Pearson's Comprehensive Medical Assisting Administrative and Clinical Competencies
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1 Pearson's Comprehensive Medical Assisting Administrative and Clinical Competencies THIRD EDITION CHAPTER 30 The Digestive System Lesson 2: Pathology of the Digestive System
2 Lesson Objectives Upon completion of this lesson, students should be able to: 1. Define and spell the terms to learn for this chapter. 2. Briefly explain common disorders associated with the digestive system.
3 Critical Thinking Question 1. What are some causes of digestive system disorders?
4 Digestive Disorders Range from nonserious to serious and life-threatening Most complex with subtle symptoms and often unknown causes Some may be genetic Some may develop from stress, fatigue, diet, smoking, alcohol abuse
5 Medical history and physical examination for accurate diagnosis Laboratory tests Endoscopic procedures Imaging techniques
6 Appendicitis Inflammation of appendix Occurs most often between ages 10 and 30 Appears to have no known function Removal does not cause change in digestive function
7 Appendicitis Acute pain at McBurney point Pain not relieved by over-the-counter pain relievers, rest, or change of position
8 FIGURE 30-9 McBurney point.
9 Appendicitis Surgical removal (appendectomy) only course of treatment Considered medical emergency Most common acute surgical emergency of abdomen If treatment delayed, appendix can burst, causing infection and even death
10 Cirrhosis Potentially life-threatening condition Scarring (fibrosis) replaces healthy tissue Prevents liver from functioning normally
11 Cirrhosis Develops after years of liver inflammation Causes Years of excessive alcohol consumption and forms of viral hepatitis
12 Cirrhosis Nonalcoholic fatty liver disease (NAFLD) caused by excessive amounts of fat in liver Common in obese patients Other causes Problems with immune system or inherited diseases
13 Cirrhosis Fluid buildup in legs (edema); abdomen (ascites) Fatigue Yellowing of skin (jaundice) Itching Nosebleeds
14 Cirrhosis Redness of palms and easy bruising Weight loss and muscle loss Abdominal pain Frequent infections Confusion
15 Cirrhosis Avoid substances that further damage liver (alcohol; nonsteroidal antiinflammatory drugs) Dietary changes Weight loss Medications Surgery Liver transplant
16 Colitis Inflammation of large intestine
17 Colitis Many disease processes may cause colitis Abdominal pain Diarrhea Dehydration
18 Colitis Many disease processes may cause colitis Fever and chills Abdominal bloating Increased intestinal gas Bloody stools
19 Colitis Identified by flexible sigmoidoscopy or colonoscopy Treating underlying cause: Infection Inflammation Lack of blood flow Another cause
20 Critical Thinking Question 1. What does the term "colitis" tell about the disorder?
21 Colorectal Cancer Colon cancer Cancer of large intestine (colon) Rectal cancer Cancer of rectum Second-leading cause of cancer-related deaths of men and women in United States
22 Colorectal Cancer Most cases of colon cancer begin as adenomatous polyps that become cancerous Regular screening tests important
23 Colorectal Cancer Predisposing factors Increases with age Inflammatory bowel disease Type II diabetes Family history of colorectal cancer Race and ethnicity
