• Dysphagia Difficulty swallowing
o Causes Nero disease: Parkinson’s, dementias, muscular dystrophy, Huntington’s, ALS, MN,
Guillain Barre Syndrome. Other: Congenital issues/cerebral palsy, Esophageal stenosis,
esophageal diverticula, tumors, stroke, achalasia
• Vomiting – why and consequences Why: protect against substance, reverse peristalsis, increase
intracranial pressure, severe pain. Consequences: lead to fluid, electrolyte, pH imbalance,
aspiration
o Emesis types and why the emesis would be a problem Hematemesis: blood in vomit (protein),
Yellow/green: presence of bile. Deep brown: fecal matter. Undigested food
o Treatment of vomiting disorders Antiemetic med., fluid replacement, correct
electrolyte imbalance, restore acid-base
• Esophageal disorders
o Hiatal hernia Stomach section protrudes through diaphragm
▪ Causes: Weakening of diaphragm muscle, trauma, congenital defects. Manifestation:
Indigestion; heartburn; frequent belching; nausea; chest pain; strictures; dysphagia;
and soft abdominal mass. diagnosis: H & P; barium swallow; upper GI Xrays; EGD,
treatment: eat small meals, sleep elevated, antacid
o GERD
▪ Causes: Certain foods: chocolate, caffeine, carbonated beverages, citrus fruit, tomatoes,
spicy or fatty foods, peppermint , Alcohol consumption; nicotine, Hiatal hernia, Obesity;
pregnancy, Certain medications – such as corticosteroids; beta blockers; calcium-
channel blockers; anticholinergics, NG intubation, Delayed gastric emptying
▪ Manifestations: Heartburn, Epigastric pain, Dysphagia, Dry cough,
Laryngitis Pharyngitis, Food regurgitation, Sensation of lump in throat
▪ Diagnosis: H & P; barium swallow; EGD; esophageal pH monitoring
▪ Treatments: Avoid triggers; avoid restrictive clothing, Eat small frequent meals;
high Fowler’s positioning, Weight loss; stress reduction; Antacids; acid reducing
agent;
mucosal barrier agents, Herbal therapies (licorice, chamomile), Surgery
▪ Complications: Esophagitis; strictures; ulcerations; esophageal cancer;
chronic pulmonary disease
o Gastritis/gastroenteritis
▪ Acute: Can be mild, transient irritation or can be severe ulceration with
hemorrhage, Usually develops suddenly, Likely to also have nausea & epigastric
pain
▪ Chronic: Develops gradually
▪ May be asymptomatic but usually accompanied by dull epigastric pain and a sensation of
fullness after minimal intake
▪ Complications: peptic ulcer; gastric cancer; hemorrhage
▪ H. pylori: Most common cause of chronic gastritis
▪ Bacteria embeds in mucous layer; activates toxins & enzymes that cause inflammation
▪ Genetic vulnerability & lifestyle behaviors (smoking, stress) may increase susceptible
▪ Other causes: Organisms through food/water contamination, LT NSAID use,
Excess alcohol use, Severe stress, Autoimmune conditions
▪ Manifestations of GI bleeding: Indigestion; heart burn, Epigastric pain; abdominal
cramping, N/V; anorexia, Fever; malaise, Hematemesis, Dark, tarry stools = ulceration
& bleeding
, 3
• GI tract disorders
o Peptic ulcer disease
▪ Duodenal: Most commonly associated with excess acid or H.pylori infections,
Typically present with epigastric pain relieved by food
▪ Gastric: Less frequent; more deadly, typically associated with malignancy and
NSAIDs, Pain worsens with food
▪ Symptoms:
▪ Curling’s ulcer from what: associated with burns
▪ Cushing’s ulcer from what: associated with head injuries
▪ Complications of ulcers: GI hemorrhage; obstruction; perforation; peritonitis
▪ Manifestations: Epigastric or abdominal pain, Abdominal cramping,
Heartburn; indigestion, N/V
▪ Diagnosis: same as gastritis
▪ Treatment: Same as for gastritis, Surgical repair may be necessary for perforated
or bleeding ulcers, Prevention is crucial – may need prophylactic medications (ex:
acid-
reducers) for at-risk clients
o Gallbladder disorders
▪ Cholelithiasis: Gallbladder stones
▪ Cholecystitis: Inflammation or infection in the biliary system caused by calculi
▪ Manifestations: Biliary colic; abdominal distension; N/V; jaundice; fever; leukocytosis
▪ Diagnosis: H & P; abdominal Xray; gallbladder US; laparoscopy
▪ Treatments: Low-fat diet, medications to dissolve calculi, Antibiotic therapy, NG
tube with intermittent sxn, Lithotripsy, Choledochostomy, Laparoscopic surgery
o Liver disorders
▪ Hepatitis – infectious: A, B, C, D, E vs. noninfectious: Giant cell hepatitis, Ischemic
hepatitis, Non-alcoholic fatty liver hepatitis, Autoimmune hepatitis, Toxic & drug-
induced hepatitis, Alcoholic hepatitis
▪ Transmission of viral hepatitis: If it’s a Vowel, it comes from the Bowel. All others
are blood
▪ Define: acute: Proceeds through 4 stages—asymptomatic stage then 3 symptomatic
stages chronic: Characterized by continued liver disease > 6 months, Symptom severity
and disease progression vary by degree of liver damage, Can quickly deteriorate with
declining liver integrity fulminant: Uncommon, rapidly progressing form that can
quickly
lead to
▪ Liver failure, hepatic encephalopathy, or death within 3 wks
• Diagnosis: H & P, Serum hepatitis profile, Liver enzymes, Clotting studies,
Liver biopsy, Abdominal US
• treatment for viral hepatitis: treat with interferon & antiviral mediations
▪ Cirrhosis
• Common causes: Hep C and chronic alcohol abuse most common cause in
U.S. Hepatitis and all factors that can lead to hepatitis
• What happens to liver: Leads to fibrosis, nodule formation, impaired blood
flow, and bile obstruction liver failure
• Manifestations: Portal hypertension, Varicosities, Bleeding –slow or severe,
Muscle wasting, Bile accumulation, Clay-colored stools, Dark urine, Ulcers/GI
bleeding, Encephalopathy, Spontaneous bacterial peritonitis
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