiber, alcohol, milk, spices

Drugs

Antibiotics

Steriods

Immune system suppressors

Anti-diarrheal and fluid/electrolyte replacements


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Appendicitis

Appendix attached to cecum (large intestine)

Produces mucus and antibodies

Delivered to colon

When opening from appendix to colon is blocked

Excessive mucus or stool

Bacteria invade wall of appendix

Inflammation

Surgery to remove appendix


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Figure 23.1


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Inflamed Appendix

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