24 Critical Thinking Question 1. What are some ways to prevent colon cancer?
25 Colorectal Cancer Change in bowel habits Bloody stools Long and thin stool Persistent abdominal cramping Gas abdominal pain Appetite loss and weight loss Excessive fatigue
26 Colorectal Cancer Surgery main treatment If part of colon removed, sometimes remaining colon brought to surface of abdomen so stool comes out of a stoma (colostomy) into attached receptacle instead of through rectum Chemotherapy Radiation
27 Crohn's Disease and Ulcerative Colitis Chronic inflammatory disease of intestines Closely related to ulcerative colitis Two diseases referred to as inflammatory bowel disease (IBD) Not contagious Exact cause unknown May have genetic component
28 Crohn's Disease and Ulcerative Colitis Abdominal pain Pain with defecation Watery diarrhea Weight loss
29 Crohn's Disease and Ulcerative Colitis Poor appetite Fever Night sweats Rectal pain Rectal bleeding
30 Crohn's Disease and Ulcerative Colitis No cure Goals of treatment Induce remission Maintain remission Minimize side effects of treatment Improve quality of life
31 Diverticulosis and Diverticulitis Diverticulosis Condition of having diverticula, small pouches or sacs in wall of colon Few or no symptoms Abdominal cramping and bloating
32 Diverticulosis and Diverticulitis Diverticulitis Inflammation or infection of diverticula Pain Fever Chills Cramping
33 Diverticulosis and Diverticulitis Diverticulitis Inflammation or infection of diverticula Bloating Decreased appetite Constipation Diarrhea
34 Diverticulosis and Diverticulitis Preventing formation of diverticula in colon High-fiber diet Treatment of diverticulitis depends on severity of condition and symptoms
35 FIGURE Colon with diverticulosis. An inflamed or infected diverticulum is called diverticulitis.
36 Critical Thinking Question 1. Why is there a higher incidence of diverticulosis in the elderly?
37 Gastroesophageal Reflux Disease (GERD) Cardiac sphincter does not close tightly or relaxes inappropriately Gastric fluids and stomach contents back up into esophagus (reflux)
38 Gastroesophageal Reflux Disease (GERD) Risk factors Obesity Hiatal hernia Pregnancy Smoking Certain types of medications
39 Gastroesophageal Reflux Disease (GERD) Complications Reflux esophagitis Barrett's esophagitis Perforation of esophagus Esophageal cancer Esophageal stricture Esophageal ulcers
40 Gastroesophageal Reflux Disease (GERD) Heartburn (worse when lying down) Sore throat Hoarse voice Bad taste in mouth
41 Gastroesophageal Reflux Disease (GERD) Sensation of food being stuck behind breast bone Belching Regurgitation of food
42 Gastroesophageal Reflux Disease (GERD) Treatment Medications that block production of hydrochloric acid and protect mucosa of esophagus Surgery that tightens cardiac sphincter Dilation, or expansion, of narrowed area
43 Hemorrhoids Dilated, or enlarged, vein in walls of anus and sometimes rectum Caused by increased pressure in the anus Major sign is bleeding after defecation, particularly bright red blood Itching and pain in anal region
44 Critical Thinking Question 1. How can increasing fiber intake help to control hemorrhoids?
45 Hemorrhoids Topical hemorrhoid creams relieve discomfort from itching and irritation Corticosteroid creams reduce swelling and inflammation Hemorrhoid removal (hemorrhoidectomy)
46 Hernia Abnormal protrusion of an organ or part of an organ through a weakness in the wall of the body cavity that contains it Common types of abdominal hernias include: Hiatal hernias Inguinal hernias
47 Hiatal Hernia Upper portion of stomach protrudes into chest cavity through opening in diaphragm Obesity Poor seated posture Frequent coughing
48 Hiatal Hernia Upper portion of stomach protrudes into chest cavity through opening in diaphragm Straining with constipation Frequent bending over or heavy lifting Heredity Smoking Congenital defects
49 FIGURE Hiatal hernia.
50 Hiatal Hernia Chest pain or pressure Difficulty swallowing Coughing, belching, hiccups Can be associated with GERD Heartburn Treatment: medications used to treat acid reflux Only cure is surgical repair
51 Critical Thinking Question 1. What other serious condition has symptoms of chest pain and/or pressure?
52 Inguinal Hernia Part of intestine pushes through abdominal wall in groin area causing a bulge
53 Inguinal Hernia Causes Appear gradually or suddenly Lifting heavy weights Coughing Bending Straining Even laughing
54 Inguinal Hernia Incarcerated hernia can worsen to point of strangulation Strangulated hernia so constricted that blood supply to intestine is cut off Can be potentially life-threatening condition
55 FIGURE Inguinal hernia.
56 Inguinal Hernia Pain and discomfort Swelling, heaviness, tugging or burning sensation in area of hernia, scrotum, or inner thigh Nausea and vomiting Surgery is the only treatment and cure
57 Irritable Bowel Syndrome (IBS) Common disorder that interferes with normal colon function
58 Irritable Bowel Syndrome (IBS) Causes Unclear and may be stress-related Abdominal pain and cramps Changes in bowel movements Gassiness and bloating Nausea
59 Irritable Bowel Syndrome (IBS) Causes Unclear and may be stress-related Urgency to defecate Passage of mucus during bowel movements Feeling bowels are not emptied
60 Irritable Bowel Syndrome (IBS) No cure Treatment Controlling symptoms and improving day-to-day quality of life Dietary and lifestyle changes Psychological treatment
61 Oral Cancer Starts in flat squamous cells that line mouth Aging, particularly after 50 Gender: more men Smoking and heavy alcohol consumption, particularly if combined
62 Oral Cancer Starts in flat squamous cells that line mouth Using chewing tobacco, snuff, chewing betel nut Excessive sun exposure to lips Human papillomavirus (HPV) Poor dental hygiene Immunosuppressant medications
63 Oral Cancer Sores, ulcers, irritation, or swelling in mouth that lasts longer than two weeks Velvety red or white patches in mouth Persistent sore throat Sores under dentures Lump in lip, tongue, or neck
64 Oral Cancer Weight loss Swollen lymph nodes in neck Trouble chewing, swallowing, or speaking
65 Oral Cancer Treatment depends on extent and stage of condition when diagnosed Surgery Radiation Chemotherapy
66 Pancreatic Cancer Adenocarcinoma Develops in exocrine glands of pancreas Very rare form Pancreatic neuroendocrine carcinoma (islet cell tumor) One of the deadliest of all cancers
67 Pancreatic Cancer Signs and symptoms generally vague Clay-colored stool and/or diarrhea Dark urine Jaundice or yellowing of skin Upper abdominal pain or discomfort
68 Pancreatic Cancer Signs and symptoms generally vague Weight loss and loss of appetite Nausea and/or indigestion Fatigue Back pain Blood clots
69 Pancreatic Cancer Complete surgical removal of the cancer only known cure Most common procedure performed is Whipple procedure Radiation Chemotherapy High mortality rate
70 Peptic Ulcer Disease (PUD) Disruption in lining of stomach, esophagus, or duodenum Duodenal ulcers most common Ulcers in stomach also common Common cause is infection with bacterium Helicobacter pylori (H. pylori) Causes erosion of the stomach mucosa
71 FIGURE Peptic ulcer disease (PUD).
72 Peptic Ulcer Disease (PUD) Prevented by avoiding alcohol and tobacco and limiting use of NSAIDs and aspirin Abdominal pain Nausea and vomiting Weight loss Heartburn
73 Peptic Ulcer Disease (PUD) Prevented by avoiding alcohol and tobacco and limiting use of NSAIDs and aspirin Chest pain Tarry black or maroon stools Bright red blood in stools Burning or gnawing pain in stomach or back
74 Stomach or Gastric Ulcers Pain or burning sensation (similar to indigestion) Pain made worse by eating Difficulty swallowing or regurgitation Bloating, retching, and feeling sick Vomiting and nausea Loss of appetite and weight loss Bleeding may indicate a serious problem
75 Peptic Ulcer Disease (PUD) Avoidance of tobacco and alcohol Antibiotics Medication change Proton pump inhibitors Histamine (H2) blockers Occasionally, surgery may be required
76 Pyloric Stenosis Develops in some infants when pylorus gradually swells and thickens, interfering with flow of food into intestine Can occur between birth and 6 months of age
77 Pyloric Stenosis Main symptom is infant's repeated vomiting after feeding Always treated with surgery (pyloromyotomy)
78 Questions?
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